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Item The spread of COVID-19 outbreak in the first 120 days: a comparison between Nigeria and seven other countries(BioMed Central, 2021) Adebowale, A. S.; Fagbamigbe, A. F.; Akinyemi, J. O.; Obisesan, O. K.; Awosanya, E. J.; Afolabi, R. F.; Alarape, S. A.; Obabiyi, S. O.Background: COVID-19 is an emerging public health emergency of international concern. The trajectory of the global spread is worrisome, particularly in heavily populated countries such as Nigeria. The study objective was to assess and compare the pattern of COVID-19 spread in Nigeria and seven other countries during the first 120 days of the outbreak. Methods: Data was extracted from the World Bank’s website. A descriptive analysis was conducted as well as modelling of COVID-19 spread from day one through day 120 in Nigeria and seven other countries. Model fitting was conducted using linear, quadratic, cubic and exponential regression methods (α=0.05). Results: The COVID-19 spread pattern in Nigeria was similar to the patterns in Egypt, Ghana and Cameroun. The daily death distribution in Nigeria was similar to those of six out of the seven countries considered. There was an increasing trend in the daily COVID-19 confirmed cases in Nigeria. During the lockdown, the growth rate in Nigeria was 5.85 (R2 =0.728, p< 0.001); however, it was 8.42 (R2 =0.625, p< 0.001) after the lockdown was relaxed. The cubic polynomial model (CPM) provided the best fit for predicting COVID-19 cumulative cases across all the countries investigated and there was a clear deviation from the exponential growth model. Using the CPM, the predicted number of cases in Nigeria at 3-month (30 September 2020) was 155,467 (95% CI:151,111-159,824, p< 0.001), all things being equal. Conclusions: Improvement in COVID-19 control measures and strict compliance with the COVID-19 recommended protocols are essential. A contingency plan is needed to provide care for the active cases in case the predicted target is attained.Item Situation assessment and natural dynamics of COVID-19 pandemic in Nigeria, 31 May 2020(Elsevier B.V., 2021) Adebowale, S.; Fagbamigbe, A. F.; Akinyemi, J. O.; Obisesan, K. O.; Awosanya, E. J.; Afolabi, R. F.; Alarape, S. A.; Obabiyi, S. O.Background: The coronavirus disease (COVID-19) remains a global public health issue due to its high transmission and case fatality rate. There is apprehension on how to curb the spread and mitigate the socio-economic impacts of the pandemic, but timely and reliable daily confirmed cases’ estimates are pertinent to the pandemic’s containment. This study therefore conducted a situation assessment and applied simple predictive models to explore COVID-19 progression in Nigeria as at 31 May 2020. Methods: Data used for this study were extracted from the websites of the European Centre for Disease Control (World Bank data) and Nigeria Centre for Disease Control. Besides descriptive statistics, four predictive models were fitted to investigate the pandemic natural dynamics. Results: The case fatality rate of COVID-19 was 2.8%. A higher number of confirmed cases of COVID-19 was reported daily after the relaxation of lockdown than before and during lockdown. Of the 36 states in Nigeria, including the Federal Capital Territory, 35 have been affected with COVID-19. Most active cases were in Lagos (n = 4064; 59.2%), followed by Kano (n = 669; 9.2%). The percentage of COVID-19 recovery in Nigeria (29.5%) was lower compared to South Africa (50.3%), but higher compared to Kenya (24.1%). The cubic polynomial model had the best fit. The projected value for COVID-19 cumulative cases for 30 June 2020 in Nigeria was 27,993 (95% C.I: 27,001–28,986). Conclusion: The daily confirmed cases of COVID-19 are increasing in Nigeria. Increasing testing capacity for the disease may further reveal more confirmed cases. As observed in this study, the cubic polynomial model currently offers a better prediction of the future COVID-19 cases in Nigeria.Item Dynamics of poverty-related dissimilarities in fertility in Nigeria: 2003-2018(Elsevier B.V, 2020) Adebowale, A. S.; Fagbamigbe, A. F.; Akinyemi, J. O.; Olowolafe, T.; Onwusaka, O.; Adewole, D.; Sadikue, S.; Palamuleni, M.Nigeria is one of the high fertility countries worldwide. Little is known about the differences in fertility experience of women in poor and rich households in Nigeria. We ex amined the relationship between household wealth and fertility in Nigeria with focus on women from poor and rich households.This national representative and cross-sectional design study involved analysis of fourrounds (2003, 2008, 2013, 2018) of Nigeria Demographic Health and Survey data . Theoutcome variable was fertility measured from the full birth history information reported by women of reproductive age. Data were analyzed using descriptive statistics, direct and Gompertz-relational demographic methods, logistic regression and negative binomial re gression models (α=0.05). Across the survey years, the mean number of children ever born (CEB), the total fer tility rate and the percentage of women who had high fertility were consistently higher among the women from poor households than those from the rich households. From 2003 to 2018, declining pattern (slope = -0.87) in percentage of high fertility women was observed among rich unlike the poor women (slope = +0.31) where a slight increase was observed. In 2018 as for other survey rounds, about 18.7% and 38.4% of rich and poor women had high fertility (CEB≥5) respectively. The likelihood of high fertility (CEB≥5) was 2.74 (C.I=2.60-2.89, p<0.001) times higher among poor women than the rich women. In 2018,the fertility incidence risk ratio was about 8.0% higher among the women from the poo rhouseholds than their counterparts from the rich households and this pattern was observed when some other factors were included in the regression model across the survey years (2003-2018).Item Derivation and appraisal of maternal mortality estimates in Nigeria from the 2012 National HIV/AIDS and Reproductive Health Survey(College of Medicine, University of Ibadan, 2017) Akinyemi, J. O.; Yusuf, O. B.; Fagbamigbe, A. F.; Bamgboye, E. A.; Kawu, I. B.; Ngige, E.; Amida, P.; Bashorun, A.Background Despite the huge burden of in Nigeria, accurate and reliable data fur maternal mortality measurement arc locking The federal Ministry of Health in collaboration with development partners included questions that allow indirect estimation of maternal mortality m us 2012 National HIV/AIDS and Reproductive Health Survey (NARHS) The aim of this paper was to derive estimates of Maternal Mortality Ratio (MMR) and Lifetime Risk of maternal death (LTR) from the 2012 NARHS data Methods: This was a secondary analysis of data from the maternal mortality module of NARHS 2012. During the survey, respondents (men aged 15-59 years and women aged 15-49 years) were selected via a multi-stage cluster sampling technique and data collected by trained field workers. In this study, report on survival or otherwise of adult female siblings were analysed to derive estimates of life tune risk of maternal death using the indirect sisterhood method. Results: Data from 15,596 men and 15,639 women were analysed A total of 12.810 adult female siblings had been exposed to the risk of death out of which 377 (2.9*4) have died of the 377 adult female deaths. 70 (18 6%) were pregnancy related the estimates of LTR and MMR were I in 71 women and 256 (95% CT. 196 - 316) maternal deaths per 100,000 live births respectively. There were north-south and rural-urban differences. Conclusion: The high level of maternal mortality is worrisome, concerted efforts aimed at reduction and provision of routine data for its measurement should be intensified.Item Modelling the survivorship of Nigeria children in their first 10 years of life(Nigerian Medical Association, Rivers State, Nigeria, 2016) Fagbamigbe, A. F.; Akinyemi, J. O.Introduction: Several studies have attributed social demographic and environmental characteristics to differentials in children mortality rates worldwide but there is paucity of information on modelling of children survival in Nigeria. In this study we modelled children survival in Nigeria for first five years of life and predicted their chances of survival in their sixth to tenth years of life. Methods: We used the data from the 2013 Nigeria Demographic and Health Survey to carry out a retrospective analysis of children survival. We computed the probability of survival and mortality rates for the first five years and predicted survivals for 6th to 10th years of life using life table techniques and compared our estimates with those obtained using Brass indirect techniques. Results: The probability of a child surviving up to exact age 1 and 5 were 0.9212 (95% CI: 0.919-0.923) and 0.8583 (95% CI: 0.855-0.861), respectively. About 142 of every 1000 children would not make their tenth birthday in Nigeria. We found higher survivorship trend among female children than the males with higher rates in Southern Nigeria than in the Northern parts. The estimates of probabilities of survival from age 1 to 5 from the fitted curves agreed very closely with those obtained from Brass indirect techniques as the variability was less than 2%. Conclusion: Child mortality is high in Nigeria with fewer children deaths among females. Probability of not attaining age 10 in South West is lower than chances of not marking first birthday in North West zone. Efforts must be concentrated in reversing the worrisome survival trend in Nigeria especially in the Northern parts of the country.Item Controlling malaria in pregnancy: how far from the Abuja targets?(Dutch Malaria Foundation, 2016) Yusuf, O. B.; Akinyemi, J. O.; Fagbamigbe, A. F.; Ajayi, I. O.; Bamgboye, E. A.; Ngige, E.; Issa, K.; Abatta, E.; Ezire, O.; Amida, P.; Bashorun, A.Background. The Roll Back Malaria (RBM) initiative recommended that all pregnant women receive Intermittent Preventive Treatment (IPTp) and that by 2010 at least 80% of people at risk of malaria (including pregnant women) use insecticide-treated bednets (ITN) in areas with stable transmission. We evaluated ITN/IPTp coverage, explored its associated factors, and estimated the number of pregnancies protected from malaria. Materials and methods. This analysis was based on data from the 2012 National HIV/AIDS and Reproductive Health Survey (NARHS Plus). To assess ITN coverage, we used the population of women that was pregnant (n=22,438) at the time of the survey. For IPTp coverage, we used women that had a live birth in the 5 years preceding the survey (n= 118,187) and extracted the population of pregnant women that, during their last pregnancy, received drugs for protection against malaria. We estimated the number of live births using the projected population of females in each state, population of women of child -bearing age and the total fertility rate. The estimated number of pregnancies covered/protected by ITN and IPTp was obtained from a product of the estimated live births and the reported coverage. Multivariate logistic regression was used to determine factors associated with ITN and IPTp use. Results. We estimated that there were 5,798,897 live births in Nigeria in 2012, of which 3,537,327 and 2,302,162 pregnancies were protected by ITN and IPTp, respectively. Four of 36 states achieved the 80% RBM target for ITN coverage. No state achieved the 100% target for IPTp. Education and socio-economic status were associated with IPTp use. Conclusion. ITN coverage was higher than in previous estimates even though it is still below the RBM targets. However, IPTp coverage remained low in 2012 and was not likely to increase to match the 2015 target coverage of 100%.Item The Nigeria wealth distribution and health seeking behaviour: evidence from the 2012 national HIV/AIDS and reproductive health survey(Springer-Verlag GmbH, 2015) Fagbamigbe, A. F.; Bamgboye, E. A.; Yusuf, B. O.; Akinyemi, J. O.; Issa, B. K.; Ngige, E.; Amida, P.; Bashorun, A.; Abatta, E.Background: Recently, Nigeria emerged as the largest economy in Africa and the 26th in the world. However, a pertinent question is how this new economic status has impacted on the wealth and health of her citizens. There is a dearth of empirical study on the wealth distribution in Nigeria which could be important in explaining the general disparities in their health seeking behavior. An adequate knowledge of Nigeria wealth distribution will no doubt inform policy makers in their decision making to improve the quality of life of Nigerians. Method: This study is a retrospective analysis of the assets of household in Nigeria collected during the 2012 National HIV/AIDS and Reproductive Health Survey (NARHS Plus 2). We used the principal component analysis methods to construct wealth quintiles across households in Nigeria. At 5% significance level, we used ANOVA to determine differences in some health outcomes across the WQs and chi-square test to assess association between WQs and some reproductive health seeking behaviours. Result: The wealth quintiles were found to be internally valid and coherent. However, there is a wide gap in the reproductive health seeking behavior of household members across the wealth quintiles with members of households in lower quintiles having lesser likelihood (33.0%) to receive antenatal care than among those in the highest quintiles (91.9%). While only 3% were currently using modern contraceptives in the lowest wealth quintile, it was 17.4% among the highest wealth quintile (p < 0.05). Conclusion: The wealth quintiles showed a great disparity in the standard of living of Nigerian households across geo-political zones, states and rural–urban locations which had greatly influenced household health seeking behavior.Item Gender variation in self-reported likelihood of HIV infection in comparison with HIV test results in rural and urban Nigeria(Biomed Central, 2011) Fagbamigbe, A. F.; Akinyemi, J. O.; Adedokun, B. O.; Bamgboye, E. A.Background: Behaviour change which is highly influenced by risk perception is a major challenge that HIV prevention efforts need to confront. In this study, we examined the validity of self-reported likelihood of HIV infection among rural and urban reproductive age group Nigerians. Methods: This is a cross-sectional study of a nationally representative sample of Nigerians. We investigated the concordance between self-reported likelihood of HIV and actual results of HIV test. Multivariate logistic regression analysis was used to assess whether selected respondents’ characteristics affect the validity of self-reports. Results: The HIV prevalence in the urban population was 3.8% (3.1% among males and 4.6% among females) and 3.5% in the rural areas (3.4% among males and 3.7% among females). Almost all the respondents who claimed they have high chances of being infected with HIV actually tested negative (91.6% in urban and 97.9% in rural areas). In contrast, only 8.5% in urban areas and 2.1% in rural areas, of those who claimed high chances of been HIV infected were actually HIV positive. About 2.9% and 4.3% from urban and rural areas respectively tested positive although they claimed very low chances of HIV infection. Age, gender, education and residence are factors associated with validity of respondents’ self-perceived risk of HIV infection. Conclusion: Self-perceived HIV risk is poorly sensitive and moderately specific in the prediction of HIV status. There are differences in the validity of self-perceived risk of HIV across rural and urban populations.Item Phenotyping stroke in Sub-Saharan Africa: stroke investigative research and education network (SIREN) phenomics protocol(Karger Publishers, 2015) Akpalu, A.; Sarfo, F. S.; Ovbiagele, B.; Akinyemi, R.; Gebregziabher, M.; Obiako, R.; Owolabi, L.; Sagoe, K.; Jenkins, C.; Arulogun, O.; Adamu, S.; Appiah, L. T.; Adadey, M. A.; Agyekum, F.; Quansah, J. A.; Mensah, Y. B.; Adeoye, A. M.; Singh, A.; Tosin, A. O.; Ohifemen, O.; Sani, A. A.; Tabi-Ajayi, E.; Phillip, I. O.; Isah, S. Y.; Tabari, N. A.; Mande, A.; Agunloye, A. M.; Ogbole, G. I.; Akinyemi, J. O.; Akpa, O. M.; Laryea, R.; Melikam, S. E.; Adinku, D.; Uvere, E.; Burkett, N.-S.; Adekunle, G. F.; Kehinde, S. I.; Azuh, P. C.; Dambatta, A. H.; Ishaq, N. A.; Arnett, D.Background: As the second leading cause of death and the leading cause of adult-onset disability, stroke is a major public health concern particularly pertinent in Sub-Saharan Africa (SSA), where nearly 80% of all global stroke mortalities occur, and stroke burden is projected to increase in the coming decades. However, traditional and emerging risk factors for stroke in SSA have not been well characterized, thus limiting efforts at curbing its devastating toll. The Stroke Investigative Research and Education Network (SIREN) project is aimed at comprehensively evaluating the key environmental and genomic risk factors for stroke (and its subtypes) in SSA while simultaneously building capacities in phenomics, biobanking, genomics, biostatistics, and bioinformatics for brain research. Methods: SIREN is a transnational, multicentre, hospital and community-based study involving 3,000 cases and 3,000 controls recruited from 8 sites in Ghana and Nigeria. Cases will be hospital-based patients with first stroke within 10 days of onset in whom neurovascular imaging will be performed. Etiological and topographical stroke sub types will be documented for all cases. Controls will be hospital- and community-based participants, matched to cases on the basis of gender, ethnicity, and age (±5 years). Information will be collected on known and proposed emerging risk factors for stroke. Study Significance: SIREN is the largest study of stroke in Africa to date. It is anticipated that it will shed light on the phenotypic characteristics and risk factors of stroke and ultimately provide evidence base for strategic interventions to curtail the burgeoning burden of stroke on the sub-continent.Item Wealth status and sexual partnership pattern among Nigerian men(International Research Journals, 2014) Adeolu, M. O.; Akinyemi, J. O.; Akpa, O. M.; Issa, K.; Bamgboye, E. A.Studies in sub-Saharan Africa have shown that many people engage in multiple sexual partnerships despite the high knowledge about the contribution of such practice to the spread of HIV. The culture in many African countries especially in Nigeria favour men to engage in sexual experimentation with many sexual partners as a symbol of manhood. Past studies on sexual behaviour in Nigeria have focused on women and adolescents while men’s sexuality has received less attention. This study used data extracted from 2007 National HIV/AIDS and Reproductive Health Survey of sexually active Nigerians to investigate correlates and pattern of multiple sexual partnerships among men in Nigeria using multilevel logistic regression models. The findings indicate that individual characteristics such as ever use of condom influenced sexual behaviour of men compared to their contextual characteristics. Compared to men in the poorest group, moderately rich men were more likely to have multiple (OR=1.10, 95%CI=0.93-1.30) and non-regular sexual partners (OR=1.05, 95%CI=0.89-1.25). We found marital status, ever use condom, students, age (21-49years) as significant determinants of multiple sexual partnerships. Sexual behaviour in the men population is driven not only by their occupations or economic state; younger men are more prone to risky sexual behaviour.