FACULTY OF PUBLIC HEALTH
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Item Utilisation of modern contraceptive among women of childbearing age in resource constraint setting: evidence from 2008 national demographic and health survey in Nigeria(Scientific & Academic Publishing, 2014) Igbodekwe, F. C.; Oladimeji, O. O.; Oladimeji, K. E.; Adeoye, I. A.; Akpa, O. M.; Lawson, L.Nigerian women are known to have high fertility rates and a low utilization of modern contraceptives. Understanding the factors affecting the use of contraceptives using a nationally representative data is crucial to tackling the low prevalence of contraceptive use in Nigeria. Methods: Secondary dataset of 33,385 women aged 15-49 years, who participated in the 2008 National Demographic and Health Survey was analysed. We calculated contraceptive prevalence rates for various population sub-groups, and examined the association between socio-demographic characteristics and current modern contraceptive use, using multiple logistic regressions. Results: Mean age of the respondents was 31.1±8.8 years. Current contraceptive prevalence rate was 13.2%, while that of modern methods was 9.4%. The significant factors associated with the utilization of contraceptives were urban residence (OR=1.22, 95%CI=1.11-1.35), being a working class woman (OR=1.22, 95%CI=1.11-1.35), being educated (OR=1.22, 95%CI=1.11-1.35), parity (OR=1.22, 95%CI=1.11-1.35), being wealthy (OR=2.62, 95%CI=2.14-3.21). Importantly, the likelihood utilization varied across the gradient of wealth. Women in richest (OR=2.62, 95%CI=2.14-3.21), richer (OR=2.44, 95%CI=2 .02-2.94), and middle (OR=1.78, 95%CI=1.48-2.14) wealth quintiles were more likely to use modern method compared to women in the poorest category. Conclusions: Prevalence rates were very low across virtually all segments of the population. Concerted efforts are required to increase use of modern methods of contraception.Item Perceptions and recommendations by scientists for a potential release of genetically modified mosquitoes in Nigeria(Biomed Central Ltd, 2014) Okorie, P. N.; Marshall, J. M.; Akpa, O. M.; Ademowo, O. G.Background: The use of genetically modified mosquitoes (GMMs) for the control of malaria and other mosquito-borne diseases has been proposed in malaria-endemic countries, such as Nigeria, which has the largest burden in Africa.Scientists are major stakeholders whose opinions and perceptions can adversely affect the success of the trials of GMMs if they are not involved early. Unfortunately, information on the awareness of Nigerians scientists and their overall perception of the GMMs is practically non-existent in the literature. Therefore, this study aimed at understanding how receptive Nigerian scientists are to a potential release of GMMs for the control of malaria. Methods: The sample consisted of 164 scientists selected from academic and research institutions in Nigeria. Data were collected from participants using a semi-structured, self-administered questionnaire. Questions were asked about the cause and prevention of malaria, genetic modification and biotechnology. Specific questions on perception and acceptable conditions for the potential release of GM mosquitoes in Nigeria were also covered. Results: All participants cited mosquitoes as one of several causes of malaria and used various methods for household control of mosquitoes. The main concerns expressed by the scientists were that GMMs can spread in an uncontrolled way beyond their release sites (89%) and will mate with other mosquito species to produce hybrids with unknown consequences (94.5%). Most participants (92.7%) agreed that it was important that before approving the release of GMMs in Nigeria, there had to be evidence of contingency measures available to remove the GMMs should a hazard become evident during the course of the release. In general, a majority (83.5%) of scientists who participated in this study were sceptical about a potential release in Nigeria, while 16.5% of the participants were in support. Conclusions: Although a majority of the participants are sceptical about GMMs generally, most encourage the use of genetic modification techniques to make mosquitoes incapable of spreading diseases provided that there are contingency measures to remove GMMs if a hazard becomes evident during the course of the release.Item Modeling the determinants of fertility among women of childbearing age in Nigeria: Analysis using generalized linear modeling approach(Brooklyn Research and Publishing Institute (BRPI), 2012) Akpa, O. M.; Ikpotokin, O.Apart from proximate determinants, certain sociodemographic factors have been reported to inform fertility in some developing nations but a comprehensive report for Nigeria is lacking in the literature. This study tested effects of some determinants of fertility on the level of fertility in Nigeria using data from the 2008 Nigerian Demographic Health Survey (NDHS). Data on 20,974 women were extracted from the 2008 NDHS data and analyzed using descriptive statistics and Poisson regression. Women with no education and those with secondary school education had 1.36 times risk and 17% increases in fertility (respectively) over those with higher education. Rural women were 1.02 times more likely to be at risk of high fertility compared to women in urban areas. Fertility level in Nigeria is higher in the rural areas than in the urban areas while level of education of women negatively impacted on their risk of having high fertility.Item Seroprevalence of HIV/AIDS and HIV risk factors among prison inmates in Ogun State, Nigeria.(Elsevier Urban & Partner, 2012) Muhammeda, O. T.; Akpa, O. M.; Atilola, G. O.; Komolafea, I. O. O.Background: Prevalence of HIV in Ogun State has remained low since the history of HIV infection in Nigeria. Nevertheless, there have been evidences of higher HIV prevalence in some populations within the state but studies among inmates in the state have not been comprehensive. In the present study, we report data to bridge this gap in knowledge. Methods: A total of 340 inmates comprising of 101 and 239 consenting inmates from the Sagamu and the Abeokuta prisons (respectively) participated in this study. Trained personnels interviewed consented inmates using structured questionnaires. Blood samples collected from all participants were tested for HIV antibodies on a one-on-one basis using Determine® and Starpac® test kits (for the HIV test and the confirmatory test respectively). Descriptive statistics, chi-square test and the logistic regressions were used to analyze the data using SPSS version 13. Results: We found that 10.6% of the inmates had been involved in same sex. Although the overall HIV prevalence among inmates in this study was found to be 2.4%, HIV prevalence was 2.6% and 2.1% among inmates who don’t use and those who use condom during casual sex respectively. The odds of not using condom and their respective 95% confidence interval (CI) were found to be 2.03 (1.19–3.46) and 3.68 (1.17–11.57) among inmates in the 31–60 age category and among inmates who were students respectively. Conclusions: The presence of same sex practices among the inmates is a potential precursor for future explosion of HIV infection in these prisons, particularly that some of them were HIV positive.Item Mathematical modeling of the epidemiology and the transmission dynamics of HIV/AIDS infections in Nigeria(College of Medicine, University of Ibadan, 2010) Akpa, O. M.; Oyeloja, B. A.Many of the already proposed models for the transmission of HIV/AIDS do not fit the situations in Nigeria. This is in part due to the fact that many of the models pay more attention to either homogeneity of sexual contact or population of homosexuals. Although some notable models have also been studied by different authors in times and places for heterosexual transmission of HIV/AIDS epidemics, none of these models addressed the peculiar transmission dynamics in Nigeria. In this study, we grouped the population into susceptible, infected and AIDS men and women with sexual contact as the major route for HIV transmission. Assuming a strong sexual network between the groups and with the AIDS group unable to contribute to infection, we formulated mathematical models for the heterosexual transmission dynamics of HIV/AIDS in Nigeria. Our models incorporated parameters and variables that describe the nature and the strength of the transmission across the groups. We also presented model predictions on pattern of mixing between and Within the groups and how these in turn determine the global dynamics of the epidemics in Nigeria. Our simulation results show that, an increase in the transmission probability as well as in the number of sexual partnership poses more treat to the population than other parameters. The model predictions show that the epidemics tend to level up after year 2010. The number of sexual partners change per year and the probability of an effective contact are among the most critical variables in the HIV/AIDS epidemics in a community of heterosexual Nigerians. Our results agree with recent findings of similar models for some Sub-Saharan African countries. Also, results from the predictions based on the most recent National HIV Seroprevalence Surveillance Survey conducted in Nigeria agree with our findings.Item Analysis of trends and projections of the emergence, impact and the epidemiology of HIV/AIDS in Nigeria(Nigerian Statistical Association, 2010) Akpa, O. M.; Oyejola, B. A.The first case of AIDS was reported in Nigeria-(Lagos) in 1986. Since then, both the incidence and the prevalence of the epidemic has grown steadily, particularly during the military regimes. In this study, We used the UNAIDS softwares: Estimation and Projection Package-(EPP) and AIDS Impact Mode/-(AIM), to present models, trends analysis and projections/or the incidence a/HIVIAIDS in the six geopolitical zones in Nigeria. 0111' results show that the peak incidence 0/HIVIAIDS epidemics in the zones was during the Military rule in Nigeria. We also projected that by year 2010, the incidence are expected to be stable.Item Statistical modelling of HIV/AIDS epidemics; Nigeria’s most needful statistical support for meeting the MDGs in HIV/AIDS intervention initiatives.(Nigerian Statistical Association, 2006) Akpa, O. M.; Oyejola, B. A.Since the first cases of AIDS were identified in the United State of America nearly two decades ago, researchers have made significant progress in understanding the epidemiology of HIV/AIDS Pandemic worldwide, with special attention to Sub-Saharan Africa. However, no particular attempt has been made to Model either the transmission dynamics or the trajectory of HIV/AIDS infection in Nigeria. In this paper, we review various methods adopted by Mathematicians and statisticians to Model HIV/AIDS epidemics. Their peculiar applicability and limitations with reference to Nigeria are discussed. We also discuss why Statistical Modeling of HIV/AIDS Epidemics is one of the most needed Statistical support for meeting the Millennium Development Goals (MDGs), particularly in Nigeria.Item Application of structural equation modelling to public health concern on psychosocial functioning and quality of life of adolescents in Nigeria(Andkolad Nigeria Limited, Ife, Nigeria, 2019) Akpa, O. M.; Fowobaje, K. R.; Olutola, O. M.Structural equation modelling (SEM) is an efficient statistical method for the analysis and evaluation of complex research objectives involving relationships between observed and unobserved (latent) variables. Unfortunately, its application in Public Health research has been very limited in Nigeria. This paper documents basic theories, principles and application of SEM to research in Public Health with a focus on the psychosocial functioning and quality of life of adolescents in Nigeria. The cross-sectional study was conducted among adolescents (n=983) in Benue state, Nigeria. The study presents a step-by-step approach to SEM and also describes variety of research questions that SEM can be used to answer in public health domain with empirical application of SEM on psychosocial functioning and quality of life. Results of the empirical application showed that poor psychosocial functioning negatively impacts the quality of life of adolescents in Nigeria. There is need to encourage researchers in public health to apply SEM in their research.