FACULTY OF PUBLIC HEALTH
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Item Prediabetes among Nigerian adolescents: A School-based study of the prevalence, risk factors and pattern of fasting blood glucose in Ibadan, Nigeria(Springer Nature, 2016-06) Arigbede, O.; Adeoye, I.; Jarrett, O.; Yusuf, O.Pre diabetes and type 2 diabetes (T2DM) are emerging public health challenges in sub-Saharan Africa which have been given little research focus among adolescents. The behavioural and cardiometabolic factors that drive these conditions have hardly been documented among adolescents in Nigeria. A cross-sectional study was conducted to investigate the prevalence and risk factors of pre diabetes among 500 in school adolescents and their fasting blood glucose pattern in Ibadan, Nigeria. Potential factors including blood pressure, anthropometric measurements and fasting blood glucose (FBG) levels were assessed. Pre diabetes was defined as FBG between 100 –125 mg/dl. Data were analyzed using descriptive statistics and bivariate logistic regression at 5 % level of significance. The overall prevalence of pre diabetes among the adolescents was 4.0 % 95 % CI (2.2–5.7 %) and the mean FBG of adolescents was 85.3 ± 8.2. Males compared to females had significantly higher levels of FBG—mean difference [1.65:95 % CI (0.017–3.14) p = 0.03]. Factors that increased the odds for pre diabetes included frequent consumption of carbonated drinks (OR = 1.45; 95 % CI 0.46–3.30; p = 0.48), attending a private school (OR = 2.58; 95 % CI 0.77– 9.0; p= 0.66) elevated blood pressure (OR = 2.04; 95 % CI 0.57– 7.35; p= 0.57) and being overweight or obese (OR = 2.91; 95 % CI 0.38–22.3; p = 0.30). Correspondingly, while those who skipped breakfast [1.29;95 % CI (−0.23;−2.8) p = 0.096] had higher FBG, those who walked daily back from school [−2.07;95 % CI (−3.55; − 0.59) p= 0.01] had significantly lower FBG. Pre diabetes and risk factors are prevalent among the secondary school adolescents in Ibadan. Surveillance of potential risk factors through school-based screening among adolescents is crucial for prevention and early interventionItem Prevalence, pattern and predictors of hearing loss among rural school-age children in Ogun State, Nigeria(College of Medicine, University of Ibadan, and University College Hospital (UCH), Ibadan, Nigeria., 2016) Udofia, E. E; Adeoye, I. A.; Fasunla, A. J.Background: Hearing loss is one of the commonest and most neglected disabilities in developing countries. However, most of these are preventable with early detection through screening and appropriate interventions. Methods: We determined the prevalence, pattern and predictors of hearing loss in school aged children in selected rural communities in Ogun state, Nigeria, using a cross sectional study design. A multistage cluster sampling technique was used to select 305 pupils from 6 randomly selected primary schools. Semi-structured interviewer administered questionnaires and a calibrated Amplivox 240 diagnostic audiometer were used for data collection. Multiple logistic regression analysis was used to determine the risk factors. Results: The prevalence of bilateral hearing loss was 19.6% while unilateral hearing loss was 11.8% on the left side and 7.9% on the right.Low frequency hearing lossconstituted the commoner type of hearing loss with [54(64.3%)] occurring on the right and [69 (71.1%)] on the left. Logistic regression analysis revealed that history of ear discharge (OR= 2.80, 95% CI= 1.23-6.38: p=0.006), ear injury (OR= 2.28, 95% CI= 1.09-4.74: p=0.028), head trauma (OR= 4.54, 95% CI= 1.97-10.44: pItem Women’s status within the household as a determinant of maternal health care use in Nigeria(Faculty of Medicine, Makerere University, 2015-03) Fawole, O. I.; Adeoye, I. A.Background: Although gender inequality is often cited as a barrier to improving maternal health in sub-saharan Africa, there is lack of empirical data on how women’s socio-cultural characteristics may influence use of health services in Nigeria. Objective: To describe how women’s position in the household affects receipt of maternity care services. Methods: Secondary data analysis of 10,052 and 4,590 currently married women aged 15 to 49 years from the 2008 Nigerian DHS who receive skilled antenatal and delivery care at least till pregnancy was done. Results: Receipt of skilled delivery care was by 37.9% while, natal care was by 98.4%. Education, residence and wealth index all significantly influenced receipt of maternal health care. Women who were involved in decision making on their own health (aOR=1.97; 95%CI=1.88-2.06) and were employed throughout the year (aOR=1.11; 95%CI=1.01-1.23) were more likely to receive skilled antenatal care, while those who justified physical intimate partner violence were less likely to receive both skilled antenatal care (aOR=0.92; 95%CI=0.85-0.98) and delivery services (aOR 0.54; 95% CI 0.33-0.87). Conclusion: Interventions aimed at improving maternal care should promote women empowerment (decision making, self worth, educational and economic) and should involve partnersItem What Are the Factors That Interplay From Normal Pregnancy to Near Miss Maternal Morbidity in a Nigerian Tertiary Health Care Facility?(Taylor & Francis, 2014-10) Adeoye, I. A.; Ijarotimi, O. O.; Fatusi, A. O.Researchers in Nigeria examined the epidemiological charac teristics and factors associated with maternal outcomes using a mixed method approach: a prospective case control study design involving 375 pregnant women who received maternal care from a tertiary facility and in-depth interviews reporting the experience of near-miss survivors. A generalized ordered logit model was used to generate the estimates of partial proportional odds ratios (and 95% confidence intervals) across categories of the outcome variable. Factors strongly associated with maternal morbidity were late refer ral of women, presence of complications at booking antenatal visits, low birth weight, and severe birth asphyxia. The nearmiss women were further characterized, and a low proportion (25%) had organ dysfunction or failure. The challenge of such diagnoses in resource-constrained settings raises questions about the appropri ateness of using organ dysfunction criteria in developing countries.Item Prevalence and correlates of intimate partner violence towards female students of the University of Ibadan, Nigeria(BioMed Central, 2014-12) Umana, J. E.; Fawole, O. I.; Adeoye I. A.Background: In Nigeria, there is paucity of information on the IPV burden and experience among young women in courtship and dating relationships. This study assesses the prevalence and correlates of IPV in female undergraduate and postgraduate students in a tertiary institution. Methods: The study was a cross-sectional survey. A four-stage sampling technique was used to select 1,100 undergraduate and 255 postgraduate female students from the University of Ibadan, Nigeria. Data was collected using a 43-item self-administered structured questionnaire. Descriptive statistics and multivariate analyses were carried out at 0.05 level of significance. Results: The life-time prevalence of IPV was 42.3% (postgraduate: 34.5%, undergraduate: 44.1%; P < 0.05). Lifetime experience of psychological, physical and sexual IPV were 41.8%, 7.9% and 6.6% respectively. Recent experience (within the previous 12 months) of violence was also more frequently reported by respondents who had a previous history of physical (62.5%) (OR = 2.65; 95% CI: 2.02-3.49) and sexual (53.2%) (OR = 1.63; 95% CI:1.12-2.35) violence than respondents who had no such history. Postgraduate (OR = 0.64; 95% CI: 0.46-0.87) and married (OR = 0.53; 95% CI: 0.35-0.78) students were less likely to have experienced IPV than undergraduate and single students respectively. Students who smoked (OR = 2.46; 95% CI: 1.58-3.83); consumed alcohol (OR = 2.36; 95% CI: 1.82- 3.06); and with history of interparental violence (OR = 2.40; 95% CI: 1.88- 3.07) had a higher likelihood of experiencing violence than students who were not exposed to these behaviors. Adverse effects (such as the inability to concentrate) of IPV on academic performance were reported by 10.3% of victims. Conclusion: The prevalence of IPV was high. There is the urgent need for interventions that will reduce vulnerability by addressing modifiable risk factors like smoking and alcohol consumption. Interventions should also encourage seeking health care following violence to reduce its consequences.Item Contraceptive use among Nigerian women with no fertility intention: interaction amid potential causative factors(Union for African Population Studies, 2013-10) Adebowale, S. A.; Adeoye, I. A; Palamuleni, M. E.High fertility (HF) remains a public health problem and the intention to reduce fertility is a global phenomenon. The health hazards and economic burden of HF on women are enormous. Contraception is widely known as a fertility reduction method. Achieving desirable MDGs and PoA of 1994ICPD will be an illusion if research on the relationship between fertility intention and contraceptive use is neglected. The study which focused on 2,257 women of childbearing age who do not have any intention to bear more children utilized the Nigeria Demographic Health Survey, 2008 dataset. Data was analysed using Chi-square, binary and multinomial logistic regression (=5.0%). The mean ages of the women and children ever born were 40.91±5.73 years and 6.28±2.62 respectively. The prevalence of Current Use of Any Contraceptive Method (CUACM) was 37.6%, with 12.4% and 25.2% currently using natural and modern family planning methods respectively. About 7.0% of women in the poorest wealth quintile are CUACM compared to 61.8% of those in the richest wealth quintile. The current use of modern contraceptive prevalence rate was strikingly higher among Yorubas (41.8%) than Hausas (3.6%). Multivariate analysis identified age, region, residence, education, ethnicity and family planning media exposure as significant predictors of CUACM. In addition, religion and decisions on how to spend family income were identified as predictors of current use of modern contraceptive methods (p<0.05). The use of contraceptives is not adequately practised in Nigeria. The identified predictors of contraceptive use in this study should be considered while designing strategies to improve the contraceptive prevalence rate in Nigeria.Item Incidence, determinants and perinatal outcomes of near miss maternal morbidity in Ile-Ife, Nigeria: a prospective case control study(Springer Nature, 2013-04) Adeoye, I. A.; Onayade, A. A.; Fatusi, A. O.Maternal mortality ratio in Nigeria is one of the highest in the world. Near misses occur in larger numbers than maternal deaths hence they allow for a more comprehensive analysis of risk factors and determinants as well as outcomes of life-threatening complications in pregnancy. The study determined the incidence, characteristics, determinants and perinatal outcomes of near misses in a tertiary hospital in South-west Nigeria. Methods: A prospective case control study was conducted at the maternity units of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife Nigeria between July 2006 and July 2007. Near miss cases were defined based on validated disease-specific criteria which included severe haemorrhage, hypertensive disorders in pregnancy, prolonged obstructed labour, infection and severe anaemia. Four unmatched controls of pregnant women were selected for every near miss case. Three categories of risk factors (background, proximate, clinical) which derived from a conceptual framework were examined. The perinatal outcomes were also assessed. Bi-variate logistic regressions were used for multivariate analysis of determinants and perinatal outcomes of near miss. Results: The incidence of near miss was 12%. Severe haemorrhage (41.3%), hypertensive disorders in pregnancy (37.3%), prolonged obstructed labour (23%), septicaemia (18.6%) and severe anaemia (14.6%) were the direct causes of near miss. The significant risk factors with their odds ratio and 95% confidence intervals were: chronic hypertension [OR=6.85; 95% CI: (1.96 – 23.93)] having experienced a phase one delay [OR=2.07; 95% CI (1.03 – 4.17)], Emergency caesarean section [OR=3.72; 95% CI: (0.93 – 14.9)], assisted vaginal delivery [OR=2.55; 95% CI: (1.34 – 4.83)]. The protective factors included antenatal care attendance at tertiary facility [OR=0.19; 95% CI: (0.09 – 0.37)], knowledge of pregnancy complications [OR=0.47; 95% CI (0.24 – 0.94)]. Stillbirth [OR=5.4; 95% CI (2.17 – 13.4)] was the most significant adverse perinatal outcomes associated with near miss event. Conclusions: The analysis of near misses has evolved as a useful tool in the investigation of maternal health especially in life-threatening situations. The significant risk factors identified in this study are amenable to appropriate public health and medical interventions. Adverse perinatal outcomes are clearly attributable to near miss events. Therefore, the findings should contribute to Nigeria’s effort to achieving MDG 4 and 5.Item Investigation of a measles outbreak in a Rural Nigerian community – the aladura experience(Academic Journals, 2010-03) Adeoye, I. A.; Dairo, M. D.; Adekunle, L. V.; Adedokun, H. O.; Makanjuola, J.The global burden of measles has remained a public health challenge. Worldwide, measles is the fifth leading cause of death among under-five children with an estimate of 197,000 deaths in 2007. In Nigeria, measles is an important cause of childhood morbidity and mortality. Measles outbreaks have been increasingly common in the country with 30, 194 and 256 outbreaks reported in 2006, 2007 and 2008 respectively. This paper describes the investigation, findings and mitigation efforts of a measles outbreak in Ogunmakin, a rural community in South-western Nigeria from 7th January to 15th February 2009. The study design was descriptive and cross-sectional in nature. The investigation was multidisciplinary in nature performed based on the national guidelines for investigating a measles outbreak. This involved data and blood sample collection from the initial cases, notification of the local government health authority, active search and line listing of cases from other health facilities. A household survey was conducted to find additional cases as well as to define the extent of the outbreak. Qualitative techniques were also employed to explore the issues associated with the uptake of immunization in the community. A total of 29 measles cases were identified, all were less than five years old. There were two deaths giving a case fatality rate of 6.9%. Majority of the cases (96.5%) were not immunized against measles. The epidemic spanned 5 weeks with majority of the cases occurring in the 2nd week. There was a clustering of cases in one of the five quarters/settlement – Otesile. The measles immunization coverage for the community was estimated as 22.9%. The stated reasons for the poor uptake of immunization were lack of time, not regarding it as important. A total of 432 children aged 9 months to 15 years received measles antigen during the response vaccination campaign. The measles outbreak in Ogunmakin village was due to low routine immunization coverage resulting in an accumulation of susceptible children. Socio-cultural factors and weak health infrastructure contribute significantly to the low uptake of immunization. There is the need mobilized the entire community on the importance of immunization as well as strengthen the provision of routine immunization.Item Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017. A Systematic Analysis for the Global Burden of Disease Study(American Medical Association (AMA), 2019) Fitzmaurice, C.; Abate, D.; Olagunju, A. T.; Olagunju, T. O.; Oluwasanu, M. M.; Omonisi, A. EImportance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572 000 deaths and 15.2 million DALYs), and stomach cancer (542 000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819 000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601 000 deaths and 17.4 million DALYs), TBL cancer (596 000 deaths and 12.6 million DALYs), and colorectal cancer (414 000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care.Item Ensuring health security for Nigerians by 2050: closing the equity gaps in reproductive health(BioMed Central, 2019) Abiona, O.; Oluwasanu, M.; Oladepo, O. O.Background: Reproductive health is a key foundation for strategies to address health security. It constitutes a vital element in the vision to achieve improved health, quality of life and well-being of individuals and families and the realisation of national economic goals. Developing a blue print for health security in reproductive health matters may contribute to closing the equity gaps in Nigeria by the year 2050. Methods: Gaps in reproductive health were identified through situation analysis of selected reproductive health indices. SWOT analysis was also conducted to outline areas of strengths and opportunities, in addition to weaknesses and threats. Key reproductive health indicators were forecasted for 2050. Results: Despite all efforts, gaps still exist in the country’s reproductive health indices including maternal, perinatal, contraceptive, abortion and gynaecological. Most pregnancy-related deaths are linked largely to preventable causes. If unaddressed, these challenges would undermine gains from previous interventions and responses from governmental and non-governmental organizations and pose serious threats to the nation’s health security. Conclusions: The country must be committed to reproductive health agenda that is focused on the International Conference on Population and Development goal in its bid to achieve health security by the year 2050. Due considerations must be accorded to emerging reproductive health issues like men’s reproductive health and their involvement intheir partners’ reproductive health, and the reproductive health needs of the aged, people with disabilities and those in humanitarian settings. Further in achieving health security for Nigerians by the year 2050, the principles underlying the reproductive health policy of the country must be upheld. These include equity, right based approach, gender and age responsiveness, cultural sensitivity and continuum of care amongst others.