FACULTY OF CLINICAL SCIENCES

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Start date: 2000

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    Psychiatric morbidity among pregnant and non-pregnant women in Ibadan, Nigeria.
    (Taylor & Francis, 2023) Bello, O.B.; Bella-Awusah, T.T.; Adebayo, A.M.; John Akinola, J.O; Ndikom, C.M.; Ilori, T.; Cadmus, E.O.; Omokhodion, F.
    A comparative cross-sectional study was conducted among 991 pregnant and 674 non-pregnant women of reproductive age attending healthcare facilities in Ibadan, Nigeria using the General Health Questionnaire-12 (GHQ), and WHO self-reporting questionnaire (SRQ). Logistic regression analysis was conducted to identify predictors of psychiatric morbidity at p<0.05. A significantly higher proportion of pregnant women experienced psychological distress on the GHQ (51.8%) and psychiatric morbidity on SRQ (33.3%) compared with 28.6% and 18.2% of non-pregnant women, respectively. Predictors of psychiatric morbidity among pregnant women were the type of facility, poor satisfaction and communication with partners, the experience of violence in the home, previous abortions, and previous history of depression. Psychiatric morbidity among non-pregnant women was predicted by younger age, previous history of depression, poor satisfaction and communication with partners. There is a need for early identification of psychiatric morbidity among women of reproductive age, to ensure early interventions and prevent long-term disability.
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    Predictors of Shisha use among Medical and Dental Students in Ibadan, Nigeria
    (College of Health Sciences, Obafemi Awolowo University, 2022) Fagbule, O.F.; Cadmus, E.O.
    Background: Shisha is a form of smoked tobacco product. Medical trainees arepotential stakeholders in providing accurate information about shisha and discouraging its use. However, few studies have targeted medical trainees to provide much‑needed information for policymaking and planning of programs. Aim: To determine the prevalence and predictors of shisha use among medical and dental students in Ibadan, Nigeria. Subjects and Methods: A cross‑sectional study was conducted among medical and dental students (n = 252) of the University of Ibadan, selected using the stratified random sampling technique. The Global Health Profession Students Survey (GHPSS) questionnaire was used to obtain information about socio‑demographics, shisha and other tobacco use, and knowledge and attitude towards shisha use. The data were analyzed using Statistical Package for the Social Sciences (SPSS) version 25. Continuous data were presented using mean and standard deviation, whereas categorical variables were reported as proportions. The association between the outcome variable (shisha use) and independent variables (sociodemographic characteristics, having friends who use shisha) was measured using Pearson’s Chi‑square test, and factors significant (P < 0.05) were entered into the multivariable logistic regression model. Result: The mean age (± SD) was 21.7 (± 3.1) years. Over half [136 (54%)] were males, and most [199 (79%)] were medical students. About 28 (11%) were not aware of shisha, whereas 22 (8.7%) reported they had ever used shisha. The mean knowledge score was 5.6 ± 4.7, and 76 (33.9%) supported shisha use. Positive predictors of shisha use included the male gender [OR: 6.4 (95% CI: 1.76–23.10)] and having a friend who uses shisha [OR: 28.2 (95% CI: 5.49–144.23)]. Conclusion: The prevalence of shisha use among medical and dental students in Ibadan is unacceptably high, although low compared to other countries in similar resource settings. Surprisingly, the students had poor knowledge about shisha, and over a third supported its use, especially males who were more prone to use it. There is a need to design targeted health promotion and education for the students, especially males.
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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.
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    Qualitative exploration of health system response to COVID-19 pandemic applying the WHO health systems framework: Case study of a Nigerian state
    (Elsevier, 2021) Akinyemi, O.O.; Popoola, O.A.; Fowotade, A.; Adekanmbi O.; Cadmus, E.O.; Adebayo. A. M.
    Pandemics can result in significantly high rates of morbidity and mortality with higher impact in Lower- and Middle-Income Countries like Nigeria. Health systems have an im- portant role in a multi-sector response to pandemics, as there are already concerns that COVID-19 will significantly divert limited health care resources. This study appraised the readiness and resilience of the Nigerian health system to the COVID-19 pandemic, using Oyo State, southwest Nigeria, as a case study. This study was a cross-sectional qualita- tive study involving key informant and in-depth interviews. Purposive sampling was used in recruiting participants who were members of the Task Force on COVID-19 in the state and Emergency Operations Centre (EOC) members (physicians, nurses, laboratory scientists, "contact tracers", logistic managers) and other partners. The state's health system response to COVID 19 was assessed using the WHO health systems framework. Audio recordings of the interviews done in English were transcribed and thematic analysis of these tran- scripts was carried out using NVIVO software. Results show that the state government re- sponded promptly by putting in place measures to address the COVID-19 pandemic. How- ever, the response was not adequate owing to the fact that the health system has already been weakened by various challenges like poor funding of the health system, shortage of human resources and inadequate infrastructure. These contributed to the health system's sub-optimal response to the pandemic. In order to arm the health system for adequate and appropriate response during major health disasters like pandemics, fundamental pillars of the health system-finance, human resources, information and technology, medical equip- ment and leadership - need to be addressed in order to have a resilient health system.
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    Rural–urban differences in quality of life and associated factors among community-dwelling older persons in Oyo state, South-Western Nigeria.
    (Rural–urban differences in quality of life and associated factors among community-dwelling older persons in Oyo state, South-Western Nigeria., 2021) Cadmus, E. O; Adebusoye, L. A.; Owoaje, E.T
    Aim The decline of health and functional status as a result of old age makes it necessary to assess the Quality of Life (QoL) among older persons. There is, however, limited information in this regard from low and middle-income countries such as Nigeria. This study compares the QoL and associated factors among rural and urban community-dwelling older persons (≥ 60 years) in Oyo State, Nigeria. Subject and methods A cross-sectional, comparative community-based study was carried out using an interviewer administered, semi-structured questionnaire. The QoL was determined using the World Health Organisation Quality of Life Brief Scale (WHOQOLBREF). Data were analysed using Stata version 14 at p < 0.05. Results Overall, 1,180 (588 urban and 592 rural-dwelling) respondents were interviewed. Females constituted more than half of the respondents in both communities, accounting for over two thirds (69.2%) of the population. The mean QoL scores were similar in the psychological (54.2 ± 7.4) and environmental (54.7 ± 9.5) domains. However, the mean score for the physical domain was 69.2 ± 17.0 and 74.1 ± 12 for the social domain. There was no statistically significant difference between mean scores of the QoL in the two locations except in the environmental domain (p < 0.05). Good self-rated health was a common positive predictor of higher mean scores across the four domains in both the rural and urban settings (p < 0.05). Conclusion The rural–urban differences in the mean quality of life scores in the environmental domain in the study and poorer scores in the psychological and environmental domains necessitate areas for targeted intervention and more in-depth research
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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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    Attitude towards ageing and perceived health status of community-dwelling older persons in a low resource setting: a rural-urban comparison
    (BioMed Centra, 2021) Cadmus, E. O.; Adebusoye, L. A.; Owoaje, E. T.
    Background: Older person’s attitude to ageing is critical for their adjustment, acceptance of health-related behaviour, survival and choices. Their attitude influences how they cope with the challenges experienced while ageing, which affects their quality of life and health-related outcomes. Despite the increasing number of older persons in sub-Saharan Africa, there is limited information about their experience. This study examines the experience and attitude of older persons in Nigeria regarding the ageing process. Methods: A descriptive cross-sectional study among older persons aged 60 years and above was carried out in a selected rural and an urban community in Oyo State, south-western Nigeria. The study participants were selected using a multi-stage sampling technique. Trained research assistants collected data with the aid of an interviewer administered, semi-structured questionnaire. The Attitude to Ageing Questionnaire (AAQ) was used to measure participants’ perception of ageing in three domains (psychosocial loss, physical changes and psychological growth). Data were analysed using Stata version 14 at a level of significance p < 0.05. Results: A total of 1,180 participants (588 rural vs. 592 urban) were recruited for the study. The mean age was 73.2 ± 9.3 years. The majority (69.7 %) were females and still working (50.5 %). Overall, urban-dwelling participants had a better attitude to the ageing process in all the domains compared with rural-dwelling participants (psychological growth 32.5 ± 3.4 vs. 32.4 ± 3.3, p = 0.30; physical change 27.5 ± 5.1 vs. 26.9 ± 5.0, p = 0.03; and psychosocial loss 25.3 ± 5.7 vs. 25.0 ± 5.3, p = 0.60). Among the rural and urban-dwelling participants, good self-rated health was significantly associated with a positive attitude to ageing across the domains. Conclusions: Older persons residing in urban communities had higher positivity to ageing than their rural older counterparts. The common factor significantly associated with a positive attitude to ageing in both groups was good self-rated health. This information can be used for the planning of targeted interventions and informing policy formation for improved provisions for community-dwelling older persons in Nigeria and other sub-Saharan African countries.
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    Correlates of quit intentions among current Nigerian smokers: Evidence from the 2012 Global Adult Tobacco Surveys (GATS).
    (European Publishing (on behalf of the European Network for Smoking and Tobacco Prevention - ENSP), 2020) Iken, O.; Cadmus, E.O.; Ahmed, B
    INTRODUCTION Approximately 3.1 million people use tobacco in Nigeria contributing to the burden of tobacco-related morbidity and mortality. However, many tobacco users who have tried to quit have been unable to do so at the first try, but may succeed or give up after multiple attempts. The transtheoretical model helps by classifying those with quit intentions into preparation, contemplation and precontemplation stages. These assist in the development of targeted interventions towards smokers in each stage for more effective results. There is limited evidence about cessation and quitting behaviour in the Nigerian context. This study aimed to explore the factors related to the intention to quit among current tobacco smokers in Nigeria using the transtheoretical model. METHODS The study was a secondary data analysis of the Nigeria 2012 Global Adult Tobacco Survey (GATS). The survey included non-institutionalized men and women aged ≥15 years. Data were analysed using SPSS version 21. The primary outcome variable was smoking quit intention. The correlates of quit intentions were determined for a p<0.05. RESULTS A total of 429 current smokers were mostly in precontemplation (64.7%) while 14.9% were in the preparation stage. Exposure to anti-tobacco media messages was associated with increased quit attempts, however, knowledge about the harmful effects of tobacco was associated with fewer quit intentions. Very few had access to cessation therapy and none had accessed a quitline. Male respondents were 9 times more likely to have a quit intention compared to females (OR=9.615; 95% CI: 1.449–1.478). Respondents with primary education were nearly three times more likely to have quit intentions than those with tertiary education (OR=2.991; 95% CI: 2.930–3.053). CONCLUSIONS While attention is on smoking prevention, most smokers in Nigeria are not considering quitting. There is a need for targeted interventions to reach smokers at various stages.
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    Insights into the gut microbiota of Nigerian elderly with type 2 diabetes and non-diabetic elderly persons.
    (U.S. Department of Health and Human Services., 2020) Afolayan, A.; Adebusoye, L.; Cadmus, E.O.; Ayeni, F
    Type 2 diabetes (T2D) is a prevalent non-communicable disease among the world's growing elderly population. The contribution of the gut microbiota to T2D in several Westernized countries has been established. However, there is little information on the role of the gut microbiota in T2D from the African continent where lifestyle and life expectancy are different. Aims: This study sought to investigate gut microbiota variation in relation to elderly people living with T2D. in Nigeria. Methods: Whole microbial community DNA were derived from the stool samples of healthy urban-dwelling elderly individuals and urban-dwelling elderly individuals with T2D. The V4 region of the 16S rRNA gene was Illumina- sequenced and analyzed using QIIME2. Results: Beta taxonomic diversity was significantly different between healthy elderly individuals and elderly in- dividuals with T2D. However, no difference in the alpha taxonomic diversity and predicted functional alpha diversity of the gut microbiota was observed. The genus Ruminococcus (T2D versus Healthy: 2.89% vs 2.21%), families Coriobacteriaceae (Collinsella, T2D versus Healthy: 2.62 % vs 1.25%) and Bifidobacteriaceae were enriched in elderly individuals with T2D, while members of Clostridiaceae (Clostridium, Healthy versus T2D: 5.6% vs 3.2%) and Peptostreptococcaceae (Healthy versus T2D: 3.45% vs 1.99%) were enriched in healthy volunteers. Pathways involved in amino acid biosynthesis were enriched in elderly individuals with T2D, while pathways involved in respiration and the biosynthesis of vital building blocks were enriched in healthy volunteers. Conclusions: The study demonstrated for the first time in an African elderly population that the abundance of Bifidobacteriaceae, Collinsella, and Ruminococcus within the gut varies in relation to T2D. Findings from this study suggest that the restoration of features associated with healthiness via the way of gut microbiota modification could be one step needed to improve elderly patient care.
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    Acceptability of Child Adoption and adoption services among civil servants in Ibadan, Nigeria
    (Pan African Medical Journal (PAMJ), 2020) Nwachukwu, C. C.; Cadmus, E. O.; Nwachukwu, A. C.; Adebayo, A. M.; Owoaje, E. T.
    Child adoption provides an opportunity for children to have new families and for parents to have children. Its acceptance by the society, however, may affect people’s decision to adopt. This study was conducted to determine the attitude and acceptability of child adoption and adoption services among 403 civil servants in Oyo State Secretariat, Ibadan in February and May, 2008.Self-administered questionnaire was used to collect data. Likert scale of score range 1-5 was used to measure respondents’ attitudes. Each positive attitude answer was given a score of 5, while each negative attitude answer had a score of 1. Total scores were computed for each respondent. Attitudinal scores within the range of 16-50 and 51-80 were considered negative and positive respectively. The mean age of respondents was 40.2 ± 9.7 years. Sixty five percent had tertiary education. Overall, 45.9% had positive attitude to adoption. A higher proportion of respondents who had tertiary education (56.3%) were supportive of adoption compared to the others. About 65.0% would support or encourage a relation to adopt a child while 68.5% would recommend adoption to a childless couple. Males, (57.2%), were more willing to support a relation who would like to adopt compared with females, (65.6%). The main reason for non-support of adoption by 32.4% of respondents was that they believed that the childless couples would have their biological children. Efforts should be made to improve the acceptability of adoption.