FACULTY OF CLINICAL SCIENCES

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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.
5 Fluorouracil versus mitomycin-c as adjuncts to conjuctival autograft in preventing pterygium recurrence
(Springer, 2012) Bekibele, C. O.; Ashaye, A.; Olusanya, B.; Baiyeroju, A.; Fasina, O.; Ibrahim, A. O.; Ogun, O.
To compare the efficacy of 5-fluorouracil (5-FU) with mitomycin C (MMC) in preventing pterygium recurrence when used as an adjuvant following pterygium excision with conjunctival autograft. Low-dose MMC combined with conjunctival autograft is an effective treatment for preventing recurrence following pterygium excision, but safety, cost, and availability limit its use in developing countries. There is a paucity of data on the efficacy of 5-FU when used in Africa as an adjuvant to conjunctival autograft following pterygium excision. This is a randomized controlled prospective trial using either 50 mg/ml 5-FU or 0.01% MMC. Eighty eyes of 80 subjects were studied. Forty-six subjects with a mean age 49.8 ± 13.8 years were treated with 5-FU (USD 13.0 per unit), while 34 patients with a mean age 51.9 ± 12.1 years were treated with MMC (USD 20.0 per unit). There was no significant difference in mean age between the two groups (p = 0.48). The ratio of male to female patients in both groups was similar at 0.92:1 for the 5-FU group and 1:1 for the MMC group (p = 0.85). Mean follow-up period was 35.2 ± 29.1 weeks. Recurrence rate in the 5-FU group was 8.7% compared to 11.8% in the MMC group (recurrence risk ratio = 0.71, 95% CI 0.17-3.1, p = 0.7). One patient from the MCtreated group had corneoscleral melting. Other complications were mild and not sight threatening. In the prevention of pterygium recurrence, 5-FU appears to compare favorably with low-dose MMC when used as an adjuvant following pterygium excision and conjunctival autograft. Further studies are required to assess the long-term effect of using 5-FU in such cases.
5-flourouracil vs. beta-aiiadiation in the prevention of pterygium recurrence
(Blackwell Publishing Limited, 2004) Bekibele, C. O.; Baiyeroju, A. M.; Ajayi, B. G. K
Aim: The aim of this study was to compare 5-fluorouracil (5-FU) with beta-irradiation in the prevention of pterygium recurrence. Materials and methods: A retrospective non-randomised review of cases of fleshy pterygium treated with bare sclera excision and adjuvant 5-FU were compared with similar morphologically appearing ptervgia, marched for age and sex, treated with bare seleral excision and adjuvant beta-irradiation. All surgeries were carried out at the university college hospital and Ojulowo eye hospital, Ibadan, Nigeria. Results: Twenty-seven eyes of 24 patients who had pterygium excision with adjuvant treatment with 5-FU were compared with 31 eyes of 24 patients who were treated with excision and beta-irradiation. The mean age for the 5-FU group was 46.1 years while that for the beta-irradiation group was 46.9 years. Both sexes were equally represented, 12 males and 12 females. There were seven (25.9%) initial recurrences in the 5-FU group but four of these became atrophic, and therefore, cosmetically acceptable leaving three eyes (11 %) with unacceptable recurrent pterygium. The beta-irradiation group, however, had seven (22.5) initial recurrence but five of these became atrophic and fell short of the cornea, leaving two (6.5%) with clinically unacceptable recurrence. The difference was, however, nor statistically significant (Zc = 0.74 and p > 0.1). The associated complications were mostly mild in both groups and included cornea opacitv of 10 (37%) complications, conjunctivitis of three (11 %) complications, sclera granuloma of three (11%) complications and conjunctiva necrosis of one (3.7%) complication for the 5-FU group, and while the beta-irradiation group had corneal opacity of one(3.7%) complication and conjunctivitis of three (11%) complications. Conclusion: The non-statistical significance of a lower pterygium recurrence rate with use of beta-irradiation for the treatment of fleshy pterygium compared with 5-FU may have been partly due to the small number of patients studied. A randomised-controlled study using a larger sample size is therefore proposed. However, the fact that over half of those with initial recurrence in the 5-FU group became atrophic (and therefore cosmetically acceptable) over rime as well as less cost implication in the purchase of 5-FU relative to Strontium-90 association with few and mild complications makes it a desirable adjuvant therapy in depressed economics. However, beta-irradiation still has a place when cost issue is not an inhibiting factor in view of its clinically superior outcome
A case report of suspected angioedema in a child after administration of mebendazole, cotrimoxazole and leaf extracts
(Association of Resident Doctors (ARD), UCH, Ibadan, 2016) Ashubu, O. F.; Ademola, A. D.; Asinobi, O. A.
A case report on Lassa fever and hearing loss: a rare occurrence and review of the literature.
(2017) Daniel, A.; |Raji, Y.R.; |Ijitola, J.O.; Bello, T.O.; Jinadu, O.Y.; Ajayi, S.O.; Olaleye, O.D.; Salako, B.L; Lasisi, O.A.
Lassa fever is highly endemic in Nigeria and other West African countries, it is a disease associated with high case fatality and chronic sequelae in those that survived. Lack of effective vaccine has made the disease difficult to control and it prevention depends on eradications of the multmammate rats and universal precautions by all when a case is identified. We report a case of a 51 years old health worker who had a severe form of Lassa fever complicated by sensorineural deafness at the University College Hospital, Ibadan, South West Nigeria.
A community-based intervention for improving utilization of medical services by rape survivors in refugee camps in Zambia
(2019) Oladeji, O.; Owoaje, E.; Oladeji, B.; Fatiregun, A.
Background: Rape is the most common form of violence in conflict and refugee situations but because of the associated stigma few cases are reported. This study assessed the outcome of an intervention targeted at women groups on the utilization of medical services by rape survivors in refugee camps in Zambia. Methods: A prospective quasi-experimental community-based intervention study was carried out in two refugee camps allocated into intervention and comparison areas. The intervention was participatory education sessions for women groups. Data was collected using the clinic records and the main outcome was the number of rape survivors who utilized and completed medical services provided at the camp clinics. Univariate, bivariate and multivariate analyses were carried out with level of significance set at 5%. Results: The proportion of the rape survivors who accessed medical care within 72 hours increased significantly from 41.2% to 84.8% in the intervention area but from 31.1% to 38.9% in the comparison area, (p=0.005). Those who completed their medical treatment and the follow-up visits increased significantly from 42.8% to 94.8% in intervention area but reduced from 38.5% to 21.4% in the comparison area, (p=0.002). Being resident in the intervention area predicted the utilization of medical services, [OR: 3.15; 95%CI: 1.955-5.681], p=0.002. Conclusion: Community-based intervention using participatory women’s group discussion had a significant impact on increasing the utilization of medical services by rape survivors and should be considered for scaling up as a key intervention for increasing utilization of medical services for rape survivors especially in refugee situations.
A comparative review of the efficacy of 24-hour versus 48-hour dose regimen of amoxicillin/ clavulanic acid prophylaxis for postoperative infections following elective caesarean section at the University College Hospital, Ibadan, Nigeria.
(Zambia Medical Association, 2022) Oloko, O.O.; Ogunbode, O.O.; Obajimi, G.O.; Arowojolu, A.O
Objectives: To compare the efficacy of 24 hour versus 48 hour prophylaxis of amoxicillin/clavulanic acid in the prevention of postoperative infections. Study Design: This study was a randomized controlled clinical trial conducted in a tertiary hospital in Ibadan, Nigeria. Two hundred and fifty - two pregnant women scheduled for elective caesarean section were randomly assigned into two groups. After the initial pre-incision antibiotic a dmi n i s t r a t i o n , g r o u p A r e c e i v e d t h e Amoxicillin/Clavulanic Acid for 24 hours while group B received the same drug for 48hours. Main Outcomes: Participants were examined on the3rd, 10th and 17th post-operative days for evidence of infections. All entry and analysis of data was by computer using the Statistical Package for Social Sciences version 22 (IBM, New York).Statistically significant differences were determined at p value of< 0.05. Results: The incidence of postoperative wound infection, postoperative fever and endometritis in this study was 5.2%, 9.1% and 5.6% respectively. There were no significant differences in the incidence of postoperative wound infection, postoperative fever and endometritis between the two regimens of antibiotics.
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 fifteen year experience of total thyroidectomy for the management of simple multinodular goitres in a low medium income country
(Association of Surgeons of South Africa, 2016) Afolabi, A. O.; Ayandipo, O. O.; Afuwape, O. O.; Ogundoyin, O. A.
Introduction: Total thyroidectomy as a treatment for simple multinodular goitre is not well recognised in most centres in low middle income countries. Methods: This paper is a retrospective review of outcomes of total thyroidectomy for simple multinodular goitres in the last fifteen years in a tertiary hospital in Nigeria. Results: A total of 652 thyroidectomies were done from January 2001 to December 2015. Simple multinodular goitres were indication for a total thyroidectomy in 447 patients (68.6%) with a male to female ratio of 1:6. Postoperative complications were hypocalcaemia in 22 (4.9%), unilateral recurrent laryngeal nerve palsy in 13 (2.8%) and haemorrhage in 2 patients. Others were seroma and cellulitis. Tracheostomy was required in 35 (5.8%) patients but none was permanent. Conclusion: Total thyroidectomy is a relatively safe treatment option for patients who have simple multinodular goitre. It provides a permanent cure with a low postoperative morbidity risk. The burden of replacement l-thyroxine needs to be discussed with the patients.
A pilot randomized controlled trial of a stepped care intervention package for depression in primary care in Nigeria
(2015) Oladeji, B. D.; Kola, L.; Abiona, T.; Montgomery, A. A.; Araya, R.; Gureje, O.
Background: Depression is common in primary care and is often unrecognized and untreated. Studies are needed to demonstrate the feasibility of implementing evidence-based depression care provided by primary health care workers (PHCWs) in sub-Saharan Africa. We carried out a pilot two-parallel arm cluster randomized controlled trial of a package of care for depression in primary care. Methods: Six primary health care centers (PHCC) in two Local Government Areas of Oyo State, South West Nigeria were randomized into 3 intervention and 3 control clinics. Three PHCWs were selected for training from each of the participating clinics. The PHCWs from the intervention clinics were trained to deliver a manualized multicomponent stepped care intervention package for depression consisting of psychoeducation, activity scheduling, problem solving treatment and medication for severe depression. Providers from the control clinics delivered care as usual, enhanced by a refresher training on depression diagnosis and management. Outcome measures Patient’s Health Questionnaire (PHQ-9), WHO quality of Life instrument (WHOQOL-Bref) and the WHO disability assessment schedule (WHODAS) were administered in the participants’ home at baseline, 3 and 6 months. Results: About 98% of the consecutive attendees to the clinics agreed to have the screening interview. Of those screened, 284 (22.7%) were positive (PHQ-9 score ≥ 8) and 234 gave consent for inclusion in the study: 165 from intervention and 69 from control clinics. The rates of eligible and consenting participants were similar in the control and intervention arms. In all 85.9% (92.8% in intervention and 83% in control) of the participants were successfully administered outcome assessments at 6 months. The PHCWs had little difficulty in delivering the intervention package. At 6 months follow up, depression symptoms had improved in 73.0% from the intervention arm compared to 1.6% control. Compared to the mean scores at baseline, there was improvement in the mean scores on all outcome measures in both arms at six months. Conclusion: The results provide support for the feasibility of conducting a fully-powered randomized study in this setting and suggest that the instruments used may have the potential to detect differences between the arms.
A predominance of hypertensive heart failure in the Abuja heart study cohort of urban Nigerians: a prospective clinical registry of 1515 de novo cases.
(2012) Ojji D.; Stewart, S.; Ajayi, S.; Manmak, M.; Sliwa K.
Aims: Even though cardiovascular disease is gradually becoming the major cause of morbidity and mortality in sub-Saharan Africa, there are very few data on the pattern of heart disease in this part of the world. We therefore decided to determine the pattern of heart disease in Abuja, which is one of the fastest growing and most westernized cities in Nigeria, and compare our findings with those of the Heart of Soweto Study in South Africa. Methods and results: Detailed clinical data were consecutively captured from 1515 subjects of African descent, residing in Abuja, and equivalent Soweto data from 4626 subjects were available for comparison. In Abuja, male subjects were on average, 2 years older than female subjects. Hypertension was the primary diagnosis in 45.8% of the cohort, comprising more women than men [odds ratio (OR) 1.96, 95% confidence interval (CI) 1.26– 2.65], and hypertensive heart failure (HF) was the most common form of HF in 61% of cases. On an age- and sex-adjusted basis, compared with the Soweto cohort, the Abuja cohort were more likely to present with a primary diagnosis of hypertension (adjusted OR 2.10, 95% CI 1.85– 2.42) or hypertensive heart disease/failure (OR 2.48, 95% CI 2.18–2.83); P , 0.001 for both. They were, however, far less likely to present with CAD (OR 0.04, 95% CI 0.02 –0.11) and right heart failure (2.5% vs. 27%). Conclusion: As in Soweto, but more so, hypertension is the most common cause of de novo HF presentations in Abuja, Nigeria.
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.
A Scoping Review of the Health of African Immigrant and Refugee Children
(MDPI, 2021) Salami, B.; Fernandez-Sanchez, H.; Fouche, C. A.; Kwankye, S. O.; Evans, C.; Sibeko, L.; Tulli, M.; Bulaong, A.; Kwankye, S. O.; Ani-Amponsah, M.; Okeke-Ihejirika, P.; Gommaa H.; Agbemenu K.; Ndikom, C. M.; Richter S.
Migration is a growing phenomenon around the world, including within the African continent. Many migrants, especially African children, face challenges related to health and social in-clusion and can face increased health risks. A systematic scoping review of available literature on the health of African migrant children across the globe was conducted to offer insight into these health risks. The review was conducted over a 15-month period from January 2019 to April 2020, yielding 6602 articles once duplicates were removed. This search included electronic databases, reference lists of articles reviewed, and searches of libraries of relevant organisations. A total of 187 studies met the inclusion criteria, of which 159 were quantitative, 22 were qualitative, and 6 used mixed methods. The findings reveal decreased health in this population in areas of nutrition, infectious diseases, mental health, birth outcomes, sexual and reproductive health, physical and developmental health, parasitic infections, oral health, respiratory health, preventative health, endocrine disorders, health care services, and haematological conditions. The findings offer insights into factors influencing the health of African immigrant and refugee children. Further studies, especially qualitative studies, are needed to determine barriers to service access after migration and to investigate other underexplored and overlooked health concerns of African migrant children, including pneumonia and child maltreatment.
A Study of 31 Patients with Primary Complaint of Halitosis in a Tertiary Hospital in South-Western Nigeria.
(College of Medicine, University of Ibadan, 2019) Adeyemi, B.F.; Esan, O. B.; Akinyamoju, A. O.
BACKGROUND: Halitosis is a common cause of dental consultation. Patients presenting with primary complaint of halitosis consist of dissatisfied people with genuine and pseudo-halitosis. OBJECTIVES: To assess the demographic and clinico-pathologic features of patients presenting with primary complaint of halitosis as well as evaluate the treatment outcome. METHODS: Consenting patients presenting with primary complaint of halitosis from 1st of March to 31st August, 2015 were recruited. All had intraoral examination, were screened for psychiatric morbidity and halitosis using the organoleptic method. Data concerning the complaint of halitosis was retrieved from all through an interviewer-administered structured questionnaire. All the patients were educated on the aetiology of halitosis, those with oral disease were treated and all had scaling and polishing, oral hygiene instruction/motivation in addition to hydrogen peroxide mouth rinse for two weeks. Patients’ opinions were sought concerning the presence/ intensity of halitosis at two weeks and six months post treatment. RESULTS: Thirty-one patients with a mean age of 38.48 years and male: female ratio of 1.3 were recruited. Intraoral pathology was observed in 48.4% of patients. None of the patients smoked cigarette or pipe. Twenty patients (64.5%) had been informed of the foulness of their breath by at least one person in the past; the information generated negative feelings in 19 of them. Six patients had psychiatric morbidity which was significantly associated with female gender and presence of body odour. At two weeks post treatment, 54.8% of patients were free of halitosis, while at six months only 25.8% were free. CONCLUSION: The patients who complained of halitosis were non-smokers with a mean age of 38.48±14.0 years. Intraoral pathologies were found in fifteen (15) patients, while six (6) had psychiatry morbidity. About half of the patients and about a quarter were free of halitosis following scaling and polishing and two weeks’ hydrogen peroxide mouth rinse at 2 weeks and 6 months’ reviews, respectively.
A Study of Anxiety on First Time Pregnant Women in Ibadan
(The International Journal of Development Studies, 2008) Olanisimi, B. O.; Ndikom, C. M.
As a result of previous studies that anxiety has deleterious effect on pregnancy, 146 primigradae were tested, on the modified Sarason s General Anxiety scale, at the ante-nata! clinics of the three biggest hospitals in Nigeria. The data generated was analyzed using simple frequency count and percentages. The result indicated that 81% of the primigravidae, representing about 109 of the subjects, were anxious. Similar result was obtained far young, elderly, educated, uneducated and subjects in their second and third trimesters. The counselling implication of the findings includes the need to provide young women with basic childbirth information and counselling before and during pregnancy. Added to this is the need to subject every pregnant woman, who comes far ante-natal clinic, to anxiety test so that remedial action could be taken on those who were found to have anxiety
A survey of traditional and faith healers providing mental health care in three sub-Saharan African countries
(Springer Science + Business Media, 2019) Esan, O.B.; Appiah-Poku, J.; Othieno, C.; Kola, L.; Harris, B.; Nortje, G.; Makanjuola, V.; Oladeji, B.; Price, L.; Seedat, S.; Gureje, O.
Background: Traditional and faith healers constitute an important group of complementary and alternative mental health service providers (CAPs) in sub-Sahara Africa. Governments in the region commonly express a desire to integrate them into the public health system. The aim of the study was to describe the profile, practices and distribution of traditional and faith healers in three sub-Saharan African countries in great need for major improvements in their mental health systems namely Ghana, Kenya and Nigeria. Materials and methods: A mapping exercise of CAPs who provide mental health care was conducted in selected catchment areas in the three countries through a combination of desk review of existing registers, engagement activities with community leaders and a snowballing technique. Information was collected on the type of practice, the methods of diagnosis and the forms of treatment using a specially designed proforma. Results: We identified 205 CAPs in Ghana, 406 in Kenya and 82 in Nigeria. Most (> 70%) of the CAPs treat both physical and mental illnesses. CAPs receive training through long years of apprenticeship. They use a combination of herbs, various forms of divination and rituals in the treatment of mental disorders. The use of physical restraints by CAPs to manage patients was relatively uncommon in Kenya (4%) compared to Nigeria (63.4%) and Ghana (21%). CAPs often have between 2- to 10-fold capacity for patient admission compared to conventional mental health facilities. The profile of CAPs in Kenya stands out from those of Ghana and Nigeria in many respects. Conclusion: CAPs are an important group of providers of mental health care in sub-Saharan Africa, but attempts to integrate them into the public health system must address the common use of harmful treatment practices.
Abdominal paraganglioma in a pediatric patient
(2008) Atalabi, O. M; Lee, E. Y.
Abdominal ultrasonography inHIV/AIDS patients in southwestern Nigeria.
(BioMEd Central Limited, 2008) Obajimi, M. O.; Atalabi, M. O.; Ogbole, G. I.; Adeniji-Sofoluwe, A. T.; Agunloye, A. M.; Adekanmi, A. J.
"Though the major target of the HIV-virus is the immune system, the frequency of abdominal disorders in HIV/AIDS patients has been reported to be second only to pulmonary disease. These abdominal manifestations may be on the increase as the use of antlretroviral therapy has increased life expectancy and improved quality of life. Ultrasonography is an easy to perform, non invasive, inexpensive and safe imaging technique that is invaluable in Africa where AIDS is most prevalent and where sophisticated diagnostic tools are not readily available. Purpose: To describe the findings and evaluate the clinical utility of abdominal uitrasonography in HIV?AIDS patients in Ibadan. Methods:A Prospective evaluation of the abdominal ultrasonography of 391 HIV-positive patients as well as 391 age and sex- matched HIV-negative patients were carried out at the University College Hospital, Ibadan.Results: Of the 391 cases studied, 260 (66.5%) were females; the mean age was 38.02 years, (range 15-66 years). The disease was most prevalent in the 4th decade with an incidence of 40.4%. Compared with the HIV-negative individual group of patients had a significantly higher proportion of splenomegaly (13.5% vs. 7.7%; p < 0.01), lymphadenopathy (2.0% vs. 1.3%; p < 0.70), and renal abnormalities (8.4% vs. 3.8%; p < 0.02). There were no differences in hepatic and pancreatic abnormalities between the HIV+ and HIV- groups. There were significantly fewer gallstones in the HIV+ group (1.4% vs. 5.1%; p < 0.01). Conclusion:AIDS is a multi-systemic disease and its demographic and clinical pattern remains the same globally. Ultrasond optimally suited for its clinical management especially in Africa. Its accuracy and sensitivity may be much improved with clinico-pathologic correlation which may not be readily available in developing countries; further studies may provide much needed diagnostic algorithms. "