FACULTY OF CLINICAL SCIENCES
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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 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.Item Pattern of congenital hand anomalies at a tertiary plastic surgery service in south-western Nigeria: a 10-year, cross-sectional retrospective review(2020) Michael, A.I.; Ademola, S.A.; Olawoye, O.A.; Iyun, A.O.; Oluwatosin, O.M.Context: Although congenital hand anomalies are among the more common musculoskeletal anomalies worldwide, we do not know its prevalence in our practice. Aims: The aim of the study was to determine the pattern of congenital hand anomalies presenting to our tertiary plastic surgery outpatient service in South-Western Nigeria. Materials and Methods: This is a cross-sectional retrospective analysis of outpatient cases of congenital hand anomalies presenting over a 10-year period. Descriptive and inferential statistics were performed using frequencies, Student’s t-test and Chi-square as appropriate. The data were analysed using IBM SPSS Statistics 23.0. The statistical significance value was set at P < 0.05. Results: One hundred and twenty-two cases were identified. The highest number of cases was seen in the year 2012, 23 patients (19.3%). There was a male preponderance of 66 patients (55.1%). Thirty-two patients (26.2%) presented as neonates and 36 (29.5%) as infants. Bilateral anomalies were seen in 67 patients (54.9%). The most common anomaly was failure of differentiation, 88 patients (72.1%) followed by duplication, 26 patients (21.3%). Syndactyly with 43 patients (35.2%) was the most common anomaly under failure of differentiation. No significant associations were found between the type of anomaly and gender or laterality. Conclusions: Syndactyly was the most common congenital hand anomaly in this study. There was a preponderance of bilateral involvement in both syndactyly and polydactyly.Item H3Africa partnerships to empower clinical research sites to generate high-quality biological samples(2020) Croxton, T.; Agala, N.; Jonathan, E.; Balogun, O.; Ozumba, P.J.; Onyemata, E.; Onyemata, E.; Lawal, S.; Mamven, M.; Ajayi, S.; Melikam, S.E.; Owolabi, M.; Ovbiagele, B.; Adu, D.; Ojo, A.; Beiswanger, C.M.; Abimiku, A.Background: The Institute of Human Virology Nigeria (IHVN) – Human Heredity and Health in Africa (H3Africa) Biorepository (I-HAB) seeks to provide high-quality biospecimens for research. This depends on the ability of clinical research sites (CRS) – who provide biospecimens – to operate according to well-established industry standards. Yet, standards are often neglected at CRSs located in Africa. Here, I-HAB reports on its four-pronged approach to empower CRSs to prepare high-quality biospecimens for research. Objectives: I-HAB sought (1) to assess a four-pronged approach to improve biobanking practices and sample quality among CRSs, and (2) to build human capacity. Methods: I-HAB partnered with two H3Africa principal investigators located in Nigeria and Ghana from August 2013 through to May 2017 to debut its four-pronged approach (needs assessment, training and mentorship, pilot, and continuous quality improvement) to empower CRSs to attain high-quality biospecimens. Results: Close collaborations were instrumental in establishing mutually beneficial and lasting relationships. Improvements during the 12 months of engagement with CRSs involved personnel, procedural, and supply upgrades. In total, 51 staff were trained in over 20 topics. During the pilot, CRSs extracted 50 DNA biospecimens from whole blood and performed quality control. The CRSs shipped extracted DNA to I-HAB and I-HAB that comparatively analysed the DNA. Remediation was achieved via recommendations, training, and mentorship. Preanalytical, analytical and post-analytical processes, standard operating procedures, and workflows were systematically developed. Conclusion: Partnerships between I-HAB and H3Africa CRSs enabled research sites to produce high-quality biospecimens through needs