FACULTY OF CLINICAL SCIENCES
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Item Genomic approaches to the burden of kidney disease in Sub-Saharan Africa: the Human Heredity and Health in Africa (H3Africa) kidney disease research network(International Society of Nephrology., 2016) Osafo, C.; Raji, Y. R.; Olanrewaju, T.; Mamven, M.; Arogundade, F.; Ajayi, S.; Ulasi, I.; Salako, B.; Plange-Rhule, J.; Mengistu, Y.; Mc’Ligeyo, S. O.; Moturi, G.; Winkler, C. A.; Moxey-Mims, M. M.; Rasooly, R. S.; Kimmel, P.; Adu, D.; Ojo, A.; Parekh, R. S.; Ademola, A. D.Item Prevalence of precancerous lesions and other cervical abnormalities among internally displaced women in Benue State Nigeria(Pan African Medical Journal(PAMJ), 2024) Ngwibete, A.; Ogunbode, O.; Swende, L. T.; Agbada, M. M.; Omigbodun, A.Introduction: visual inspection is a low-cost screening strategy that can be used to prevent cervical cancer in women. These techniques can improve screening health outcomes for internally displaced women (IDW) who have poor sexual and reproductive health and rights' behaviors and outcomes. This study aimed to determine the prevalence of precancerous lesions and other clinical features using a visual inspection with acetic acid (VIA) technique during a cervical cancer screening campaign in two internally displaced people (IDP) camps in Benue State, Nigeria. Methods: this was a cross-sectional study of 166 IDW who voluntarily participated in the study during a VIA cervical cancer screening campaign in two IDP camps in Benue State, Nigeria the screening was done by a group of qualified and trained healthcare workers and data was collected using a structured, pretested questionnaire. Results: a total of 99(60%) of the women had a first sexual experience at 16 years, while 78(47%) had more than 5 full-term pregnancies. Although only 72(43.4%) of the women acknowledged having more than one sexual partner, over 70% of the women stated that their sexual partner had another sexual partner. The prevalence of precancerous lesions among women was 10.8%. Smoking(p=0.003), age at menarche (p≤ 0.001) and sexual behaviors (p=0.009, p=0.004) were factors that had a statistically significant relationship with the presence of a precancerous lesion among the IDW. The study also highlights the high rate (95%) of cervicitis among the women and the relatively high rate (5.4%) of leukoplakia. Conclusion: the majority of IDW had sociodemographic and lifestyle characteristics that predisposed them to developing cervical cancer More targeted interventions aimed at improving the sociodemographic and lifestyle characteristics of IDW are recommended. In addition, there is a need to create awareness about cervical cancer among IDW and make screening available in camp facilities for early detection and management.Item Understanding the performance of a pan-African intervention to reduce postoperative mortality: a mixed-methods process evaluation of the ASOS-2 trial(Elsevier, 2021) Vickery, N.; Stephens, T.; Toit, L. D.; Straaten, D. V.; Pearse, R.; Torborg, A.; Rolt, L.; Puchert, M.; Martin, G.; Biccard, B. B.; Osinaike, B. B.; Ogunbode, O. O.; Idowu, O.; Lawal, T. A.; Ogundiran, T. O.; Shittu, O. B.; Ayandipo, O. OBackground: The African Surgical OutcomeS-2 (ASOS-2) trial tested an enhanced postoperative surveillance intervention to reduce postoperative mortality in Africa. We undertook a concurrent evaluation to understand the process of intervention delivery. Methods: Mixed-methods process evaluation, including field notes, interviews, and post-trial questionnaire responses. Qualitative analysis used the framework method with subsequent creation of comparative case studies, grouping hospitals by intervention fidelity. A post-trial questionnaire was developed using initial qualitative analyses. Categorical variables were summarised as count (%) and continuous variables as median (inter-quartile range [IQR]). Odds ratios (OR) were used to rank influences by impact on fidelity. Results: The dataset included eight in-depth case studies, and 96 questionnaire responses (response rate 67%) plus intervention fidelity data for each trial site. Overall, 57% (n¼55/96) of hospitals achieved intervention delivery using an inclusive definition of fidelity. Delivery of the ASOS-2 interventions and data collection presented a significant burden to the investigators, outstripping limited resources. The influences most associated with fidelity were: surgical staff enthusiasm for the trial (OR¼3.0; 95% confidence interval [CI], 1.3e7.0); nursing management support of the trial (OR¼2.6; 95% CI, 1.1e6.5); performance of a dummy run (OR¼2.6; 95% CI, 1.1e6.1); nursing colleagues seeing the value of the intervention(s) (OR¼2.1; 95% CI, 0.9e5.7); and site investigators’ belief in the effectiveness of the intervention (OR¼3.2; 95% CI, 1.2e9.4). Conclusions: ASOS-2 has proved that coordinated interventional research across Africa is possible, but delivering the ASOS-2 interventions was a major challenge for many investigators. Future improvement science efforts must include better planning for intervention delivery, additional support to investigators, and promotion of strong inter-professional teamwork.Item Reproductive health challenges among women in internally displaced camps in Benue State: A protocol for a community-based health education interventional study.(2023) Ngwibete, A.; Ogunbode, O.; Oluwasola, T.; Omigbodun, A.Sexual and reproductive health (SRH) services are a necessity for marginalized persons such as the displaced. The protocol describes an intervention that can contribute to overcoming challenges associated with SRH service delivery of three selected reproductive health (RH) services: HIV/AIDS, contraception, and cervical cancer screening. A pre-and post-intervention approach will be used to evaluate the effect of an intervention with trained Community-Based Reproductive Health Personnel (CBRHP) and/or mHealth technology within the selected IDP camps. Three (3) months of health education through the CBRHP and/or via mHealth technology will be provided. Using a questionnaire, interviews, and Focus Group Discussion (FGD) guide, the researcher will assess the suitability of this intervention to attain the objectives. Data analysis will be done with SPSS version 26. Univariate analysis will include mean and standard deviation, bivariate analysis will include a chi-square test of goodness for the association of variables, and McNemer’s test to evaluate the effect of the intervention by comparing consistency in response across the variables under study. Multivariate analysis will be used to assess if sociodemographic, knowledge and health service impacts access and use of RH services. For qualitative analysis, findings will be grouped into themes. The outcomes of each theme will be used to complement the findings of the quantitative analysis. The primary outcome measures will include the level of knowledge of SRH, the number of people who want to access RH services and which RH services are most sought by the respondents. If the use of CBRHP is successful, there will be an increase in knowledge and use of HIV/AIDS, contraception and cervical cancer services. Challenges associated with access and uptake of RH services will also be assessed.Item Endometriosis and associated symptoms among nigerian women(Elsevier Ireland Ltd, 2015) Adeniran, O. F.; Bello, F. A.; Ogunbode, O.; Odukogbe, A. A.; Nkwocha, G. C.; Nnoaham, K. E.; Zondervan, K. T.; Akintan, A.; Abdus-Salam, R. A.; Okunlola, M. A.Objective: To determine the prevalence of endometriosis and identify associated symptoms among Nigerian women. Methods: A cross-sectional study was conducted at a center in Ibadan, Nigeria, between October 2008 and December 2010. All women aged 18–45 years scheduled for their first diagnostic laparoscopy for gynecologic indications were enrolled. Participants completed a previously validated self-administered questionnaire. Endometriosis was diagnosed on the basis of visual evidence. Results: Among 239 women analyzed, 115 (48.1%) had endometriotic lesions. Endometriosis was more common among women reporting dysmenorrhea and pelvic pain than among those not reporting these symptoms (20/28 [71.4%] vs 95/211 [45.0%]; P = 0.009). Women who reported dysmenorrhea were significantly more likely to have endometriosis than were those without dysmenorrhea (90/171 [52.6%] vs 25/68 [36.8%]; P = 0.027). The risk of endometriosis was not significantly increased in women with one pain symptom (odds ratio [OR]1.69; 95% confidence interval [CI] 0.67–4.27), but was significantly increased in women with two (OR 2.70; 95% CI 1.13–6.52) or three (OR 4.87; 95% CI 1.88–12.82) pain symptoms (χ2 trend = 15.5; P b 0.001). In a multivariate logistic regression model, only pain other than dysmenorrhea or dyspareunia independently predicted endometriosis (P=0.017). Conclusion: Endometriosis is fairly common among Nigerian women. Efforts to increase the awareness of endometriosis among the public, researchers, and clinicians are needed.Item Retinopathy of prematurity in a tertiary facility: an initial report of a screening programme(Paediatric Association of Nigeria, 2020) Olusanya, B. A.; Oluleye, T. S.; Tongo, O. O.; Ugalahi, M. O.; Babalola, Y. O.; Ayede, A. I.; Baiyeroju, A. M.Retinopathy of prematurity (ROP) screening in Nigeria is at a nascent stage and at the moment there are no National guidelines for ROP screening in Nigeria. Thus it is desirable for screening programs to report findings amongst screened preterm infants in order to facilitate the development of national ROP screening criteria and guidelines. The aim of this report is to describe the frequency, severity and risk factors for retinopathy of prematurity (ROP) among preterm and very low-birth-weight babies screened within the first year of initiating an ROP screening program at a Nigerian tertiary facility. Methods: A cross-sectional study of infants born at less than 34 weeks gestational age; or with birth weight less than 1500g between May 2016 and May 2017. ROP screening examinations were performed by ophthalmologists with the use of an indirect ophthalmoscope, after pupillary dilation, in collaboration with the neonatology team. Information on gestational age at birth, birth weight, oxygen therapy and presence of other risk factors were recorded and analyzed. Results: A total of 74 infants were screened during the period. There were 36 (48.6%) males. Mean gestational age at birth was 29.6 (±2.35) weeks. Mean birth weight was 1.26 (±0.27) kg with a range of 800 to 1950g. ROP was detected in 9 (12.2%) infants. Two (22.2%) of these had Threshold ROP. There was no significant difference between the mean birth weight and mean gestational age of the infants who had ROP compared to those without ROP. The two infants with Threshold ROP were treated with intravitreal Bevazicumab and had regression of ROP. Conclusion: Retinopathy of prematurity was diagnosed in at risk infants in this facility. There is, therefore, a need to establish ROP screening programs in all neonatal units across the country. In addition, established programs need to evaluate their screening criteria with a view towards developing country-specific screening guidelines.Item Immunization of children in Africa: strides and challenges(Wolters Kluwer - Medknow, 2023-06) Olawuyi, D. A.; Esanju, D. O.; Olowolayemo, S. A.; Asogwa, C. S.; Salako, O. O.; Kolajo, A. E.; Akano, O. S.; Ibekwe, J. P.; Mbey, A. N.; Raji, A. H.Background: The African continent is behind by a wide margin in the childhood vaccination race which contributes significantly to the high childhood morbidity and mortality rate from vaccine-preventable diseases in the continent. Some African countries are still struggling to achieve routine immunization coverage for all recommended expanded program on immunization vaccines. Aim: In this study, we aimed to identify the barriers hindering childhood immunization in Africa and to identify the remarkable progress made so far. Materials and Methods: Peer-reviewed articles published in English that focused on the barriers to childhood immunization in Africa and the progress made so far was reviewed. This was achieved by searching relevant search terms in PubMed, Google Scholar, Wiley Online Library, and CINAHL databases dating back from January 2000 to June 2022. Result: A total of 30 papers were reviewed. The barriers include parents’ education status, economic status, and gender/age; place of birth and place of residence; cultural beliefs and religious affiliations; fear of contracting diseases and lack of trust in health public institutions; vaccine awareness and delivery; and dose-specific delays. The achievements include international support and oriented actions, plans for technological integration and its implementation, and domestic immunization-oriented actions and research work. Conclusion: Childhood immunization is still low in Africa with the majority of the countries yet to realize the global immunization targets. Technologies and immunization-related interventions have been implemented to support Africa but more concerted effort and aid are required to reduce vaccine-preventable deaths to the bare minimum.Item Ocular morbidity among orphans and vulnerable children living in shelters in Ibadan metropolis(Wolters Kluwer - Medknow, 2024) Ajetunmobi, B. S.; Ugalahi, M. O.; Uchendu, O. C.; Baiyeroju, A. M.Globally, orphans and vulnerable children (OVC) represent a significant population at risk of poor health as well as a high risk of developing ocular disorders. These ocular disorders could lead to childhood visual impairment or blindness if left undetected or untreated. This study therefore focuses on ocular morbidity among OVC living in shelter facilities to provide relevant data for planning eye care interventions. Methods: A descriptive, cross-sectional study was conducted among OVC ages 5–16 years living within shelter facilities in Ibadan, Oyo State. Sociodemographic characteristics were obtained. Ocular examinations, including visual acuity measurements, colour vision test, Hirschberg test, anterior and posterior segments assessment, and cycloplegic refraction were conducted. Descriptive and inferential analysis was done with IBM SPSS Statistics version 24. All analyses were at 5% level of statistical significance. Results: A total of 497 eligible OVC participated in the study. The mean age was 11 ± 3.4 years, and 263 (52.9%) were males. The prevalence of ocular morbidity was 18.1%. The most common types of ocular morbidity were refractive errors 47 (9.5%) and allergic conjunctivitis 18 (3.6%), with more females affected by both conditions, 28 (59%) and 11 (61%), respectively. Ocular morbidity was most common (28.3%) among the 14–16 years age group (P=0.001). Conclusion: Refractive errors and allergic conjunctivitis, which are treatable ocular conditions, were the most common ocular morbidities among these children. Regular eye screening as well as the provision of quality and affordable eye care services is advocated for this vulnerable population of children.Item Is couching rare in the pediatric age group? a report of bilateral couching in a child(Wolters Kluwer - Medknow, 2019-12) Ugalahi, M. O.; Ata, A. S.; Olusanya, B. A.; Baiyeroju, A. M.Background: Couching, an ancient procedure for cataract surgery, is unfortunately still being practiced in many developing countries. There are several reports of couching in adult populations; however, literature is sparse on its occurrence in children. Case report: We report a case of a 10-year-old boy who had bilateral couching on account of congenital cataracts due to presumed congenital rubella syndrome. The patient had initially presented to our clinic during neonatal period and was scheduled for surgery. Unfortunately, surgery was not performed due to various reasons which were either patient related or health system related. He represented to the eye clinic 6 years post-couching with complaints of poor vision. Conclusion: This report aims to highlight the fact that couching is, indeed, being performed on children’s eyes, especially as a consequence of inefficiencies in the eye healthcare delivery system.Item Familial cataracts: profile of patients and their families at a child eye care tertiary facility in a developing country(2023) Ugalahi, M. O.; Onebunne, E. O.; Olusanya, B. A.; Baiyeroju, A. M.Purpose: The aim of this study is to describe the clinical profile, pedigree charting, and management of children with familial cataracts at a child eye health tertiary facility in southwest Nigeria. Methods: The clinical records of children ≤16 years diagnosed with familial cataracts at the Pediatric Ophthalmology Clinic, University College Hospital Ibadan (Ibadan, Nigeria) from January 1, 2015, to December 31, 2019, were retrospectively reviewed. Information on demographic data, family history, visual acuity, mean refractive error (spherical equivalent), and surgical management was retrieved. Results: The study included 38 participants with familial cataract. The mean age at presentation was 6.30 ± 3.68 years, with a range of 7 months to 13 years. Twenty-five patients (65.8%) were male. All patients had bilateral involvement. The mean duration from onset of symptoms to presentation at the hospital was 3.71 ± 3.20 years, with a range of 3 months to 13 years. In 16 of the 17 pedigree charts obtained, at least one individual was affected in each generation. The most common cataract morphology was cerulean cataract, observed in 21 eyes (27.6%). The most common ocular comorbidity was nystagmus which was observed in seven patients (18.4%). Sixty-seven eyes of 35 children underwent surgery within the period of the study. The proportion of eyes that had best-corrected visual acuity ≥6 / 18 before surgery was 9.1%; this proportion had increased to 52.7% at the last postoperative visit. Conclusions: Autosomal dominant inheritance appears to be the major pattern among our patients with familial cataract. The most common morphological type found in this cohort was cerulean cataract. Genetic testing and counseling services are vital for the management of families with childhood cataract.