Scholarly works in Community Medicine

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30-day all-cause mortality rate amongst older patients admitted to the medical ward of a tertiary hospital in Nigeria.
(Medknow / Obafemi Awolowo University, 2021) Adebusoye, L.; Cadmus, E. O.
Introduction: Older people face challenges in the overburdened health‑care services in Nigeria, especially when hospitalised. Few available studies on mortality were retrospective, oftentimes with incomplete data which may affect the establishment of the outcome. Objectives: This study determined the 30‑day all‑cause mortality rate (MR) and associated factors amongst older patients in the medical wards of University College Hospital, Ibadan. Materials and Methods: A prospective cohort study of 417 patients (>60 years) from the 1st day of admission to death or discharge at the end of 30th day of admission. Data were collected with a semi‑structured questionnaire. Information obtained included respondents’ sociodemographic characteristics, anthropometric measurements, frailty and functional status. Others were morbidity profile, quality of life, cognition, nutrition, anxiety and depression. Data were analysed using SPSS version 24 at a level of significance P < 0.05. Results: The mean age was 71.6 ± 8.1 years and 216 (51.8%) were females. Eighty‑seven (20.9%) deaths were recorded. The unadjusted 30‑day all‑cause MR was 13.7 deaths (95% confidence interval [CI]: 11.0–16.9/1000 patient‑days). This was significantly higher amongst males than females with a MR ratio (MRR) of 1.93 ([95% CI: 1.23–3.05]; P = 0.01). Factors significantly associated with mortality were being financially self‑supporting (MRR = 2.82; 95% CI: 1.01–6.41), having a cognitive impairment (MRR = 1.92; 95% CI: 1.12–3.20), frailty (MRR = 1.65; 95% CI: 1.01–2.84), ischemic heart disease (MRR = 1.93; 95% CI: 1.18–3.07) and acute exacerbation of bronchial asthma (MRR = 3.92; 95% CI: 1.04–9.42). Conclusion: The 30‑day MR was high amongst older patients, especially the males. Modifiable factors contributing to hospital mortality should be addressed at admission.
A descriptive study of the morbidity pattern of older persons presenting at a geriatric centre in southwestern Nigeria.
(Wolters Kluwer - Medknow Publications, 2017) Cadmus, E. O.; Adebusoye, L. A.; Olowookere, O. O.; Oluwatosin, O. G.; Owoaje, E. T.; Alonge, T. O.
Context: Rapid population ageing is a demographic reality in most countries of the world. Old age is associated with changes which may culminate in health problems, necessitating provision of appropriate preventive, curative, and rehabilitative services. However, reports from many low- and middle-income countries have shown lack of preparedness to cater for the healthcare needs of older persons. Aim: This study described the morbidity profile and its determinants among persons aged 60 years and above who presented at an established geriatric centre in southwestern Nigeria. Materials and Methods: Data were obtained from electronic health records of 4886 patients aged ≥60 years who visited the facility between 1st January 2013 and 31st December 2014. Data were analyzed using Stata version 13 (Texas, USA). Frequency distributions were used for descriptive analysis, and chi-square test was used to test associations. Results: More than a half, 2919 (59.7%), of the respondents were females and almost three quarters 3501 (71.7%) were aged between 60 and 74 years. Mean number of morbidities was 1.81 ± 0.9, and less than half, 1097 (42.0%), presented with only one morbidity, most commonly, hypertension. There were significant age-related differences for musculoskeletal (P = 0.001), endocrine (P = 0.01), and psychological problems (P = 0.01). In addition, gender differences were observed as a significantly higher proportion of females presented with general symptoms (P = 0.02) and musculoskeletal problems (P = 0.0001) than men. Conclusion: The most common presenting morbidities at this geriatric health centre were mostly no communicable diseases. Information obtained will be useful in the design of similar facilities in other parts of the country and region at large.
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.
Acceptability of Child Adoption and adoption services among civil servants in Ibadan, Nigeria
(Pan African Medical Journal (PAMJ), 2020) Nwachukwu, C. C.; Cadmus, E. O.; Nwachukwu, A. C.; Adebayo, A. M.; Owoaje, E. T.
Child adoption provides an opportunity for children to have new families and for parents to have children. Its acceptance by the society, however, may affect people’s decision to adopt. This study was conducted to determine the attitude and acceptability of child adoption and adoption services among 403 civil servants in Oyo State Secretariat, Ibadan in February and May, 2008.Self-administered questionnaire was used to collect data. Likert scale of score range 1-5 was used to measure respondents’ attitudes. Each positive attitude answer was given a score of 5, while each negative attitude answer had a score of 1. Total scores were computed for each respondent. Attitudinal scores within the range of 16-50 and 51-80 were considered negative and positive respectively. The mean age of respondents was 40.2 ± 9.7 years. Sixty five percent had tertiary education. Overall, 45.9% had positive attitude to adoption. A higher proportion of respondents who had tertiary education (56.3%) were supportive of adoption compared to the others. About 65.0% would support or encourage a relation to adopt a child while 68.5% would recommend adoption to a childless couple. Males, (57.2%), were more willing to support a relation who would like to adopt compared with females, (65.6%). The main reason for non-support of adoption by 32.4% of respondents was that they believed that the childless couples would have their biological children. Efforts should be made to improve the acceptability of adoption.
After obstetric fistula repair; willingness of women in Northern Nigeria to use family planning
(Informa Healthcare, 2018) Uchendu, O.; Adeoti, H.; Adeyera, O.; Olabumuyi, O.
Utilisation of modern family planning (FP) is important for women with obstetric fistula (OF). Preventing pregnancy ensures a proper healing and the success of fistula repair. In Northern Nigeria, prevalence of OF is high while the prevalence of FP utilisation is low. This study assessed the willingness to use family planning among 420 women receiving care at obstetric fistula centres in three northern Nigerian States using a semi-structured questionnaire. Concerning family planning methods, 56.7% were aware, only three (1.3%) had ever utilised any method and 63.8% were willing to use a family planning method in the near future. Age, type of marriage and the presence of surviving children were the significant predictors of willingness to use family planning among women with fistula. There is a moderate awareness of family planning with very low utilisation rates. However, a high proportion of these women are willing to use FP. Therefore, there is a need for integration of FP services with OF services.
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.
An urban-rural comparison of the prevalence, patterns and factors associated with elder abuse in Oyo State, southwestern Nigeria.
(MJ & M Biolabs, 2014) Cadmus, E. O.; Owoaje, E. T.
Background; The social restructuring of families due to modernization and urbanization has led to a decrease in the available primary care givers for the elderly and places them in a position of risk of abuse. Elder abuse has hitherto been uncharacterized in Nigeria. This study compares the prevalence, patterns and factors associated with elder abuse in a rural and an urban community in Oyo State, south western Nigeria. Methods: A comparative cross sectional survey of the elderly (aged 60 years and above) was conducted in selected rural (Iwajowa) and urban (Ibadan South-East) Local Government Areas of Oyo State, Nigeria in 2010. Data were obtained using a semi-structured questionnaire and were analysed using Stata version 12. Results: Overall prevalence of abuse was 29.1%. Emotional abuse (15.8%) was the most frequent followed by financial abuse (14.3%) and physical abuse (9.0%). Only 2 (0.6%) respondents in the urban area reported sexual abuse. The urban and rural prevalence of abuse were: emotional abuse 23.7% versus 8.0%; physical abuse 14.5% versus 3.6% and financial abuse 20.9% versus 7.7% respectively. Although there were differences based on location, for the total population, predictors of elder abuse were, urban dwelling, being unmarried, and financially dependence. Conclus ion : This study has revealed that elder abuse is not uncommon in these communities. All forms of elder abuse are quite prevalent except sexual abuse. Financial insufficiency and dependence on family members for care are contributory factors. Appropriate social and welfare interventions are required to ameliorate the problem.
Appraisal of the Geriatric Centre University College Hospital Ibadan.
(West African College of Physicians and the West African College of Surgeons, 2021) Adebusoye, L. A.; Olowookere, O.; Ajayi, S.; Cadmus, E.O.; Labaeka, E
Geriatric medicine is an emerging subspecialty in Nigeria. The interest in the care of older Nigerians followed the Madrid International Plan of Action on Ageing in April 2002. This led to an increase in research, publications and advocacy culminating in the establishment of the pioneer geriatric centre in Nigeria in 2012. Since then, there has been an increase in capacity building, manpower development and institutionalization of geriatric care in Nigeria. This is an account of the evolution of the Chief Tony Anenih Geriatric Centre, University College Hospital, Ibadan (UCH). METHODS: We undertook the review of the history, structure and key service elements in the Geriatric Centre, UCH from January 1, 2013, to December 31, 2020. RESULTS: The number of patients rose from 2,559 in the first year to 19,300 by the end of 2020. The initial four multidisciplinary units increased to 12 over the review period. Likewise, the in-patient admission increased between the first year (122 patients) and 2020 (141 patients). The overall mortality rate was 11.4% over the review period. Internship opportunities were provided to students including resident doctors, undergraduates (medical) and postgraduate students (Masters and PhD). Besides, 139 medical doctors have undergone the annual basic certificate training in geriatric medicine organised by the Centre. Also, 7 fellowship dissertations and 11 peer-reviewed papers have been published. CONCLUSION: The centre has demonstrated the possibility of caring for older patients in a low-resource setting. The employment of the multidisciplinary approach yielded a low mortality rate, higher attendance and manpower development.
Attitude towards ageing and perceived health status of community-dwelling older persons in a low resource setting: a rural-urban comparison
(BioMed Centra, 2021) Cadmus, E. O.; Adebusoye, L. A.; Owoaje, E. T.
Background: Older person’s attitude to ageing is critical for their adjustment, acceptance of health-related behaviour, survival and choices. Their attitude influences how they cope with the challenges experienced while ageing, which affects their quality of life and health-related outcomes. Despite the increasing number of older persons in sub-Saharan Africa, there is limited information about their experience. This study examines the experience and attitude of older persons in Nigeria regarding the ageing process. Methods: A descriptive cross-sectional study among older persons aged 60 years and above was carried out in a selected rural and an urban community in Oyo State, south-western Nigeria. The study participants were selected using a multi-stage sampling technique. Trained research assistants collected data with the aid of an interviewer administered, semi-structured questionnaire. The Attitude to Ageing Questionnaire (AAQ) was used to measure participants’ perception of ageing in three domains (psychosocial loss, physical changes and psychological growth). Data were analysed using Stata version 14 at a level of significance p < 0.05. Results: A total of 1,180 participants (588 rural vs. 592 urban) were recruited for the study. The mean age was 73.2 ± 9.3 years. The majority (69.7 %) were females and still working (50.5 %). Overall, urban-dwelling participants had a better attitude to the ageing process in all the domains compared with rural-dwelling participants (psychological growth 32.5 ± 3.4 vs. 32.4 ± 3.3, p = 0.30; physical change 27.5 ± 5.1 vs. 26.9 ± 5.0, p = 0.03; and psychosocial loss 25.3 ± 5.7 vs. 25.0 ± 5.3, p = 0.60). Among the rural and urban-dwelling participants, good self-rated health was significantly associated with a positive attitude to ageing across the domains. Conclusions: Older persons residing in urban communities had higher positivity to ageing than their rural older counterparts. The common factor significantly associated with a positive attitude to ageing in both groups was good self-rated health. This information can be used for the planning of targeted interventions and informing policy formation for improved provisions for community-dwelling older persons in Nigeria and other sub-Saharan African countries.
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.
Blueprint for health security in Nigeria by 2050: Ageing and ageing- related diseases
(University of Ibadan, Nigeria, 2019) Akinyemi, R. O.; Cadmus, E. O.; Adeniji, O.; Ajayi, S.; Farombi, T.; Omobowale, O. C.; Olowookere, O. O.; Adebusoye, L. A.; Alonge, T. O.; Ogunniyi, A
Background: Nigeria is currently populated by about 200 million people of diverse ethnic, cultural and religious inclinations. Projections estimate that the proportion and absolute number of older persons aged 60 years and above (currently about 5% of the total population) will increase to 25 million by the year 2050. Ageing of the Nigerian population has far reaching multifaceted economic, psychosocial, educational and health implications. Situation analysis: In this paper, a scenario-based analysis is presented on the likely trajectory of health security for older Nigerians by the year 2050. Ageing – associated diseases are predominantly non - communicable (NCD) and their burden is likely to increase over the next 30 years. The combined burden of NCDs and infectious diseases (malaria, tuberculosis, HIV/AIDS, emerging and re – emerging diseases) suggest that the demand on health services (preventive, diagnostic, curative, rehabilitative and palliative care) from older persons and the elderly will increase in tandem with the growth of this segment of the population. Conclusion: A blueprint for achieving healthy ageing for older persons by the year 2050 is presented. This encompasses set targets, strategic plans and a monitoring and evaluation scheme. Improved funding and coverage of the National Health Insurance Scheme, better pensions and retirement benefit coverage, other social schemes and policy interventions and rigorous implementation schemes are all required for achieving health security by the year 2050 with respect to ageing and ageing – related disorders.
Care seeking for under-five children and vaccine perceptions during the first two waves of the COVID-19 pandemic in Lagos State, Nigeria: a qualitative exploratory study
(BMJ Publishing Group Ltd, 2023) Bakare, A. A.; Olojede, O. E.; King, C.; Graham, H.; Uchendu, O.; Colbourn, T.; Falade, A. G.; Alvesson, H. M.
Objective To explore healthcare seeking practices for children and the context-specific direct and indirect effects of public health interventions during the first two waves of COVID-19 in Lagos State, Nigeria. We also explored decision-making around vaccine acceptance at the start of COVID-19 vaccine roll-out in Nigeria. Design, setting and participants A qualitative explorative study involving 19 semistructured interviews with healthcare providers from public and private primary health facilities and 32 interviews with caregivers of under-five children in Lagos from December 2020 to March 2021. Participants were purposively selected from healthcare facilities to include community health workers, nurses and doctors, and interviews were conducted in quiet locations at facilities. A data-driven reflexive thematic analysis according to Braun and Clark was conducted. Findings Two themes were developed: appropriating COVID-19 in belief systems, and ambiguity about COVID-19 preventive measures. The interpretation of COVID-19 ranged from fearful to considering it as a ‘scam’ or ‘falsification from the government’. Underlying distrust in government fuelled COVID-19 misperceptions. Care seeking for children under five was affected, as facilities were seen as contagious places for COVID-19. Caregivers resorted to alternative care and self-management of childhood illnesses. COVID-19 vaccine hesitancy was a major concern among healthcare providers compared with community members at the time of vaccine roll-out in Lagos, Nigeria. Indirect impacts of COVID-19 lockdown included diminished household income, worsening food insecurity, mental health challenges for caregivers and reduced clinic visits for immunisation. Conclusion The first wave of the COVID-19 pandemic in Lagos was associated with reductions in care seeking for children, clinic attendance for childhood immunizations and household income. Strengthening health and social support systems with context-specific interventions and correcting misinformation is crucial to building adaptive capacity for response to future pandemics.
Caring for older adults during the COVID pandemic and beyond: Experience from a specialized tertiary facility for the care of older persons in a low-resource setting.
(Pan African Medical Journal (PAMJ), 2020) Adebusoye, L. A.; Cadmus, E.O.; Labaeka, E. O.; Ajayi, S. A.; Olowookere, O. O.; Otegbayo, J. A.
The ongoing Coronavirus disease (COVID-19) pandemic has markedly changed health care provisions and arrangements for patient care. Older adults are most susceptible to worse outcomes. The public health impact of the disease in terms of morbidity and mortality has necessitated the evolution of management protocols for effective care of older persons. This review describes our experience during this period attending to the healthcare needs of both the acutely ill and clinically stable patients at the first purpose-built facility for the care of older persons in Nigeria, the Chief Tony Anenih Geriatric Centre (CTAGC), University College Hospital, Ibadan. A major strategy recommended by the World Health Organization was a lockdown with restricted movements and laid down rules for engagement. As such, the CTAGC also embarked on steps to ensure patient safety as well as effective care. Prior to the lockdown, targeted activities included fumigation of the centre as well as health education and promotional activities. Measures were put in place to care for up to 95% of our patients at home. Thus, a “Care in Place” approach was adopted to enable them to take ownership of their care. Ambulatory older patients were seen on an out-patient basis following scheduled appointments after a telephone consultation through the hospital’s designated lines. Clients were managed for their routine health conditions which were mostly non-communicable diseases (NCDs). Also,
Child Passenger Safety, Child Car Restraint, Child Car Seat, Mobile Health Intervention
(Society for Public Health Professionals of Nigeria (SPHPN)., 2017) Olumide, A.O.; Adebayo, E.S.; Cadmus, E.O.; Folajimi, Y.; Amodu, O.K.; Balogun, F.M.
Background: Child car-passenger safety practices remain low in Nigeria. Findings from the formative phase of a project to deliver an m-health intervention on child-passenger safety to mothers/caregivers attending selected child-immunization clinics in Ibadan are presented in this paper. The aim of this study was to describe stakeholders’ awareness of child passenger safety measures; to determine the cost of child car seats and acceptability of interventions to improve child-passenger safety practices. Methods: Twenty-four key-informant interviews with traffic enforcement officers (four), physicians (five), and mothers of children (fifteen) ;and a market survey was conducted. Results: Physicians and traffic law enforcement officers were more knowledgeable about child passenger safety measures compared to mothers. Cost of infant seats ranged from N6, 000.00 - N36, 000.00 (USD27.9 - USD 167.67) and toddler seats, N6, 000.00 - N81, 000.00 (USD27.95 - USD377.27). Acceptance of a mobile-phone intervention and its accompanying law enforcement was very high. Conclusions: Our findings suggest that an intervention to improve child-passenger safety practices using mobile technology is acceptable to stakeholders in the study area. The intervention should address caregivers’ misconceptions about current child passenger safety measures as this could further enhance compliance with these safety measures.
Child seating position and retraint use in the Ibadan metropolis, South Western Nigeria
(University of South Africa (UNISA), 2006) Sangowawa, A.; Ekanem, S.; Alagh, B.; Ebong, I.; Faseru, B.; Uchendu, O.; Adekunle, B.; Shaahu, V.; Fajola, A.
Different measures, including placing children in the rear seats of vehicles and the use of age- appropriate restraints have been developed to reduce injuries among children during a motor vehicle crash. Many of these measures are not universally adhered to. This cross-sectional, observational study was accordingly conducted to describe child seating position and restraint use in the Ibadan Metropolis, south western Nigeria. Observations were made at selected primary school gates in 3 of the 5 Local Government Areas (LGAs) which make up the metropolis. Data on 796 children riding in 440 vehicles were collected. Driver restraint use was 48.0%. Restraint use among the children was 4.1%. Two hundred and twenty-three (28.0%) children between the ages 0-13 years were seated in the front, most, 86 (38.6%) of whom were aged 1-4 years. Just under a half (48.3%) of restrained drivers had at least one child seated in the front of the vehicle compared to 47.6% of unrestrained drivers. Children were more likely to be seated in the front when the rear seat was unoccupied. In addition, children were more likely to be restrained when riding in a vehicle with a restrained driver. There is an urgent need for multi-disciplinary action geared towards improving child passenger safety practices in the Ibadan metropolis. Legislation, health education and availing affordable child restraints will go a long way towards ensuring the safety of children in motor vehicles.
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.
Correlates of quit intentions among current Nigerian smokers: Evidence from the 2012 Global Adult Tobacco Surveys (GATS).
(European Publishing (on behalf of the European Network for Smoking and Tobacco Prevention - ENSP), 2020) Iken, O.; Cadmus, E.O.; Ahmed, B
INTRODUCTION Approximately 3.1 million people use tobacco in Nigeria contributing to the burden of tobacco-related morbidity and mortality. However, many tobacco users who have tried to quit have been unable to do so at the first try, but may succeed or give up after multiple attempts. The transtheoretical model helps by classifying those with quit intentions into preparation, contemplation and precontemplation stages. These assist in the development of targeted interventions towards smokers in each stage for more effective results. There is limited evidence about cessation and quitting behaviour in the Nigerian context. This study aimed to explore the factors related to the intention to quit among current tobacco smokers in Nigeria using the transtheoretical model. METHODS The study was a secondary data analysis of the Nigeria 2012 Global Adult Tobacco Survey (GATS). The survey included non-institutionalized men and women aged ≥15 years. Data were analysed using SPSS version 21. The primary outcome variable was smoking quit intention. The correlates of quit intentions were determined for a p<0.05. RESULTS A total of 429 current smokers were mostly in precontemplation (64.7%) while 14.9% were in the preparation stage. Exposure to anti-tobacco media messages was associated with increased quit attempts, however, knowledge about the harmful effects of tobacco was associated with fewer quit intentions. Very few had access to cessation therapy and none had accessed a quitline. Male respondents were 9 times more likely to have a quit intention compared to females (OR=9.615; 95% CI: 1.449–1.478). Respondents with primary education were nearly three times more likely to have quit intentions than those with tertiary education (OR=2.991; 95% CI: 2.930–3.053). CONCLUSIONS While attention is on smoking prevention, most smokers in Nigeria are not considering quitting. There is a need for targeted interventions to reach smokers at various stages.