Scholarly works in Community Medicine
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Item Willingness to uptake breast cancer screening among rural women in Southwestern Nigeria(Society for Public Health Professionals of Nigeria (SPHPN), 2017) Uchendu, O. C.; Olabumuyi, O. O.; Idowu, S.; Adamu, D.Background: The mortality attributed to breast cancer remains high especially among rural dwelling women in low-income countries. Late diagnosis that may be as a result of poor knowledge and nonutilization of available screening has been implicated in the high mortality burden. Enhancing access to and uptake of breast cancer screening will reduce the cancer burden. Objectives: This study was conducted to assess the willingness to uptake breast cancer screening among rural women in South Western Nigeria. Factors associated with willingness to uptake breast cancer screening were also determined. Methods: A community-based cross-sectional design using multi-stage sampling was used to select 920 women in Igbo-Ora, South Western Nigeria. An interviewer-administered questionnaire was used for data collection. Data was analysed using SPSS at a 5% level of statistical significance. Results: The respondents were aged 15 to 86 years with 795 (86.4%) being within the reproductive age group. Of total respondents, 546 were aware of breast cancer of which 171 (31.3%) had good knowledge about the symptoms of breast cancer. Of the 834 respondents who had never screened for breast cancer, 651 (78.1%) were willing to screen. Respondents within the reproductive age group and those that knew someone with breast cancer had odds of 2.7 and 2.5 respectively of being willing to uptake breast cancer screening. (OR=2.9; 95% CI=1.8-5.1 and OR=2.5; 95% CI 1.2-5.7) Conclusion: Although the knowledge of breast cancer and the awareness of screening methods among women in rural area is low, their willingness to get screened remains high. The use of survivors as well as survivor relatives should be considered during community-based health programmes aimed at improving uptake of screening among this population.Item Perceived effectiveness of graphic health warnings as a deterrent for smoking initiation among adolescents in selected schools in southwest Nigeria(BioMed Central Ltd, 2016) Adebiyi, A. O.; Uchendu, O. C.; Bamgboye, E.; Ibitoye, O.; Omotola, B.Background: There has been a sustained increment in young people initiating smoking in low middle income countries like Nigeria. Health warnings on cigarette packages are a prominent source of health information and an effective means of communicating specific disease risks to adolescents and young adults alike. This study evaluated the perceived effectiveness of selected graphic warnings on smoking initiation amongst in-school adolescents. Methods: This was a cross-sectional study conducted amongst secondary school students aged 13–17years in Igbo-Ora, Nigeria. A two-stage sampling technique with the school classes as the final sampling unit was used to select the students. An interviewer assisted questionnaire was used to obtain information on students demographic characteristics and their perception of graphic warnings using four images from the pictorial health warning galleries of the World Health Organization showing: ‘cigarette smoking causes cancer of the airways, harms children, causes stroke and causes impotence respectively'. Results: A total of 544 senior secondary students were included in this study with a male female ratio of 0.8:1. Of those interviewed, 40 (7.4 %) indicated that they had ever considered smoking, nine (1.7 %) responded that they had ever smoked and two students indicated that they were current smokers. With all the images, fear was the dominant emotion expressed by the respondents. This was expressed by 307 (56.4), 215 (39.5), 203 (37.3) and 228 (41.9 %) respondents to images 1, 2, 3, and 4 respectively. Furthermore, 76.7, 44.7, 58.5 and 62.1 % of respondents felt Images 1, 2, 3 and 4 respectively will to a large extent prevent people from initiating smoking. There was no association between perceived effectiveness and gender. However, those younger than 15 years rated images on cancer of the airway and impotence as probably effective to a larger extent than did those who were 15 years and older (p = 0.032). Conclusion: Introduction of graphic health warnings, especially with an imagery depicting cancer and impotence may influence non-smokers to remain abstinent. Therefore, this study provides a template for a future policy-relevant study on graphic health warning in Nigeria.Item 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.Item 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.Item 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.Item 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.Item 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.Item 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.Item Perianaesthetic complications associated With adenotonsillectomy at the University College hospital, Ibadan, Nigeria.(Internet Scientific Publishers, 2012) Sanusi, A. A.; Akinwale, M. O.; Uchendu, O. C.; Lasis, A. O.Adenoidectomy and tonsillectomy are common ear, nose and throat operations in children and are often accompanied by complications. This study assessed the perianaesthetic complications encountered among patients who had adenotonsillectomy in a tertiary hospital through May 2009 to April 2010.The study comprised of 49 subjects made up of 26 (53%) males and 23 (47%) females with a median age 36 (range=8 – 64) months and a median weight of 14kg (range = 5 –76kg). All the patients had general anaesthesia with endotracheal intubation. The procedures included tonsillectomy in 8 (16%) subjects, adenoidectomy in 18 (37%) and adenotonsillectomy in 23 (47%). Of the 49 patients, 24 (49%) had associated OSA, 2 (4%) had sickle cell disease, 1 (2%) patient had Down’s syndrome and 1 (2%) had hypertension. The estimated median blood loss was 50ml with a range of 20-200ml. The incidence of critical events and complications was 53.1%. Vomiting was the most common complication, occurring in 16% of the patients, followed by accidental tube dislodgement 14% and tube compression 10%. The use of plastic endotracheal tube was significantly associated with the occurrence of tube compression compared to the reinforced (non-kinkable) tube (Fisher’s exact=0.034), in addition, the presence of OSA is significantly associated with delayed post-operative recovery (Fisher’s exact = 0.05).We conclude that there is a high incidence of tube compression and dislodgement complicating adenotonsillectomy suggesting the need to modify the method of anchoring the endotracheal tube during the procedure.Item 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.