FACULTY OF CLINICAL SCIENCES
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Item 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, ABackground: 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.Item 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.Item Prevalenc of abnormal bone minieral density in HIV-positive patients in Ibadan, Nigeria(West African College of Surgeons, 2013) Alonge, T. O.; Okoje-Adesomoju, V. N.; Atalabi, O. M.; Obamuyide, H. A.; Olaleye, D.; Adewole, I. F.Background:There have been reports of high rate of abnormal bone mineral densities (BMD) among people living with HIV. Following the introduction of combination antiretroviral therapy (CART) into Nigeria, the country is now home to increasing population of HIV positive patients. There is paucity of data about osteoporosis/osteopaenia and bone mineral density in this population. Aim and Objectives: The aim of the study was to determine the prevalence and determinants of osteopaenia/osteoporosis in a cohort of HIV-positive patients in Nigeria. Patients and methods: The BMD of a group of patients attending the outpatient clinic of the University of Ibadan, Nigeria was assessed using a DXA machine. The relationship of bone mineral density to body weight, CART status, protease inhibitor use, and gender was investigated. Their CD4 counts and viral load were also estimated. Result: A total of 1005 patients participated with a mean age of 41.3 ± 10 years. There were 724 females (72.0%) and 29.7% were single. The median length of diagnosis was 2 years (Range 1-18 years). The Median CD4 count was 371cells/ml and Median viral load was 200 copies/ml. Of this sample, 785 (78.1%) were on CART with 99 (12.6%) on protease inhibitor. The mean body mass index (BMI) was 23.7±4.7 with 9.2% underweight and 10% obese. The prevalence of osteopaenia and osteoporosis were 46.6% and 31.9% respectively, while 19.6% had normal bone mineral density (BMD). Osteoporosis was significantly higher in those aged above 40 years (p= 0.00001), the females (p= 0.022), the single (p=0.028) and the underweight (p=0.0001). There was no significant difference in BMD of those with or without protease inhibitor containing medications as well as treatment naïve patients. Conclusion: A high prevalence of abnormal bone mineral density was found in HIV positive patients in Nigeria. Patient age above 40 years and a body mass index class of underweight were significant associated factors. Routine bone mineral density assessment is recommended as an adjunct in the evaluation of HIV positive patients in Nigeria.Item Prevalence of abnormal bone mineral density in HIV_postive patients in Ibadan, Nigeria(2013) Alonge, T. O.; Okoje-Adesomoju, V. N.; Atalabi, O. M.; Obamuyide, H. A.; Adewole, I. F."Background:There have been reports of high rate of abnormal bone mineral densities (BMD) among people living with HIV. Following the introduction of combination antiretroviral therapy (CART) into Nigeria, the country is now home to increasing population of HIV positive patients. There is paucity of data about osteoporosis/osteopaenia and bone mineral density in this population. Aim and objectives:The aim of the study was to determine the prevalence and determinants of osteopaenia/osteoporosis in a cohort of HIV-positive patients in Nigeria. Patients and methods:The BMD of a group of patients attending the outpatient clinic of the University of Ibadan, Nigeria was assessed using a DXA machine. The relationship of bone mineral density to body weight, CART status, protease inhibitor use, and gender was investigated. Their CD4 counts and viral load were also estimated. RESULTS:A total of 1005 patients participated with a mean age of 41.3 ± 10 years. There were 724 females (72.0%) and 29.7% were single. The median length of diagnosis was 2 years (Range 1-18 years). The Median CD4 count was 371cells/ml and Median viral load was 200 copies/ml. Of this sample, 785 (78.1%) were on CART with 99 (12.6%) on protease inhibitor. The mean body mass index (BMI) was 23.7±4.7 with 9.2% underweight and 10% obese. The prevalence of osteopaenia and osteoporosis were 46.6% and 31.9% respectively, while 19.6% had normal bone mineral density (BMD). Osteoporosis was significantly higher in those aged above 40 years (p= 0.00001), the females (p= 0.022), the single (p=0.028) and the underweight (p=0.0001). There was no significant difference in BMD of those with or without protease inhibitor containing medications as well as treatment naïve patients.CONCLUSION:A high prevalence of abnormal bone mineral density was found in HIV positive patients in Nigeria. Patient age above 40 years and a body mass index class of underweight were significant associated factors. Routine bone mineral density assessment is recommended as an adjunct in the evaluation of HIV positive patients in Nigeria."