FACULTY OF PUBLIC HEALTH

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2017Depression after Stroke in Sub-Saharan Africa: A Systematic Review and Meta-Analysis
(Hindawi Behavioural Neurology, 2017) Ojagbemi A.; Akpa O.; Elugbadebo F.; Owolabi M.; Ovbiagele B.
Objective. We aimed to conduct a systematic review and meta-analysis of prevalence and characteristics of poststroke depression (PSD) in sub-Saharan Africa (SSA). Methods. We searched Medline, PsycINFO, and African Journals OnLine using keywords for stroke and depression and the .mp. operator for all 54 SSA countries/regions. Further information was retrieved through a manual search of references from relevant published and unpublished articles. We included only peer-reviewed original studies with epidemiological or experimental designs, conducted random-effect meta-analysis, and identified the most commonly associated factors by weight (inverse of variance method). Results. Seventeen studies, comprising 1483 stroke survivors, met the criteria for syntheses. The pooled frequency of clinically diagnosed PSD was 31% (95% CI = 26%–36%), versus 13.9% in healthy control pairs. Prevalence did not vary much across healthcare settings but was affected by methods of depression ascertainment. PSD was significantly associated with low education, cognitive impairment, physical disability, poor quality of life, and divorced marital status. Conclusion. Almost 1 in 3 individuals with stroke in SSA has clinical depression. Despite limitations around quality of identified studies, results of the present systematic review overlap with findings in the global literature and highlight useful targets for the design and trial of tailored intervention for PSD in SSA
A Bayesian sensitivity analysis of the effect of different random effects distributions on growth curve models
(Statistics and Probability African Society, 2020) Ganjali, M.; Baghfalaki, T.; Fagbamigbe, A. F.
Growth curve data consist of repeated measurements of a contin uous growth process of human, animal, plant, microbial or bacterial genetic data over time in a population of individuals. A classical approach for analyzing such data is the use of non-linear mixed effects models under normality assumption for the responses. But, sometimes the underlying population that the sample is extracted from is an abnormal population or includes some homogeneous sub-samples. So, detection of original properties of the population is an important scientific question of interest. In this paper, a sensitivity analysis of using different parametric and non-parametric distributions for the random effects on the results of applying non-linear mixed models is proposed for emphasizing the possible heterogeneity in the population. A Bayesian MCMC procedure is developed for parameter estimation and inference is performed via a hierarchical Bayesian framework. The methodology is illustrated using a real data set on study of influence of menarche on changes in body fat accretion.
A comparative analysis of condom use among unmarried youths in rural community in Nigeria
(Scientific & Academic Publishing, 2011) Fagbamigbe, A. F.; Adebowale, A. S.; Olaniyan, F. A.
Globally, youths are more sexually active than any subgroup of the population. In Nigeria, the prevalence of condom use among youths is low. This study explored and compared condom use among in-school youths and out-of-school youths in south western Nigeria. This population based study used multistage random sampling technique to select eligible 600 youths aged 15-24 years which included 300 high school students and 300 out-of-school youths in Ekiti West Local Government area of Ekiti state, Nigeria. Descriptive statistics, t-test, chi square test and logistic regression were used for analysis. The mean age of in-school youths and out of school youths were 18.1±2.2 years and 19.0±2.7 years respectively. Overall, 35.5% of all sexually active respondents, 29.8% in-school and 40.8% out-of-school youths reported to have ever used condom during sexual intercourse (p<0.05) The study concluded that although, condom use is low across the study population, but higher among out-of-school youths. Youths aged 15-24 should be given free access to condom particularly the in-school youths.
A comparative analysis of fertility differentials in Ghana and Nigeria
(Women's Health and Action Research Centre, 2014) Olatoregun, O.; Fagbamigbe, A. F.; Akinyemi, O. J.; Yusuf, O. B.; Bamgboye, E. A.
Nigeria and Ghana are the most densely populated countries in the West African sub-region with fertility levels above world average. Our study compared the two countries’ fertility levels and their determinants as well as the differentials in the effect of these factors across the two countries. We carried out a retrospective analysis of data from the Nigeria and Ghana Demographic Health Surveys, 2008. The sample of 33,385 and 4,916 women aged 15-49 years obtained in Nigeria and Ghana respectively was stratified into low, medium and high fertility using reported children ever born. Data was summarized using appropriate descriptive statistics. Factors influencing fertility were identified using ordinal logistic regression at 5% significance level. While unemployment significantly lowers fertility in Nigeria, it wasn’t significant in Ghana. In both countries, education, age at first marriage, marital status, urban-rural residence, wealth index and use of oral contraception were the main factors influencing high fertility levels.
A comparative analysis of the infuence of contraceptive use and fertility desire on the duration of second birth interval in four sub-Saharan African countries
(BioMed Central, 2021) Afolabi, R. F.; Fagbamigbe, A. F.; Palamuleni, M. E.
Background: Fertility decline characterised by inter-birth intervals remains rather slow or stall in many countries of sub-Saharan African (SSA). Non-adherence to optimal inter-birth intervals often occasioned by low prevalence of contraceptive use and high fertility desires often lead to poor maternal and child health outcomes. Additionally, information on the influence of contraception and fertility desire on interval between first and second births (SBI) is rarely available. This study therefore aimed to examine the influence of fertility desire and contraception on SBI among women in four SSA countries. Methods: We analysed cross-sectional data on women aged 15–49 years who participated in the recent Demo graphic and Health Surveys in DR Congo, Ethiopia, Nigeria and South Africa. Semi-parametric Cox proportional hazards regression was employed for the analysis at 5% significance level. Results: The median time to second birth was 34 months in DR Congo; 35 months, Nigeria; 42 months, Ethiopia; and 71 months, South Africa. About 70% of the women desired additional child(ren) and two-thirds have never used contraceptive in both Nigeria and DR Congo. The hazard of second birth was significantly lower among women who desired additional child(ren) compared to desired for no more child in DR Congo (aHR=0.93; CI: 0.89–0.97), Ethiopia (aHR=0.64; CI: 0.61–0.67) and South Africa (aHR=0.51; CI: 0.47–0.55). Women who had never used contraceptive were 12%, 20% and 24% more likely to lengthen SBI than those who were current users in DR Congo, Nigeria and South Africa respectively. DR Congo and Nigerian women were about two times more likely to shorten SBI compared with their South African counterparts. Other significant determinants of SBI include ethnicity, rural residential, age and marital status at first birth, wealth and employment status. Conclusion: Findings showed differentials in the linkage between second birth interval and the desired fertility and contraception by country, demonstrating the importance of context. The contribution of these factors to second birth interval requires country context-specific attention if further decline in fertility and poor health outcomes associated with sub-optimal inter-birth interval is to be attained in SSA.
A cross-sectional study of the knowledge and screening practices of diabetes among adults in a south western Nigerian city
(Pacini Editore SRL, Pisa, Italy, 2021) Osiberu, A. A.; Oluwasanu, M. M.; Omobowale, M.; John Akinola, Y.; Oladepo, O.
Introduction. The control of diabetes depends largely on preventive actions often influenced by knowledge and awareness of the condition, its risk factors, complication, and management. This study assessed the awareness, knowledge, and practices regarding diabetes among adults in two communities in Ibadan, Nigeria. Methods. A community-based cross-sectional study was conducted among five hundred randomly selected non-diabetic respondents, aged 18 to 65 years. Data was collected using the pretested, modified version of the WHO STEPS instrument translated into Yoruba language. Data collected were analysed using descriptive and inferential analysis and the level of significance was set at p < 0.05. Results. Majority of the respondents (89.6%) had previously heard about diabetes. Of these (n = 448), 31.8% were knowledgeable about diabetes and only 28% have ever had their blood glucose level measured by a doctor or other health professionals. Sex and monthly income were statistically associated with respondents’diabetes knowledge while age, religion, monthly income, employment status, marital status, ethnicity and level of education were statistically associated with screening practices (p < 0.05). Monthly income was found to be a significant predictor of the level of knowledge adjusted by sex. Earning N20,000 ($ 52.60) or less had higher odds of being knowledgeable compared to earning no income (OR 0.54, CI 0.35, 0.83). Conclusion. Though Diabetes awareness is high, knowledge gaps and poor screening practices is of concern. This calls for tailored multi-component, community-based, health education interventions.
A model for measuring association between bivariate censored outcomes
(Medwell Journals, 2010) Fagbamigbe, A. F.; Adebowale, A. S.
The dependence between two random variables is completely described by their bivariate distribution. Bivariate sunrival analysis arises in the time to events analysis of measurements that are paired. Although, there are several comistent estimators of the bivariate distribution function, an efficient and consistent estimation has proven to be a difficult problem. It is of interest to determine if it exists, the possible association between pairs of variables, both of which are subject to censoring with recurrence times of kidney infection as a case study. Copula models which is one of the existing methods of measuring the possible association between bivariate cemored variables were reviewed. The overall average recurrence time and its standard deviation are 102 and 131, respectively though the recurrence time in the first kidney has average and standard deviation of 112 and 144.01, respectively whle the average and standard deviation of recurrence time in the second kidney recurrence time is 92 and 117.20, respectively. The study also showed that the modal recurrence time in the 2 kidneys is 42. The correlation between infection recurrence in the pairs of kidneys was found to be 0.268 with 95% confidential interval of (-01854985,07206918).
A qualitative study on stakeholders’ perception of child car safety and acceptability of selected interventions to improve child-passenger safety practices in Ibadan, Nigeria
(Nigerian Medical Association, Rivers State Branch, 2016) Olumide A. O.; Adebayo E. S.; Cadmus E. O.; Folajimi Y.; Amodu O. K.; Balogun F. M.
Background: Child car-passenger safety practices remain low in Nigeria. Findings from the formative phase of a project to deliver an m-health intervention on child-passenger safety to mothers/caregivers attending selected child-immumzation clinics in Ibadan are presented in this paper. The aim of this study was to describe stakeholders’ awareness of child passenger safety measures; to determine the cost of child car seats and acceptability of interventions to improve child-passenger safety practices. Methods: Twenty-four key-informant interviews with traffic enforcement officers (four), physicians (five), and mothers of children (fifteen) ;and a market survey was conducted. Results: Physicians and traffic law enforcement officers were more knowledgeable about child passenger safety measures compared to mothers. Cost of infant seats ranged from N6, 000.00 - N36, 000.00 (USD27.9 - USD167.67) and toddler seats, N6, 000.00 - N81, 000.00 (USD27.95 - USD377.27). Acceptance of a mobile-phone intervention and its accompanying law enforcement was very high. Conclusions: Our findings suggest that an intervention to improve child-passenger safety practices using mobile technology is acceptable to stakeholders in the study area. The intervention should address caregivers’ misconceptions about current child passenger safety measures as this could further enhance compliance with these safety measures.
A random effect logistic regression model of major depressive disorder among ageing Nigerians
(Scientific & Academic Publishing, 2016) Idowu, O. P.; Yusuf, O. B.; Akpa, O. M.; Gureje, O.
Major Depressive Disorder (MDD) is a major public health problem in Nigeria and has severely devastating effects on the elderly. Previous studies on MDD among elderly Nigerians have utilized cross sectional designs which are descriptive in nature and have not investigated differences in setting and time-occurrence of MDD. Therefore this study employed a random effect logistic regression model to determine the relative effects/contributions of individual and environmental factors in the occurrence of MDD. A secondary analysis of a four-year longitudinal data from the Ibadan Study of Ageing was conducted. A total of 2,149 elderly Nigerians participated in the study between 2003 and 2009. The Geriatric Depression Scale was used to assess MDD and consequently classified as “present” for scores ranging from 10 to 30 and “absent” for scores ranging from 0 to 9. A random effect logistic regression model was fitted to determine factors predicting MDD. Odds ratios (OR), 95% confidence intervals, and Intra-class Correlation Coefficients (ICC) for each random effect was estimated. The overall prevalence of MDD was 27.28%. Significant predictors of MDD included “no-contact with family members” (OR=2.9, 95%CI: 1.26-6.70), “no-contact with friends” (OR=1.32, 95%CI: 1.05-1.67)), non-participation in family activities (OR=2.07, 95%CI: 1.63-2.43), non-participation in community activities (OR=1.93, 95%CI: 1.54-2.43), and good quality of health (OR=0.25, 95%CI: 0.15-0.27). Disparities in the occurrence of MDD among the elderly were attributable to enumeration areas (6%) and the individuals (22%). Social isolation factors and self-reported quality of health are significant predictors of MDD among elderly Nigerians.
A randomized, open-label trial of combined nitazoxanide and atazanavir/ritonavir for mild to moderate COVID-19
(Frontiers Media SA, 2022) Fowotade, A.; Bamidele, F.; Egbetola, B.; Fagbamigbe, A. F.; Adeagbo, B. A.; Adefuye, B. O.; Olagunoye, A.; Ojo, T. O.; Adebiyi, A. O.; Olagunju, O. I.; Ladipo, O. T.; Akinloye, A.; Onayade, A.; Bolaji, O. O.; Rannard, S.; Happi, C.; Owen, A.; Olagunju, A.
Background: The nitazoxanide plus atazanavir/ritonavir for COVID-19 (NACOVID) trial investigated the efficacy and safety of repurposed nitazoxanide combined with atazanavir/ritonavir for COVID-19. Methods: This is a pilot, randomized, open-label multicenter trial conducted in Nigeria. Mild to moderate COVID-19 patients were randomly assigned to receive standard of care (SoC) or SoC plus a 14-day course of nitazoxanide (1,000 mg b.i.d.) and atazanavir/ritonavir (300/100 mg od) and followed through day 28. Study endpoints included time to clinical improvement, SARS-CoV-2 viral load change, and time to complete symptom resolution. Safety and pharmacokinetics were also evaluated (ClinicalTrials.gov ID: NCT04459286). Results: There was no difference in time to clinical improvement between the SoC (n = 26) and SoC plus intervention arms (n = 31; Cox proportional hazards regression analysis adjusted hazard ratio, aHR = 0.898, 95% CI: 0.492–1.638, p = 0.725). No difference was observed in the pattern of saliva SARS-CoV2 viral load changes from days 2–28 in the 35% of patients with detectable virus at baseline (20/57) (aHR = 0.948, 95% CI: 0.341–2.636, p = 0.919). There was no significant difference in time to complete symptom resolution (aHR = 0.535, 95% CI: 0.251–1.140, p = 0.105). Atazanavir/ritonavir increased tizoxanide plasma exposure by 68% and median trough plasma concentration was 1,546 ng/ml (95% CI: 797–2,557), above its putative EC90 in 54% of patients. Tizoxanide was undetectable in saliva. Conclusion: Nitazoxanide co-administered with atazanavir/ritonavir was safe but not better than standard of care in treating COVID-19. These findings should be interpreted in the context of incomplete enrollment (64%) and the limited number of patients with detectable SARS-CoV-2 in saliva at baseline in this trial.
A survival analysis model for measuring association between bivariate censored outcomes: validation using mathematical simulation
(Scientific & Academic Publishing, 2017) Fagbamigbe, A. F.; Adebowale, A. S.; Bamgboye, E. A.
Bivariate censored data occur in follow-up studies of events that can result in two different outcomes. Many studies have explored methods for inference about the marginal recurrence times of these outcomes. However, very few have focused on the dependence structures between their occurrences or recurrence times especially when these outcomes are censored as evidence in the current study. This theoretical and empirical study used simulated data to monitor and validate the survival analysis model for measuring association between recurrence times of bivariate censored outcomes. Bivariate outcomes would naturally fall into one of four possibilities: only the first, only the second, none or both conditions occurring with different and distinct likelihoods. Using predetermined correlation coefficients, n=100000 bivariate standardized binormal data were simulated. The simulated data were then subjected to different censoring chances while contributions of the likelihoods of the four possibilities were examined and Maximum Likelihood Estimate (MLE) of the association parameter determined. For the data simulated at 50% censoring, MLE of the association parameter tended to zero as the predetermined correlation coefficients fell from +1.0 to -1.0. However, at 0% censoring, the MLE were approximates of the predetermined correlation coefficients. The developed model was robust as the model responded adequately to the dynamics of the predetermined correlation and censoring conditions. The model would be appropriate in studying associations between two censored survival times.
Academic student satisfaction and perceived performance in the e-learning environment during the COVID-19 pandemic: Evidence across ten countries
(Public Library of Science, 2021) Kerzič, D.; Alex, J. K.; Alvarado, R. P. B.; Bezerra, D. S.; Cheraghi, M.; Dobrowolska, B.; Fagbamigbe, A. F.; Faris, M. E.; Franca, T.
The outbreak of the COVID-19 pandemic has dramatically shaped higher education and seen the distinct rise of e-learning as a compulsory element of the modern educational land scape. Accordingly, this study highlights the factors which have influenced how students perceive their academic performance during this emergency changeover to e-learning. The empirical analysis is performed on a sample of 10,092 higher education students from 10 countries across 4 continents during the pandemic’s first wave through an online survey. A structural equation model revealed the quality of e-learning was mainly derived from service quality, the teacher’s active role in the process of online education, and the overall system quality, while the students’ digital competencies and online interactions with their colleagues and teachers were considered to be slightly less important factors. The impact of e-learning quality on the students’ performance was strongly mediated by their satisfaction with e-learning. In general, the model gave quite consistent results across countries, gender, study fields, and levels of study. The findings provide a basis for policy recommendations to support decision-makers incorporate e-learning issues in the current and any new similar circumstances.
Acceptability of child adoption as management option for infertility in Nigeria: evidence from focus group discussions
(2009) Oladokun, A.; Arulogun, O.; Oladokun, R.; Morhason-Bello, I. O; Bamgboye, E. A.; Adewole, I. F.; Ojengbede, O. A.
Infertility remains a global health challenge with devastating psycho-social consequences in many African communities. Adoption that may serve as an alternative strategy for the affected couples is not widely practiced. This study was conceptualized to assess the acceptability of child adoption as a management option by Nigerians. Twelve focus group discussions were held involving three communities stratified into inner core, transitory and peripheral, within Ibadan metropolis, South-Western Nigeria from May to July 2008. The participants were purposively selected based on gender and age group. The barriers mentioned were cultural practices, stigmatization, financial implications, and procedural bottle-necks. Measures suggested to curb these negative attitudes were advocacy, community mobilization and enactment of supportive law that will protect all parties involved
Access to Information on Family Planning and Use of Modern Contraceptives Among Married Igbo Women in Southeast, Nigeria
(SAGE, 2019) Oluwasanu, M. M.; John-Akinola, Y. O.; Adeyimika T.; Desmennu, A. T.; Oladunni, O.; Adebowale, A. S.
This study was conducted among married Igbo women in Nigeria who have the lowest median birth interval coupled with a culture of sex preference and low use of modern contraceptives. We examined the relationship between access to information on family planning and sex preference on the use of modern contraceptive (MC). The 2013 Nigeria Demographic and Health Survey data were used. The data of 1,661 women of reproductive age were analyzed in this study. Access to information on family planning was low, and almost half (48.6%) of the women had a score of zero. Controlling for possible confounding variables, the data show that women who have good (odds ratio [OR]¼ 3.92; CI [2.28, 6.75], p <.001) and poor (OR ¼ 2.56; CI [1.85, 3.56], p <.001) access to information on family planning were more likely to use MC than those with no access to information on family planning. Sex preference showed no relationship with the use of MC. Families where husbands want more children than their wives inhibit (OR ¼ 0.62, CI [0.42, 0.90], p <.05) the use of MC compared with those families where husbands and wives fertility desire is the same. Public health programs by government and donors should intensify interventions to increase access to family planning information to promote the use of MC among married Igbo women.
Access to the Intensive Care Unit by Severe Head Injury Patients
(Scientific Scholar, 2019) Balogun J. A.; Akwada O.; Awana E.; Balogun F. M.
Background The management of severe traumatic brain injury is directed at avoidance of secondary brain injuries. The intensive care unit (ICU) provides the ideal environment to achieving improved survival and functional outcome. The study sets out to identify the factors that determine the access of patients with severe head injury presenting at our hospital, to the ICU and their impact on outcome. Materials and Methods This was a longitudinal study at the University College Hospital, Ibadan. Data of all consecutive severe head injury patients over a 9-month period, presenting to the accident and emergency department, was collected and analyzed using descriptive statistics and chi-squared test. The level of significance was p < 0.05. Result There were 36 males (80.0%) in our study, with road crashes (25; 79.5%) as the most common mechanism of injury. Most patients (33; 73.3%) were transferred to our center after initial care in another hospital. Though 31(68.9%) patients had access to the ICU, they were all delayed, with the most common reason for the delay being lack of ICU space. More patients who got admitted into ICU (14; 45.2%) were alive at 28 days into admission (p = 0.04). The females (6; 13.3%) significantly survived till 28 days on admission compared with males (p = 0.03), but there was no difference in the survival rates between children and adults. Conclusion Our study underscores the need for ICU admission in these patients to optimize outcome and identify the non-availability of beds, as the most important cause of delayed access, as well as the need for increased manpower capacity and organized resource utilization.
ADHERENCE TO CURRENT GUIDELINES ON PRESCRIPTION OF ANTIMALARIALS AND ASSOCIATED FACTORS AMONG HEALTHCARE PROVIDERS IN LOKOJA LOCAL GOVERNMENT AREA, KOGI STATE, NIGERIA
(2015-04) WELLE, Sylvanus Chima
Adherence to current treatment guidelines on prescription of antimalarials by healthcare providers can promote better malarial treatment outcomes. However, adherence rate and factors influencing adherence to treatment guidelines have not been well explored. This study was carried out to assess adherence to current guidelines on prescription of antimalarials and associated factors among healthcare providers in Lokoja Local Government Area, Kogi State, Nigeria. The study was cross-sectional in design. A total of 404 healthcare providers aged 18-65 years were selected through proportional allocation from public health facilities and patent medicine stores. Using a semi-structured, interviewer-administered questionnaire, data were collected on socio-demographic characteristics of respondents, knowledge and training on current guidelines and prescription practice. Adherence was defined as correct prescription of artemisinin-based combination therapy for uncomplicated malaria in a child and adult. Knowledge of current guidelines was assessed on a 5-point scale and scores ≥3 were categorised as good knowledge while scores <3 were categorised as poor. Data were analysed using descriptive statistics, Chi-square test and logistic regression with significance level set at 0.05. Mean age of respondents was 36.9 years (SD = 9.2 years). Respondents comprised of nurses (36.6%), patent medicine vendors (30.0%), doctors (18.3%), community health extension workers (9.7%), pharmacists (3.2%) and community health officers (2.2%). Over half (53.0%) were males and about three-quarters (74.4%) were married. Half (50.0%) had good knowledge of the guidelines of which 34.2% were doctors and 4.0% each were community health officers and pharmacists. A total of 270 (66.8%) of respondents claimed they requested for confirmatory test before treatment of malaria. In all, 54.2% had been trained on the guidelines of which 36.1% were patent medicine vendors while only 1.4% was pharmacists. Overall adherence to guidelines on anti-malaria prescription was 39.6%. The adherence among doctors was 67.6%, community health officers (55.6%), pharmacists (19.8%). Respondents who were trained on the guidelines were twice more likely to adhere to guidelines. (AOR=2.28; CI=1.41-3.69) while respondents with good knowledge were four times more likely to adhere to guidelines compared to those with poor knowledge (AOR=3.99; CI=2.39-6.69). Knowledge of and adherence to current guidelines on antimalarials prescription was generally low in Lokoja among community health officers, nurses, pharmacists and patent medicine vendors in the study. Government should train these categories of health care providers to improve their knowledge and adherence to the guidelines. Keywords: Treatment guidelines, Antimalarial prescription, Health care providers, Malaria confirmatory test. Word count: 384
Adolescent Friendly Health Services
(Rhyce Kerex, 2022) Balogun, F. M.
Advocacy for diabetes & other non-communicable diseases
(Nigerian Medical Association, 2014) Chinenye, S.; Onyemelukwe, G. C.; Johnson, T. O.; Oputa, R. N.; Oluwasanu, M.; Ogbera, A. O.
African Ancestry, APOL1, candidate genes, CDKN2A/CDKN2B, HDAC9, small vessel disease, stroke, West Africa
(John Wiley & Sons Ltd, 2017) Akinyemi R.; Tiwari H. K.; Arnett D. K.; Ovbiagele B.; Irvin M. R.; Wahab K.; Sarfo F.; Srinivasasainagendra V.; Adeoye A.; Perry R. T.; Akpalu A.; Jenkins C.; Arulogun O.; Gebregziabher M.; Owolabi L.; Obiako R.; Sanya E.; Komolafe M.; Fawale M.; Adebayo P.; Osaigbovo G.; Sunmonu T.; Olowoyo P.; Chukwuonye I.; Obiabo Y.; Onoja A.; Akinyemi J.; Ogbole G.; Melikam S.; Saulson R.; Owolabi M.
Objective: Worldwide, the highest frequencies of APOL1-associated kidney variants are found in indigenous West Africans among whom small vessel disease (SVD) is chemic stroke is the most common stroke phenotype. The objective of this study was to investigate the association and effect sizes of 23 selected SNPs in 14 genes of relevance, including the APOL1 G1 variants, with the occurrence of SVD ischemic stroke among indigenous West African participants in the Stroke Investigative Research and Education Network (SIREN) Study. Materials and Methods: Cases were consecutively recruited consenting adults (aged 18 years or older) with neuroimaging—confirmed first clinical stroke. Stroke-free controls were ascertained using a locally validated version of the Questionnaire for Verifying Stroke-Free Status (QVSFS). Logistic regression models adjusting for known vascular risk factors were fitted to assess the associations of the 23 SNPs in rigorously phenotyped cases (N = 154) of SVD ischemic stroke and stroke-free (N = 483) controls. Results: Apolipoprotein L1 (APOL1) rs73885319 (OR = 1.52; CI: 1.09-2.13, P value = .013), rs2383207 in CDKN2A/CDKN2B (OR = 3.08; CI: 1.15-8.26, P – value = .026) and rs2107595 (OR = 1.70; CI: 1.12-2.60, P-value = .014) and rs28688791 (OR = 1.52; CI: 1.03-2.26, P-value = .036) in HDAC9 gene were associated with SVD stroke at 0.05 significance level. Polymorphisms in other genes did not show significant associations. Conclusion: This is the first report of a specific association of APOL1 with a stroke subtype. Further research is needed to confirm these initial findings and deepen understanding of the genetics of stroke in people of African ancestry with possible implications for other ancestries as all humans originated from Africa
An assessment of the nutritional status of ART receiving HIV-orphaned and vulnerable children in South-West Nigeria
(Elsevier Ltd, 2019) Fagbamigbe, A. F.; Adebowale, A. S.; Ajayi, I.
Introduction: Good nutritional status is pertinent to the optimal outcome of effective ART among children. Against this backdrop, the objective of the current study is to assess the nutritional indices of children receiving ART in South-West Nigeria. Methods: The study was cross-sectional in design. We randomly selected three urban and six rural ART sites from the ones offering ART services in Oyo state. All consented children receiving ART treatments in the aforementioned sites participated in the study. A total of 390 HIV-positive children and adolescents aged 6–18 years were interviewed using a semi-structured interviewer-administered questionnaire. Children were assessed and growth curves were constructed using the 2007 World Health Organisation (WHO) growth reference standard for children as well as adolescents. Data were presented using descriptive statistics. Results: About 52% of the children are male, 136 (34.9%) have lost at least one parent, 52 (13.3%) have lost either parent to HIV/AIDS. Among the males, 19%, 27%, and 27% were underweight, stunted and thin, respectively when compared with 17%, 23% and 23%, respectively, among females. The male and female weight-for-age average z-score were (-0.98 vs -1.04), height-for-age (-1.12 vs -1.07), and BMI-for-age (-1.19 vs -1.18). Irrespective of age, sex, parental survival, and residence, weight-for-age and BMI-for-age analysis revealed substantial underweight, with the worst outcomes being among those orphaned by HIV/AIDS. Conclusion: All nutritional indices considered in this study fell short of the WHO standard. HIV positive children in the ART sites included in this study are faced with a high burden of undernourishment despite been placed on daily ART regimens. In addition to efficient ART, interventions to ameliorate poor nutritional status is needed.