FACULTY OF CLINICAL SCIENCES

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    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, A
    Background: 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.
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    The natural history of insomnia in the Ibadan study of ageing
    (Oxford University Press, 2011) Gureje, O.; Oladeji, B.D.; Abiona, T.; Makanjuola, V.; Esan, O.B.
    "Study Objectives: To determine the incidence and risk factors for insomnia among an under-studied population of elderly persons in Sub-Saharan Africa. Setting: Eight contiguous predominantly Yoruba-speaking states in south-west and north-central Nigeria representing about 22% of the national population. Participants: 1307 elderly community-dwelling persons, aged 65 years and older. Measurements: Face-to-face assessment with the Composite International Diagnostic Interview, version 3 (CIDI.3) in 2007 and 12 months later in 2008 to determine the occurrence and risk factors of incident and persistent insomnia, defined as syndrome or symptom. Results: The incidence of insomnia syndrome in 2008 at 12 months was 7.97% (95% CI, 6.60–9.60), while that of insomnia symptom was 25.68% (22.68-28.66). Females were at elevated risk for both syndrome and symptom. Among persons with insomnia symptom or syndrome at the base line, 47.36% (95% CI 43.07–51.68) continued to have it one year later. Decreasing economic status was associated with increasing incidence of insomnia. Persons with chronic medical conditions at baseline were at increased risk for new onset of insomnia. Compared to persons with the lowest body mass index (BMI) (< 18.5), those with higher BMI were at elevated risk for persistence of their insomnia, with those in the obese range (≥ 30) having a 4-fold risk. Conclusions: There is a high incidence and chronicity of insomnia in this elderly population. Persons with chronic health conditions are particularly at risk of new onset as well as persistence of insomnia. "