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2017Depression after Stroke in Sub-Saharan Africa: A Systematic Review and Meta-Analysis
(Hindawi Behavioural Neurology, 2017) Ojagbemi A.; Akpa O.; Elugbadebo F.; Owolabi M.; Ovbiagele B.
Objective. We aimed to conduct a systematic review and meta-analysis of prevalence and characteristics of poststroke depression (PSD) in sub-Saharan Africa (SSA). Methods. We searched Medline, PsycINFO, and African Journals OnLine using keywords for stroke and depression and the .mp. operator for all 54 SSA countries/regions. Further information was retrieved through a manual search of references from relevant published and unpublished articles. We included only peer-reviewed original studies with epidemiological or experimental designs, conducted random-effect meta-analysis, and identified the most commonly associated factors by weight (inverse of variance method). Results. Seventeen studies, comprising 1483 stroke survivors, met the criteria for syntheses. The pooled frequency of clinically diagnosed PSD was 31% (95% CI = 26%–36%), versus 13.9% in healthy control pairs. Prevalence did not vary much across healthcare settings but was affected by methods of depression ascertainment. PSD was significantly associated with low education, cognitive impairment, physical disability, poor quality of life, and divorced marital status. Conclusion. Almost 1 in 3 individuals with stroke in SSA has clinical depression. Despite limitations around quality of identified studies, results of the present systematic review overlap with findings in the global literature and highlight useful targets for the design and trial of tailored intervention for PSD in SSA
A Bayesian sensitivity analysis of the effect of different random effects distributions on growth curve models
(Statistics and Probability African Society, 2020) Ganjali, M.; Baghfalaki, T.; Fagbamigbe, A. F.
Growth curve data consist of repeated measurements of a contin uous growth process of human, animal, plant, microbial or bacterial genetic data over time in a population of individuals. A classical approach for analyzing such data is the use of non-linear mixed effects models under normality assumption for the responses. But, sometimes the underlying population that the sample is extracted from is an abnormal population or includes some homogeneous sub-samples. So, detection of original properties of the population is an important scientific question of interest. In this paper, a sensitivity analysis of using different parametric and non-parametric distributions for the random effects on the results of applying non-linear mixed models is proposed for emphasizing the possible heterogeneity in the population. A Bayesian MCMC procedure is developed for parameter estimation and inference is performed via a hierarchical Bayesian framework. The methodology is illustrated using a real data set on study of influence of menarche on changes in body fat accretion.
A comparative analysis of condom use among unmarried youths in rural community in Nigeria
(Scientific & Academic Publishing, 2011) Fagbamigbe, A. F.; Adebowale, A. S.; Olaniyan, F. A.
Globally, youths are more sexually active than any subgroup of the population. In Nigeria, the prevalence of condom use among youths is low. This study explored and compared condom use among in-school youths and out-of-school youths in south western Nigeria. This population based study used multistage random sampling technique to select eligible 600 youths aged 15-24 years which included 300 high school students and 300 out-of-school youths in Ekiti West Local Government area of Ekiti state, Nigeria. Descriptive statistics, t-test, chi square test and logistic regression were used for analysis. The mean age of in-school youths and out of school youths were 18.1±2.2 years and 19.0±2.7 years respectively. Overall, 35.5% of all sexually active respondents, 29.8% in-school and 40.8% out-of-school youths reported to have ever used condom during sexual intercourse (p<0.05) The study concluded that although, condom use is low across the study population, but higher among out-of-school youths. Youths aged 15-24 should be given free access to condom particularly the in-school youths.
A comparative analysis of fertility differentials in Ghana and Nigeria
(Women's Health and Action Research Centre, 2014) Olatoregun, O.; Fagbamigbe, A. F.; Akinyemi, O. J.; Yusuf, O. B.; Bamgboye, E. A.
Nigeria and Ghana are the most densely populated countries in the West African sub-region with fertility levels above world average. Our study compared the two countries’ fertility levels and their determinants as well as the differentials in the effect of these factors across the two countries. We carried out a retrospective analysis of data from the Nigeria and Ghana Demographic Health Surveys, 2008. The sample of 33,385 and 4,916 women aged 15-49 years obtained in Nigeria and Ghana respectively was stratified into low, medium and high fertility using reported children ever born. Data was summarized using appropriate descriptive statistics. Factors influencing fertility were identified using ordinal logistic regression at 5% significance level. While unemployment significantly lowers fertility in Nigeria, it wasn’t significant in Ghana. In both countries, education, age at first marriage, marital status, urban-rural residence, wealth index and use of oral contraception were the main factors influencing high fertility levels.
A comparative analysis of the infuence of contraceptive use and fertility desire on the duration of second birth interval in four sub-Saharan African countries
(BioMed Central, 2021) Afolabi, R. F.; Fagbamigbe, A. F.; Palamuleni, M. E.
Background: Fertility decline characterised by inter-birth intervals remains rather slow or stall in many countries of sub-Saharan African (SSA). Non-adherence to optimal inter-birth intervals often occasioned by low prevalence of contraceptive use and high fertility desires often lead to poor maternal and child health outcomes. Additionally, information on the influence of contraception and fertility desire on interval between first and second births (SBI) is rarely available. This study therefore aimed to examine the influence of fertility desire and contraception on SBI among women in four SSA countries. Methods: We analysed cross-sectional data on women aged 15–49 years who participated in the recent Demo graphic and Health Surveys in DR Congo, Ethiopia, Nigeria and South Africa. Semi-parametric Cox proportional hazards regression was employed for the analysis at 5% significance level. Results: The median time to second birth was 34 months in DR Congo; 35 months, Nigeria; 42 months, Ethiopia; and 71 months, South Africa. About 70% of the women desired additional child(ren) and two-thirds have never used contraceptive in both Nigeria and DR Congo. The hazard of second birth was significantly lower among women who desired additional child(ren) compared to desired for no more child in DR Congo (aHR=0.93; CI: 0.89–0.97), Ethiopia (aHR=0.64; CI: 0.61–0.67) and South Africa (aHR=0.51; CI: 0.47–0.55). Women who had never used contraceptive were 12%, 20% and 24% more likely to lengthen SBI than those who were current users in DR Congo, Nigeria and South Africa respectively. DR Congo and Nigerian women were about two times more likely to shorten SBI compared with their South African counterparts. Other significant determinants of SBI include ethnicity, rural residential, age and marital status at first birth, wealth and employment status. Conclusion: Findings showed differentials in the linkage between second birth interval and the desired fertility and contraception by country, demonstrating the importance of context. The contribution of these factors to second birth interval requires country context-specific attention if further decline in fertility and poor health outcomes associated with sub-optimal inter-birth interval is to be attained in SSA.
A model for measuring association between bivariate censored outcomes
(Medwell Journals, 2010) Fagbamigbe, A. F.; Adebowale, A. S.
The dependence between two random variables is completely described by their bivariate distribution. Bivariate sunrival analysis arises in the time to events analysis of measurements that are paired. Although, there are several comistent estimators of the bivariate distribution function, an efficient and consistent estimation has proven to be a difficult problem. It is of interest to determine if it exists, the possible association between pairs of variables, both of which are subject to censoring with recurrence times of kidney infection as a case study. Copula models which is one of the existing methods of measuring the possible association between bivariate cemored variables were reviewed. The overall average recurrence time and its standard deviation are 102 and 131, respectively though the recurrence time in the first kidney has average and standard deviation of 112 and 144.01, respectively whle the average and standard deviation of recurrence time in the second kidney recurrence time is 92 and 117.20, respectively. The study also showed that the modal recurrence time in the 2 kidneys is 42. The correlation between infection recurrence in the pairs of kidneys was found to be 0.268 with 95% confidential interval of (-01854985,07206918).
A random effect logistic regression model of major depressive disorder among ageing Nigerians
(Scientific & Academic Publishing, 2016) Idowu, O. P.; Yusuf, O. B.; Akpa, O. M.; Gureje, O.
Major Depressive Disorder (MDD) is a major public health problem in Nigeria and has severely devastating effects on the elderly. Previous studies on MDD among elderly Nigerians have utilized cross sectional designs which are descriptive in nature and have not investigated differences in setting and time-occurrence of MDD. Therefore this study employed a random effect logistic regression model to determine the relative effects/contributions of individual and environmental factors in the occurrence of MDD. A secondary analysis of a four-year longitudinal data from the Ibadan Study of Ageing was conducted. A total of 2,149 elderly Nigerians participated in the study between 2003 and 2009. The Geriatric Depression Scale was used to assess MDD and consequently classified as “present” for scores ranging from 10 to 30 and “absent” for scores ranging from 0 to 9. A random effect logistic regression model was fitted to determine factors predicting MDD. Odds ratios (OR), 95% confidence intervals, and Intra-class Correlation Coefficients (ICC) for each random effect was estimated. The overall prevalence of MDD was 27.28%. Significant predictors of MDD included “no-contact with family members” (OR=2.9, 95%CI: 1.26-6.70), “no-contact with friends” (OR=1.32, 95%CI: 1.05-1.67)), non-participation in family activities (OR=2.07, 95%CI: 1.63-2.43), non-participation in community activities (OR=1.93, 95%CI: 1.54-2.43), and good quality of health (OR=0.25, 95%CI: 0.15-0.27). Disparities in the occurrence of MDD among the elderly were attributable to enumeration areas (6%) and the individuals (22%). Social isolation factors and self-reported quality of health are significant predictors of MDD among elderly Nigerians.
A randomized, open-label trial of combined nitazoxanide and atazanavir/ritonavir for mild to moderate COVID-19
(Frontiers Media SA, 2022) Fowotade, A.; Bamidele, F.; Egbetola, B.; Fagbamigbe, A. F.; Adeagbo, B. A.; Adefuye, B. O.; Olagunoye, A.; Ojo, T. O.; Adebiyi, A. O.; Olagunju, O. I.; Ladipo, O. T.; Akinloye, A.; Onayade, A.; Bolaji, O. O.; Rannard, S.; Happi, C.; Owen, A.; Olagunju, A.
Background: The nitazoxanide plus atazanavir/ritonavir for COVID-19 (NACOVID) trial investigated the efficacy and safety of repurposed nitazoxanide combined with atazanavir/ritonavir for COVID-19. Methods: This is a pilot, randomized, open-label multicenter trial conducted in Nigeria. Mild to moderate COVID-19 patients were randomly assigned to receive standard of care (SoC) or SoC plus a 14-day course of nitazoxanide (1,000 mg b.i.d.) and atazanavir/ritonavir (300/100 mg od) and followed through day 28. Study endpoints included time to clinical improvement, SARS-CoV-2 viral load change, and time to complete symptom resolution. Safety and pharmacokinetics were also evaluated (ClinicalTrials.gov ID: NCT04459286). Results: There was no difference in time to clinical improvement between the SoC (n = 26) and SoC plus intervention arms (n = 31; Cox proportional hazards regression analysis adjusted hazard ratio, aHR = 0.898, 95% CI: 0.492–1.638, p = 0.725). No difference was observed in the pattern of saliva SARS-CoV2 viral load changes from days 2–28 in the 35% of patients with detectable virus at baseline (20/57) (aHR = 0.948, 95% CI: 0.341–2.636, p = 0.919). There was no significant difference in time to complete symptom resolution (aHR = 0.535, 95% CI: 0.251–1.140, p = 0.105). Atazanavir/ritonavir increased tizoxanide plasma exposure by 68% and median trough plasma concentration was 1,546 ng/ml (95% CI: 797–2,557), above its putative EC90 in 54% of patients. Tizoxanide was undetectable in saliva. Conclusion: Nitazoxanide co-administered with atazanavir/ritonavir was safe but not better than standard of care in treating COVID-19. These findings should be interpreted in the context of incomplete enrollment (64%) and the limited number of patients with detectable SARS-CoV-2 in saliva at baseline in this trial.
A survival analysis model for measuring association between bivariate censored outcomes: validation using mathematical simulation
(Scientific & Academic Publishing, 2017) Fagbamigbe, A. F.; Adebowale, A. S.; Bamgboye, E. A.
Bivariate censored data occur in follow-up studies of events that can result in two different outcomes. Many studies have explored methods for inference about the marginal recurrence times of these outcomes. However, very few have focused on the dependence structures between their occurrences or recurrence times especially when these outcomes are censored as evidence in the current study. This theoretical and empirical study used simulated data to monitor and validate the survival analysis model for measuring association between recurrence times of bivariate censored outcomes. Bivariate outcomes would naturally fall into one of four possibilities: only the first, only the second, none or both conditions occurring with different and distinct likelihoods. Using predetermined correlation coefficients, n=100000 bivariate standardized binormal data were simulated. The simulated data were then subjected to different censoring chances while contributions of the likelihoods of the four possibilities were examined and Maximum Likelihood Estimate (MLE) of the association parameter determined. For the data simulated at 50% censoring, MLE of the association parameter tended to zero as the predetermined correlation coefficients fell from +1.0 to -1.0. However, at 0% censoring, the MLE were approximates of the predetermined correlation coefficients. The developed model was robust as the model responded adequately to the dynamics of the predetermined correlation and censoring conditions. The model would be appropriate in studying associations between two censored survival times.
Academic student satisfaction and perceived performance in the e-learning environment during the COVID-19 pandemic: Evidence across ten countries
(Public Library of Science, 2021) Kerzič, D.; Alex, J. K.; Alvarado, R. P. B.; Bezerra, D. S.; Cheraghi, M.; Dobrowolska, B.; Fagbamigbe, A. F.; Faris, M. E.; Franca, T.
The outbreak of the COVID-19 pandemic has dramatically shaped higher education and seen the distinct rise of e-learning as a compulsory element of the modern educational land scape. Accordingly, this study highlights the factors which have influenced how students perceive their academic performance during this emergency changeover to e-learning. The empirical analysis is performed on a sample of 10,092 higher education students from 10 countries across 4 continents during the pandemic’s first wave through an online survey. A structural equation model revealed the quality of e-learning was mainly derived from service quality, the teacher’s active role in the process of online education, and the overall system quality, while the students’ digital competencies and online interactions with their colleagues and teachers were considered to be slightly less important factors. The impact of e-learning quality on the students’ performance was strongly mediated by their satisfaction with e-learning. In general, the model gave quite consistent results across countries, gender, study fields, and levels of study. The findings provide a basis for policy recommendations to support decision-makers incorporate e-learning issues in the current and any new similar circumstances.
ADHERENCE TO CURRENT GUIDELINES ON PRESCRIPTION OF ANTIMALARIALS AND ASSOCIATED FACTORS AMONG HEALTHCARE PROVIDERS IN LOKOJA LOCAL GOVERNMENT AREA, KOGI STATE, NIGERIA
(2015-04) WELLE, Sylvanus Chima
Adherence to current treatment guidelines on prescription of antimalarials by healthcare providers can promote better malarial treatment outcomes. However, adherence rate and factors influencing adherence to treatment guidelines have not been well explored. This study was carried out to assess adherence to current guidelines on prescription of antimalarials and associated factors among healthcare providers in Lokoja Local Government Area, Kogi State, Nigeria. The study was cross-sectional in design. A total of 404 healthcare providers aged 18-65 years were selected through proportional allocation from public health facilities and patent medicine stores. Using a semi-structured, interviewer-administered questionnaire, data were collected on socio-demographic characteristics of respondents, knowledge and training on current guidelines and prescription practice. Adherence was defined as correct prescription of artemisinin-based combination therapy for uncomplicated malaria in a child and adult. Knowledge of current guidelines was assessed on a 5-point scale and scores ≥3 were categorised as good knowledge while scores <3 were categorised as poor. Data were analysed using descriptive statistics, Chi-square test and logistic regression with significance level set at 0.05. Mean age of respondents was 36.9 years (SD = 9.2 years). Respondents comprised of nurses (36.6%), patent medicine vendors (30.0%), doctors (18.3%), community health extension workers (9.7%), pharmacists (3.2%) and community health officers (2.2%). Over half (53.0%) were males and about three-quarters (74.4%) were married. Half (50.0%) had good knowledge of the guidelines of which 34.2% were doctors and 4.0% each were community health officers and pharmacists. A total of 270 (66.8%) of respondents claimed they requested for confirmatory test before treatment of malaria. In all, 54.2% had been trained on the guidelines of which 36.1% were patent medicine vendors while only 1.4% was pharmacists. Overall adherence to guidelines on anti-malaria prescription was 39.6%. The adherence among doctors was 67.6%, community health officers (55.6%), pharmacists (19.8%). Respondents who were trained on the guidelines were twice more likely to adhere to guidelines. (AOR=2.28; CI=1.41-3.69) while respondents with good knowledge were four times more likely to adhere to guidelines compared to those with poor knowledge (AOR=3.99; CI=2.39-6.69). Knowledge of and adherence to current guidelines on antimalarials prescription was generally low in Lokoja among community health officers, nurses, pharmacists and patent medicine vendors in the study. Government should train these categories of health care providers to improve their knowledge and adherence to the guidelines. Keywords: Treatment guidelines, Antimalarial prescription, Health care providers, Malaria confirmatory test. Word count: 384
African Ancestry, APOL1, candidate genes, CDKN2A/CDKN2B, HDAC9, small vessel disease, stroke, West Africa
(John Wiley & Sons Ltd, 2017) Akinyemi R.; Tiwari H. K.; Arnett D. K.; Ovbiagele B.; Irvin M. R.; Wahab K.; Sarfo F.; Srinivasasainagendra V.; Adeoye A.; Perry R. T.; Akpalu A.; Jenkins C.; Arulogun O.; Gebregziabher M.; Owolabi L.; Obiako R.; Sanya E.; Komolafe M.; Fawale M.; Adebayo P.; Osaigbovo G.; Sunmonu T.; Olowoyo P.; Chukwuonye I.; Obiabo Y.; Onoja A.; Akinyemi J.; Ogbole G.; Melikam S.; Saulson R.; Owolabi M.
Objective: Worldwide, the highest frequencies of APOL1-associated kidney variants are found in indigenous West Africans among whom small vessel disease (SVD) is chemic stroke is the most common stroke phenotype. The objective of this study was to investigate the association and effect sizes of 23 selected SNPs in 14 genes of relevance, including the APOL1 G1 variants, with the occurrence of SVD ischemic stroke among indigenous West African participants in the Stroke Investigative Research and Education Network (SIREN) Study. Materials and Methods: Cases were consecutively recruited consenting adults (aged 18 years or older) with neuroimaging—confirmed first clinical stroke. Stroke-free controls were ascertained using a locally validated version of the Questionnaire for Verifying Stroke-Free Status (QVSFS). Logistic regression models adjusting for known vascular risk factors were fitted to assess the associations of the 23 SNPs in rigorously phenotyped cases (N = 154) of SVD ischemic stroke and stroke-free (N = 483) controls. Results: Apolipoprotein L1 (APOL1) rs73885319 (OR = 1.52; CI: 1.09-2.13, P value = .013), rs2383207 in CDKN2A/CDKN2B (OR = 3.08; CI: 1.15-8.26, P – value = .026) and rs2107595 (OR = 1.70; CI: 1.12-2.60, P-value = .014) and rs28688791 (OR = 1.52; CI: 1.03-2.26, P-value = .036) in HDAC9 gene were associated with SVD stroke at 0.05 significance level. Polymorphisms in other genes did not show significant associations. Conclusion: This is the first report of a specific association of APOL1 with a stroke subtype. Further research is needed to confirm these initial findings and deepen understanding of the genetics of stroke in people of African ancestry with possible implications for other ancestries as all humans originated from Africa
An assessment of the nutritional status of ART receiving HIV-orphaned and vulnerable children in South-West Nigeria
(Elsevier Ltd, 2019) Fagbamigbe, A. F.; Adebowale, A. S.; Ajayi, I.
Introduction: Good nutritional status is pertinent to the optimal outcome of effective ART among children. Against this backdrop, the objective of the current study is to assess the nutritional indices of children receiving ART in South-West Nigeria. Methods: The study was cross-sectional in design. We randomly selected three urban and six rural ART sites from the ones offering ART services in Oyo state. All consented children receiving ART treatments in the aforementioned sites participated in the study. A total of 390 HIV-positive children and adolescents aged 6–18 years were interviewed using a semi-structured interviewer-administered questionnaire. Children were assessed and growth curves were constructed using the 2007 World Health Organisation (WHO) growth reference standard for children as well as adolescents. Data were presented using descriptive statistics. Results: About 52% of the children are male, 136 (34.9%) have lost at least one parent, 52 (13.3%) have lost either parent to HIV/AIDS. Among the males, 19%, 27%, and 27% were underweight, stunted and thin, respectively when compared with 17%, 23% and 23%, respectively, among females. The male and female weight-for-age average z-score were (-0.98 vs -1.04), height-for-age (-1.12 vs -1.07), and BMI-for-age (-1.19 vs -1.18). Irrespective of age, sex, parental survival, and residence, weight-for-age and BMI-for-age analysis revealed substantial underweight, with the worst outcomes being among those orphaned by HIV/AIDS. Conclusion: All nutritional indices considered in this study fell short of the WHO standard. HIV positive children in the ART sites included in this study are faced with a high burden of undernourishment despite been placed on daily ART regimens. In addition to efficient ART, interventions to ameliorate poor nutritional status is needed.
Analysis of regional variations in influence of household and environmental characteristics on prevalence of diarrhoea among under-five children in Nigeria
(Nigeria Medical Association, 2017) Fagbamigbe, A. F.; Morakinyo, O. M.; Abatta, E.
Background: Until now, factors influencing diarrhoea in children has been studied in Nigeria without full recourse to her wide geopolitical diversities. Aim: This study assessed the differentials in regional prevalence of diarrhoea and the role of household and environmental characteristics in the distribution and likelihood of diarrhoea among children under-five years within each geopolitical region in Nigeria. Subjects and Methods: A cross-sectional study among households with under-five children. We used the data from the 2012 Nigeria National HIV/AIDS and Reproductive Health Survey (NARHS Plus II). We weighed the data and used descriptive statistics, Pearson Chi-square (x2 ) and logistic regression to analyse data at 5% significance level. Results: Over a third, 38.0% (5062/13322) of households sourced drinking water from non-improved sources, highest in North East, 45.3% (1049/2315) and least in South West, 27.6% (521/1888) Over half, 52.7% (7021/13322) of toilets were non-improved, highest in North East, 68.6% (1588/2315) and least in South West, 35.7% (674/1888), most households practice open defecation. The overall prevalence of diarrhoea was 13.0% (1732/13322), 17.0% (294/1732) in North East and higher in other regions than 9.0% (156/1732) in the south west. The odds of diarrhoea was significantly higher among rural households in the South-South (OR=2.1, 95% CI: 1.4-3.1) but more prevalent in urban North East and South East. Also, the odds of having diarrhoea increased with wealth quintile to which household belongs was significant in all the regions except in the North East. Conclusions: The prevalence of diarrhoea varied widely across the regions. Also, the influence of household and environmental characteristics on the prevalence of diarrhoea differed across the geopolitical regions. This is an indication that policies on control of diarrhoea should be region-specific.
Analysis of trends and projections of the emergence, impact and the epidemiology of HIV/AIDS in Nigeria
(Nigerian Statistical Association, 2010) Akpa, O. M.; Oyejola, B. A.
The first case of AIDS was reported in Nigeria-(Lagos) in 1986. Since then, both the incidence and the prevalence of the epidemic has grown steadily, particularly during the military regimes. In this study, We used the UNAIDS softwares: Estimation and Projection Package-(EPP) and AIDS Impact Mode/-(AIM), to present models, trends analysis and projections/or the incidence a/HIVIAIDS in the six geopolitical zones in Nigeria. 0111' results show that the peak incidence 0/HIVIAIDS epidemics in the zones was during the Military rule in Nigeria. We also projected that by year 2010, the incidence are expected to be stable.
Application of structural equation modelling to public health concern on psychosocial functioning and quality of life of adolescents in Nigeria
(Andkolad Nigeria Limited, Ife, Nigeria, 2019) Akpa, O. M.; Fowobaje, K. R.; Olutola, O. M.
Structural equation modelling (SEM) is an efficient statistical method for the analysis and evaluation of complex research objectives involving relationships between observed and unobserved (latent) variables. Unfortunately, its application in Public Health research has been very limited in Nigeria. This paper documents basic theories, principles and application of SEM to research in Public Health with a focus on the psychosocial functioning and quality of life of adolescents in Nigeria. The cross-sectional study was conducted among adolescents (n=983) in Benue state, Nigeria. The study presents a step-by-step approach to SEM and also describes variety of research questions that SEM can be used to answer in public health domain with empirical application of SEM on psychosocial functioning and quality of life. Results of the empirical application showed that poor psychosocial functioning negatively impacts the quality of life of adolescents in Nigeria. There is need to encourage researchers in public health to apply SEM in their research.
Application of the exponentiated log-logistic Weibull distribution to censored data
(Nigerian Society of Physical Sciences, 2019) Fagbamigbe, A. F.; Basele, G. K.; Makubate, B.; Oluyede, B. O.
In a recent paper, a new model called the Exponentiated Log-Logistic Weibull (ELLoGW) distribution with applications to reliability, survival analysis and income data was proposed. In this study, we applied the recently developed ELLoGW model to a wide range of censored data. We found that the ELLoGW distribution is a very competitive model for describing censored observations in life-time reliability problems such as survival analysis. This work shows that in certain cases, the ELLoGW distribution performs better than other parametric model such as the Log-Logistic Weibull, Exponentiated Log-Logistic Exponential, Log-Logistic Exponential distributions and the non-nested Gamma-Dagum (GD)
Assessing full immunisation coverage using lot quality assurance sampling in urban and rural districts of southwest Nigeria
(Royal Society of Tropical Medicine and Hygiene., 2013) Fatiregun, A. A.; Adebowale, A. S.; Ayoka, R. O.; Fagbamigbe, A. F.
Background: This study was conducted to identify administrative wards (lots) with unacceptable levels of full child immunisation coverage, and to identify factors associated with achievement of a complete child immunisation schedule in Ibadan North East (IBNE) and Ido local government areas (LGAs) of Oyo State, Nigeria. Methods: A cross-sectional survey involving 1178 mothers, 588 from IBNE LGAs and 590 from Ido LGAs, with children 12–23 months of age was conducted. Children were considered ‘fully-immunised if they received all the vaccines included in the immunisation schedule. Lot quality assurance sampling was used to determine lots with acceptable and non-acceptable coverage. Samples were weighted based on the population by lot to estimate overall coverage in the two LGAs and a logistic regression model was used to identify factors associated with the fully immunised child. Results: Mean age of the mothers was 28.5+5.6 and 28.1+6.0 years in IBNE and Ido LGAs, respectively. Eleven of 12 wards in IBNE and all the wards in Ido had unacceptable coverage. The proportion of fully immunised children was 40.2% in IBNE and 41.3% in Ido. Maternal age ≥30 years, retention of an immunisation card, completion of tertiary education, or secondary education, hospital birth and first-order birth were significant predictors of complete childhood immunisation. Conclusion: The level of full immunisation coverage was unacceptable in almost all the wards. Educational inter vention on the importance of completion of immunisation schedule should target young, uneducated mothers, mothers who delivered their babies at home and those with a high birth order.
Assessment of quality of antenatal care services in Nigeria: evidence from a population-based survey
(BioMed Central, 2015) Fagbamigbe, A. F.; Idemudia, E. S.
Background: The aim of the newly introduced “focused Antenatal Care (ANC)” is not only to achieve a minimum number of 4 visits, but also the timeliness of the commencement of the visits as well as the quality and relevance of services offered during the visits. This study is therefore designed to assess the quality of ANC services in Nigeria. Methods: We used information supplied by the 13410 respondents who claimed to have used the ANC facilities at least once within five year preceding the 2013 Nigeria Demographic and Household Survey (NDHS). Ten components of ANC including: offer of HIV test, Tetanus Toxoid injection, receiving iron supplementation, intermittent preventive treatment (IPT), intestinal preventive drug (IPD), timely ANC enrollment and number of visits were assessed. Receipts of all the ten components were classified as desirable (good) quality of ANC services while receipt of eight critical components among the ten were assumed to be the minimum acceptable quality. Data was weighted and analyzed using descriptive statistics and logistic regression models at 5 % significance level. Results: Measurement of blood pressure and receiving iron supplementation were the most commonly offered ANC component in Nigeria with 91.0 % each while IPD and IPT were given to only 20.7 % and 37.6 % respectively. Less than two thirds were taught on PMTCT while 41.7 % had HIV test and obtained results. Only 4.6 % (95 % CI: 4.2–5.1) of women received good quality of ANC while nearly 1.0 % did not receive any of the components. About 11.3 % (95 % CI: 10.6–11.9 %) of the attendees had minimum acceptable quality of ANC. Receipt of good quality ANC services was higher among users who initiated ANC early, had at least 4 ANC visits, attended to by skilled health workers, attended government and private hospitals and clinics. Higher odds of receiving good quality of ANC were found among users who lives in urban areas, having higher educational attainment, belonging to households in upper wealth quintiles and attended to by skilled ANC provider. Conclusions: The levels of desirable and minimum acceptable quality of ANC services were poor in Nigeria thereby jeopardizing efforts to achieve the MDGs. There is need for intensified commitment by national and state governments in Nigeria as well as other stakeholders to ensure that main components of ANC are received by the users.
Awareness and Utilization of Affordable Medicine Facility-Malaria among Caregivers of Under-Five Children in Ibadan North-West Local Government Area, Oyo State
(Hindawi Publishing Corporation, 2013) Ajayi, I. O.; Soyannwo, T.; Akpa, O. M.
Distribution of Affordable Medicine Facility-malaria Artemisinin CombinationTherapies (AMFm-ACTs) started in Nigeria in 2011, but its use at community level has not been documented. Methods. Four hundred seventy-eight caregivers whose under-five children had fever within two weeks prior to the survey were selected using cluster sampling technique. Information on sociodemographic characteristics, treatment seeking for malaria, and awareness and use of AMFm-ACTs was collected using an interviewer administered questionnaire. Result. More than half of the respondents (51.2%) bought AMFm-ACTs without prescription. Awareness of AMFm was low as only 9.1% has heard about the programme. Overall, 29.2% used AMFm-ACTs as their first line choice of antimalarial drug. On bivariate analysis age, group (25–34 years), public servants, respondents with tertiary education, respondents with high socioeconomic status, respondents with poor knowledge of symptoms of malaria, awareness of AMFm-ACTs, availability of AMFm-ACTs, and sources of drug were significantly associated with utilization of AMFm-ACTs (𝑃 < 0.05). Logistic regression demonstrated that only people who were aware of AMFM-ACTs predicted its use (AOR: 0.073; CI: 0.032–0.166; 𝑃 < 0.001). Conclusion. Interventions which targeted at raising awareness of AMFm-ACTs among people at risk of malaria are advocated for implementation.