FACULTY OF CLINICAL SCIENCES

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Start date: 2000Subject: search.filters.subject.Ibadan

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    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.
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    Knowledge of Child adoption services in civil servants in Ibadan, Nigeria.
    (Jana Publication and Research LLP, 2019) Nwachukwu, C. C.; Cadmus, E. O.; Owoaje, E.T.
    Adoption provides an alternative for childless couples to have their own children, but the knowledge of this option and its services affects people’s choice. This study assessed the awareness and depth of knowledge of adoption among 403 civil servants working in the Oyo State Secretariat, Ibadan, Nigeria. This was a descriptive cross-sectional study conducted between February and May, 2008. Self-administered questionnaire was used to collect data on socio-demographic characteristics, knowledge of child adoption, laws and services. Each correct knowledge question had a score of 1 and each wrong knowledge question had a score of 0. Total scores were computed for each respondent. Knowledge scores which ranged from 0-5 and from 6-13 were considered low and high, respectively. Descriptive and Chisquare statistics were used for data analysis.Mean age of respondents was 40.2 ± 9.7 years. Sixty five percent had tertiary education, 77.4% were married, and 53.3% were senior civil servants. Majority (91.8%) had heard about child adoption; of these 65.1% could correctly state its meaning. Sixty three percent were aware of adoption services; of these, 33.0% knew where adoption services were provided and 47.3% were aware of adoption laws. Also (41.1%) knew someone that had adopted a child. Overall, 16.9% had high knowledge scores. Respondents who had tertiary education were more knowledgeable about adoption than others (p< 0.05). Majority of respondents were aware of child adoption services but knowledge of the details was low. Efforts should be made to enlighten the public about adoption.
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    Perception and Satisfaction with Midwife-Led Model of Care Among Women in Ibadan, Nigeria
    (West African College of Nursing, 2020) Adebisi, T. M.; Ndikom, C. M.
    Background: Women's preference for natural childbirth and woman-friendly care has made some to patronize unskilled care providers, especially where Midwife-led care is not available which is known to contribute to maternal mortality. Aims: To evaluate women's perception and satisfaction with midwife-led model of maternal health care in Ibadan. Methods: A descriptive cross-sectional design was used. Simple randomization was used to select 367 women and data was obtained using an interviewer- administered questionnaire. Data was analyzed using descriptive and inferential statistics. Results: The mean age was 28.9 ± 6years. Most, 94.3% had good perception of MLMC. The mean satisfaction score was 39.0±5.5 out of a maximum score of 54 and 274(74.7%) claimed they had good experiences with the midwives. The experiences perceived as very important were quality of the caregiver-patient relationship, continuity of care and patient's involvement in decision-making. There was a significant association between level of education and perception of MLMC (fisher's value = 0.010) but there was no significant association between perception and satisfaction (x2= 0.622; p=0.430). Conclusion: Respondents' perception and satisfaction with midwife-led care was good. Midwives need to function more in the management of low risk pregnancies at various levels of health care.
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    Perceived Factors Influencing the Utilization of Traditional Birth Attendants in Akinyele Local Government, Ibadan, Nigeria
    (Association of Public Health Physicians of Nigeria, 2016) Ogunyomi, M. T.; Ndikom, C. M.
    Background: Studies have shown that one of the major causes of maternal death especially in developing countries is unskilled birth attendants at pregnancy and childbirth. The aim of this study is to determine the reasons for the utilization of traditional birth attendants' services among mothers in Akinyele Local Government, Ibadan, Nigeria. Methodology: The study design was cross sectional and interviewer-administered questionnaire was used to elicit information from the women who had ever given birth. Data was collected from the women who attend the post-natal and Immunization clinics in the selected health centres. A total of 130 questionnaires were retrieved and analyzed using statistical package of the social sciences (SPSS) and presented as tables and figures. Two hypotheses were tested using chi-square test p ≤ 0.05 level of significance. Results: The findings revealed that 55.4% have ever utilized the TBA. Significant reasons for patronizing of TBAs by the women were that the TBAs were more user friendly (p= 0.012), were readily accessible (p=0.000) and their belief in them (p=0.000). Poverty (p=0.988) and educational level (p =0.133) were not found to be statistically significant in this study. Conclusion: Effort should be made by care providers and policy makers to ensure that our modern health care services for mothers are more accessible, user friendly with culturally sensitive care.
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    Primary Nursing: an Emerging approach for Nursing Care Delivery In Nigeria
    (University Press PLC, 2009) Ndikom, C. M.
    Health care delivery system has evolved over time as a result of changes in the economy and increasing consumer awareness. This has resulted in many health professions trying various frameworks for delivery of care to ensure cost effective care and consumer satisfaction. Nursing has tried various frameworks of care delivery ranging from task oriented, team nursing, case nursing, Primary nursing etc. Each institution uses the method that is suitable and easily implemented. Of all the methods, primary nursing is the one that seems quite promising in the drive to achieve the goal of providing quality care and client satisfaction. Primary nursing is defined as a management system in which the professional nurse assumes full responsibility for total patient care for a small number of clients. It is seen as a way of thinking and working with patients that challenges out dated traditional nursing hierarchies and support the way forward for professional nursing. Its advantages include consistency and continuity of care, client satisfaction, increased professional autonomy, job satisfaction and improvement in quality of nursing care. The disadvantages are difficulty in implementation, which could result from not having enough adequately prepared nurses who are ready to take up the responsibility Primary nursing framework is yet to be tried and implemented in most hospitals in Nigeria. It has been tried and found suitable where it was tested but it is yet to be embraced by nurses generally in Nigeria. It is emerging in Nigeria, and there is need to increase awareness about this framework so that it can be further explored as it is quite promising in moving nursing forward as it ensures professional autonomy, accountability and job satisfaction for nurses. In conclusion, since this model is a way of moving the profession forward and improving client care, there is need to carry out objective analysis and put modalities in place for the implementation of this model to ensure client satisfaction and job satisfaction as well as professional growth.
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    Impact of axillary node-positivity and surgical resection margins on survival of women treated for breast cancer in Ibadan, Nigeria
    (ecancermedicalscience, 2020) Ayandipo, O. O.; Ogun, G. O.; Adepoju, O. J.; Fatunla, E. O.; Afolabi, A. O.; Osuala, P. C.; Ogundiran, T. O.
    Introduction: Oncologic surgical extirpation, the mainstay of loco-regional disease control in breast cancer, is aimed at achieving negative margins and lymph node clearance. Even though axillary lymph nodal metastasis is a critical index of prognostication, establishing the impact of lymph node ratio (LNR) and adequate surgical margins on disease specific survivorship would be key to achieving longer survival. This study examines the prognostic role of pN (lymph nodes positive for malignancy), LNR and resection margin on breast cancer survival in a tertiary hospital in Ibadan, Nigeria. Methods: We conducted a longitudinal cohort study of 225 patients with breast carcinoma, documented clinico-pathologic parameters and 5-year follow up outcomes – distant metastasis and survival. Chi-square test and logistic regression analysis were used to evaluate the interaction of resection margin and proportion of metastatic lymph nodes with patients’ survival. The receiver operating characteristic curve was plotted to deter mine the proportion of metastatic lymph nodes which predicted survival. The survival analysis was done using Kaplan–Meier method. Results: Sixty (26.7%) patients of the patients had positive resection margins, with the most common immuno-histochemical type being Lumina A. 110 (49%) patients had more than 10 axillary lymph nodes harvested. The mean age was 48.6 + 11.8 years. Tumour size (p = 0.018), histological type (p = 0.015), grade (p = 0.006), resection margin (p = 0.023), number of harvested nodes (p < 0.01), number of metastatic nodes (p < 0.001) and loco-regional recurrence (p < 0.01) are associated with survival. The overall 5-year survival was 65.3%. Conclusion: Unfavourable survival outcomes following breast cancer treatment is multifactorial, including the challenges faced in the multimodal treatment protocol received by our patients.
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    Experience with managing retrosternal goitres in ibadan, Nigeria
    (Wolters Kluwer - Medknow, 2016) Ayandipo, O. O.; Afolabi, A. O.; Afuwape, O. O.; Bolaji, B. E.; Salami, M. A.
    Background: There is no general consensus on the definition of retrosternal goitre however thyroidectomy remains the gold standard of treatment with or without a sternotomy Aim: To review the outcome of surgical management of retrosternal goitres. Methodology: Retrospective review of records of patients who had thyroidectomy for retrosternal goitre over a 15-year period. Results: Out of a total of 45 patients, 34(76%) were females and 11(24%) were males with a male/female ratio of 3:1; while their age ranged between 28 and 72years with a mean of 57+15SD. All the patients were euthyroid and a quarter did not have symptoms apart from a neck mass. In all, 15% of the patients had recurrent goitre. CT scan of neck and chest was done in 31 (72%) patients; while 44 (98%) patients had cervical retrosternal goitres, 1(2%) patient had ectopic retrosternal goitre. A cervical incision was sufficient in 28 (62%) patients while 17 (38%) patients required additional sternotomy. Total thyroidectomy was done in all the patients. There were post-operative complications in 19 (42%) patients. Histopathology showed that 3(6.6%) patients had papillary thyroid carcinoma while 42(93.4%) had benign pathology findings. Conclusion: Surgical removal is the treatment of choice. Most retrosternal goitres can be resected through a collar stud incision; however the possibility of a need for a sternotomy should always be planned. The simultaneous occurrence of cervical and ectopic retrosternal goitre should always be ruled out with a CT scan.
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    Colon and rectal cancer in Ibadan, Nigeria: an update
    (The Association of Coloproctology of Great Britain and Ireland, 2010) Irabor, D. O.; Arowolo, A.; Afolabi, A. A.
    Introduction Colorectal cancer was hitherto a rarity in the rural African in general and in Nigerians inclusive. Ibadan is a sprawling city in Western Nigeria with a population of about 2.5 million inhabitants. Lately, several publications from surgeons in this city have alluded to an increase in the number of colorectal cancer cases managed in the teaching hospital. Objectives To examine the incidence of this disease over 10 years in order to confirm or exclude the apparent significant increase in colorectal cancer cases in Ibadan, Nigeria. Method This is a retrospective study highlighting the age, sex, clinical features, operations performed and histopathological subtypes of patients who had surgery for colorectal cancer in the University College Hospital Ibadan between July 1995 and August 2004. Results Two and sixty-eight patients were seen over 10 years. The male: female ratio was 1.16:1. The mean age was 41 years and the peak age was the 51- to 60-years group. Fourteen per cent of the patients were 30 years and below. Sixty-two per cent of the patients had rectal carcinoma while 33.2% had colonic carcinoma. Around 60.7% of colonic lesions were right-sided. The most common histopathological subtype was adenocarcinoma (78.8%), mucinous adenocarcinoma was 10.8% and signet ring type was 2.6%. Conclusion Colorectal cancer is a disease on the increase in Ibadan. The mean age of 41 years is much lower than in the Western world. The male: female ratio still favours male patients slightly. About one in seven patients are 30 years and below. Adenomatous polyps were absent in the resected specimens.
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    Trends of infant vaccination timeliness and completion in selected urban slum communities in Ibadan, Southwestern Nigeria: A four-year review
    (PLoS ONE, 2023) Balogun F. M.; Bamgboye E. A.; Orimadegun A. E.
    Background Suboptimal infant vaccination is common in Nigeria and multiple interventions have been deployed to address the situation. Child health indicators are reported to be worse in urban slums compared with other urban areas, but urban data are usually not disaggregated to show these disparities. Examining the timeliness and completion of infant vaccination in urban slums is important to determine the effectiveness of existing interventions in improving infant vaccination among this vulnerable population. This study explored the trends of infant vaccination in selected urban slum communities in Ibadan, Southwest Nigeria between November 2014 and October 2018. Methods This was a cross sectional study where infant vaccination data were extracted from the immunization clinic records of six primary health care centers that were providing infant vaccination services for seven urban slum communities. Data was analyzed using descriptive statistics and Chi square test at α = 05. Results A total of 5,934 infants vaccination records were reviewed, 2,895 (48.8%) were for female infants and 3,002(50.6%) were from Muslim families. Overall, only 0.6% infants had both timely and complete vaccination during the four years under study. The highest number of infants with timely and complete vaccination were seen in 2015(12.2%) and least in 2018 (2.9%). Regarding timeliness of the vaccines, BCG, was the least timely among the vaccines given at birth and the pentavalent and oral polio vaccines’ timeliness reduced as the age of the infants increased. Both yellow fever and measles vaccines were timelier than th(12.1%). Those from Muslim families significantly had delayed and incomplete vaccinations compared with those from Chrisitan families (p = 0.026). Conclusion Infant vaccinations were significantly delayed and incomplete in the study communities during the years reviewed. More focused interventions are required to ensure optimal vaccination of the infants. epentavalent vaccines. Vaccines were most timely in 2016(31.3%) and least timely in 2018
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    Stated preferences for human Papillomavirus vaccination for adolescents in selected communities in Ibadan, Southwest Nigeria: A discrete choice experiment
    (2022) Balogun F. M.; Omotade O. O.
    Administration of the human papillomavirus (HPV) vaccine in early adolescence is effective in preventing cervical cancer, a common cancer in sub-Saharan Africa. Nigeria is in the pre-introduction era of the HPV vaccine. Understanding the preferences of the population for the vaccine can help design the HPV immunization program to ensure high uptake of the vaccine. This study explored the preferences for the HPV vaccine among stakeholders in selected communities in Ibadan, Nigeria. A discrete choice experiment survey based on six attributes of the HPV vaccine (which were the number of doses, the efficacy of the vaccine, cost of the vaccine, location of the service point, other benefits of the vaccine apart from prevention of cervical cancer and the odds of a side effect from the vaccine) was carried out in five communities. Data were analyzed using conditional and mixed logit models. Seven hundred community members were recruited, 144 (20.7%) were adolescents and 248 (35.4%) were males. In line with expectations, respondents preferred vaccines with higher efficacy, less severe side effects and lower costs. Preference heterogeneity was identified for adolescents that were less price-sensitive and other community members who were less likely to prefer using schools as the service point. The high socio-economic class preferred a vaccine that also prevents genital warts. There were variabilities in the preferences for the attributes of the HPV vaccine in the study communities. These variabilities need to be considered in the introduction of the HPV vaccine to ensure high uptake of the vaccine.