FACULTY OF PUBLIC HEALTH
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Item How knowledgeable are Nigerian female students of reproductive age about Iron and Folate(Springer Nature, 2024) Folasire, O. F.; Afolabi, V. I.Background: Iron and folate deficiency remains a global public health problem, especially among females of reproductive age. This study evaluated the nutrition knowledge of and consumption pattern of foods rich in iron-folate among final year female undergraduate students, as a formative assessment to plan nutrition intervention. Methods: A cross-sectional study, used simple random sampling to recruit 180 final-year undergraduate female students at the University of Ibadan, Nigeria. Level of knowledge was categorized into adequate and inadequate based on the mean knowledge score 11±6.0. A modified FFQ was used to measure dietary pattern, examined and classified as having a frequent (at least three times per week) or infrequent (less than three times per week) consumption pattern. Data analysis was with SPSS at p 0.05). Results: About 52.2% of the respondents got information on iron-rich food, while 38.9% of the respondents got information on folate-rich foods from health professionals/hospitals and internet. Mean knowledge score was 11±6.0. About 55.7% of respondents had inadequate knowledge of iron-folate, while 43.0%had adequate knowledge about iron-and folate-. Most (88.9%) of the respondents infrequently consumed green leafy vegetables, nuts and seeds (81.7%), legumes (88.9%) while, 57.8%, 55.0%, 50.6% frequently consumed meats, poultry and dairy products respectively. Largely, there was no significant relationship between the nutrition knowledge and the consumption of iron folate rich foods (p>0.05).However, inadequate knowledge of iron and folate-rich foods was significantly related with infrequent intakes of green leafy vegetables (X2=8.508, p=0.004). Conclusion: Knowledge of iron and folate among respondents was poor. Dietary consumption of iron-folate - rich foods was also generally poor except for poultry, meats and meat products. Hence, there is need for targeted nutrition intervention in this group of WRA.Item Prevalence and determinants of undernutrition among pregnant women in selected public hospitals in Ibadan, Nigeria(JournalGurus, 2024) Ocheja, S.; Adesina, O. A.; Folasire, O. F.; Okunlola, M. A.Background: Undernutrition is one of the greatest public health challenges affecting pregnant women in Africa with associated adverse pregnancy outcomes. The aim of this study is to determine the prevalence and identify the associated factors for undernutrition among pregnant women accessing antenatal care in selected public hospital facilities in Ibadan. Methodology: A cross-sectional facility-based study was conducted among 1,162 randomly selected pregnant women who attended antenatal clinic in selected public hospitals in Ibadan, Nigeria. A structured questionnaire was used to collect the data. Left mid-upper arm circumference measurement was used to assess the nutritional status of the pregnant women by using an adult non-elastic mid upper arm circumference tape at the mid-point between the tip of the shoulder and the tip of the elbow. Individual minimum dietary diversity for women (MDDW) was determined using the Food and Nutrition Technical Assistance III project. STATA was used for analysis. Result: The overall prevalence of undernutrition was 20.0% and a low minimum dietary diversity score was observed in 25.2%. Undernutrition status varies across the level of health care; the primary health care (PHC) had the highest (30.8% and 26.8%), the secondary health care facility was (14.1%) and tertiary health care; (18.7% and 9.9 %). Mother’s age 25years and above, Marital status of being married and Parity of para 1-5 had lower odds of being undernourished. However, there was no significant association between MDDW and nutritional status of the respondents. Conclusion: This study revealed a relatively high prevalence of undernutrition. Health care providers across the three level of healthcare should make nutritional assessment and counselling an active part of the routine antenatal care.Item Overall and central obesity and prostate cancer risk in African men(Springer Nature / Kluwer Academic Publishers, 2022) Agalliu, I.; Lin, W. J.; Zhang, J. S.; Jacobson, J. S.; Rohan, T. E.; Adusei, B.; Snyper, N. Y. F.; Andrews, C.; Sidahmed, E.; Mensah, J. E.; Biritwum, R.; Adjei, A. A.; Okyne, V.; Ainuson-Quampah, J.; Fernandez, P.; Irusen, H.; Odiaka, E.; Folasire, O. F.; Ifeoluwa, M. G.Purpose African men are disproportionately afected by prostate cancer (PCa). Given the increasing prevalence of obesity in Africa, and its association with aggressive PCa in other populations, we examined the relationship of overall and central obesity with risks of total and aggressive PCa among African men. Methods Between 2016 and 2020, we recruited 2,200 PCa cases and 1,985 age-matched controls into a multi-center, hospital-based case–control study in Senegal, Ghana, Nigeria, and South Africa. Participants completed an epidemiologic questionnaire, and anthropometric factors were measured at clinic visit. Multivariable logistic regression was used to examine associations of overall and central obesity with PCa risk, measured by body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR), respectively. Results Among controls 16.4% were obese (BMI≥30 kg/m2 ), 26% and 90% had WC>97 cm and WHR>0.9, respectively. Cases with aggressive PCa had lower BMI/obesity in comparison to both controls and cases with less aggressive PCa, suggesting weight loss related to cancer. Overall obesity (odds ratio: OR = 1.38, 95% CI 0.99–1.93), and central obesity (WC>97 cm: OR = 1.60, 95% CI 1.10–2.33; and WHtR>0.59: OR = 1.68, 95% CI 1.24–2.29) were positively associated with D’Amico intermediate-risk PCa, but not with risks of total or high-risk PCa. Associations were more pronounced in West versus South Africa, but these diferences were not statistically signifcant. Discussion The high prevalence of overall and central obesity in African men and their association with intermediate-risk PCa represent an emerging public health concern in Africa. Large cohort studies are needed to better clarify the role of obesity and PCa in various African populations.Item Knowledge, Attitude and Preference of Consumersfor cooking oils among Female University Administrative Staff in Souh-Western Nigeria using Health Belief Model(College of Medicine, University of Ibadan, 2022) Folasire, O. F.; Arotiba, T.; Lesi, T.Background and Rationale: Individual’s health behaviour can be explained by theories and models anchored on their perceived susceptibility to a health problem, perceived severity, perceived benefits of actions, and cues to action. Aims and Objectives: This study assessed the knowledge and attitudes as well as preference consideration of women in choosing cooking oil using the health belief model. Methods: This cross-sectional study involved 200 sampled consenting female administrative staff in the University in Nigeria. A self-administered questionnaire was used to collect information on socio-demography, Knowledge of healthy oil, preference factors considered in choosing cooking oil. Attitude to healthy oil consumption was as well assessed through health belief model using Likert scale. Categorical variables of knowledge, attitude and preference scores were analysed using chi-squared test. The level of significance was set at p < 0.05. Results: The mean age of the of the respondents was 38.6(±9) years. Less than half (45.6%) of the respondents had good knowledge of healthy oil, six out of ten had positive attitude towards the consumption of healthy oil consumption. Respondents’ preference for choice of cooking oils were based on perceived health benefits (45.1%), nutritional labelling (42.1%) and brand (37.9%). There is statistically significant association between respondents’ knowledge and age (p=0.021) as well as respondents’ knowledge and attitude (p= 0.000). Positive attitude was found to be a predictor of having good knowledge (OR=2.78, p=0.003). Conclusions: Proper knowledge on what makes cooking oil healthy is inadequate but positive attitude towards healthy oil was exhibited by female university administrative staff. The positive attitude should be leverage upon in intervening for improved knowledge and better informed choices in selecting cooking oils.Item Nutrition-related knowledge and attitude of practising Nigerian medical doctors to nutrition counselling during the covid-19 pandemic 2020.(Association of Resident Doctors (ARD), University College Hospital (UCH), Ibadan, 2021) Folasire, O. F.; Ilori, T. O.; Madaki, ABackground: Adequate nutrition is needed to enhance the immune system, especially at the time of COVID-19 pandemic for disease prevention and treatment. Objective: The study aimed to assess physicians’ knowledge to nutrition-related issues of COVID-19 infection and explore their attitudes to offering nutritional counselling to patients. Method: This was a cross-sectional online study conducted among doctors in private and public institutions across the six (6) geo-political zones in Nigeria using the social media online platforms of the Nigerian Medical Association (NMA) from August 17 to September 26, 2020. A categorisation of the knowledge score into sufficient and insufficient was done using the mean (sd) knowledge score. The attitude score was categorised into positive and negative using the median (IQR) attitude score, and bivariate analysis was used to test for associations. Results: Responses were gotten from a total of 176 doctors over six weeks of data collection. Majority 97(55.1%) were females, and 84 (47.7%) had practised between 11 and 20 years. Majority 95(54.0%) had insufficient knowledge, while 128(72.7%) of the respondents had a negative attitude to nutrition counselling of patients regarding COVID-19. Females had significantly better knowledge about nutrition related issues of COVID-19 (p=0.004). However, there was no significant difference in the respondents’ attitude based on professional cadre, gender, place of practice, and years of practice. Conclusion: Respondents were deficient in the knowledge of common food items containing relevant nutrients essential for boosting immunity. Hence, there is a need to encourage physicians training in nutrition and nutritional counselling.Item Family characteristics and childhood predictors of overweight and obesity in adults attending General Outpatients clinic, Ibadan.(Society of Family Physicians of Nigeria (SOFPON), 2020) Badru, O.; Ogunbode, A. M.; Oloowokere, O. O.; Folasire, O. F.; Ladipo, M. M. A.Background: The World Health Organization has reported that there is an increasing rate of overweight and obesity and this has reached an epidemic proportion. Parental influence during childhood and family routine characteristics are been proposed as contributing factors for overweight and obesity. Objective: The study therefore sought to determine the relationship between family characteristics, childhood predictors and overweight/obesity. Methodology: This was a case-control study amongst adult patients aged 18 -60 years. Cases were respondents with Body Mass 2 2 Index (BMI) ≥ 25 kg/m ; they were age and sex matched with controls (BMI 18.5 < 25 kg/m ), in ratio 1:1 (N=342). Interviewer administered questionnaires were applied to consenting patients to gather information on socio-demography, parental influence during childhood, family routine characteristics. The pattern of family meals was assessed with the Family Ritual Questionnaire dinnertime scale. Data was analysed with SPSS version 22. McNemar Chi-square and logistic regression were used to draw inferences at p< 0.05. Respondents with history of obesity in childhood/adolescent and family history of obesity were 3.6 and 3 times respectively more likely to be overweight or obesity than if there was no such history. Conclusion: Childhood/adolescent obesity and family history of obesity are predictors of obesity. Involving the family as a unit in weight loss control may be beneficial for both the identified patient and his/her (immediate) family members who are at increased risk of becoming overweight and obese themselves.Item Feasibility testing of a designed food portion control tool among diabetic patients at the University of Ibadan health service clinic(Nigeria Diabetes Summit, 2024) Folasire, O. F.; Olagbemide, P. A.Introduction: Diabetes, a chronic disease with global prevalence, poses significant health risks. Effective glycaemic control is crucial for preventing complications and managing diabetes with culturally appropriate dietary education, thus making this study highly relevant. Objectives: To conduct feasibility testing of a designed food portion control tool among diabetic patients at the University of Ibadan Health Service (Jaja Clinic), Ibadan. Feasibility was assessed in terms of the intervention's reach, acceptability, and practicability. Methods: A mixed study design was used, involving key informant interviews (KII) with nine healthcare personnel involved in diabetic management and a cross-sectional survey with purposive samples of 41 consenting diabetic patients presenting for routine care at the Jaja Clinic. Patients were exposed to one-on-one dietary education sessions using the food portion control tool in the form of a video recording and a take home handbill of the key intervention messages with re-enforcement SMS delivered weekly for two months. Feasibility reach was determined by adherence to the intervention messages within a month of the exposure. Acceptability was assessed using a Likert scale questionnaire and generated acceptability score; perceived practicability was evaluated using KII. Results: Majority had type 2 DM (97.6%) for > 5 years (70.7%). A total of 32 patients were compliant (26 fully compliant, 6 partially compliant) and 9 defaulters. The intervention reach (78%) was high. Mean acceptability © score (4.4/5) showed patients rated the food portion control tool as acceptable. The KII suggested that the intervention was practicable. The facilitators of implementation were awareness creation and education with continuous reinforcement of Intervention Messages. The predominant barrier was the lack of finance to procure enough green leafy vegetables/fruits and large portions of staple carbohydrate consumption. Conclusions: implementation of the food portion control tool was feasible in a real-life clinic setting, emphasising the need for an rct for further testing.Item Effective multisectoral partnerships among government ministries, agencies, and departments for stronger nutrition programming in selected Nigerian southern states: motivations, achievements, challenges and recommendations(Nutrition Society of Nigeria, 2024) Ariyo, O.; Afolabi, W. A.; Ezeogu, A.; Oyetunji, M.; Alarape, K.Background: Efforts to address malnutrition and its consequences in Nigeria has been on for more than 40 years with multi-stakeholders' involvement. Presently, there is limited opportunity for experiential learning to enhance performance. Objective: This paper documented shared experiences, challenges and opportunities in nutrition programming, strategies and framework for better co-ordination and resource mobilization as envisioned by members of seven States Committee on Food and Nutrition (SCFN). Methods: A two-day participatory workshop on strengthening multisectoral nutrition programming across states ministries, departments and agencies including technical and brainstorming sessions, group activities, opinion polls and plenary presentations was conducted. Thirty-two SCFN stakeholders from UNICEF Zone B states (Edo, Ekiti, Lagos, Ogun, Ondo, Osun, Oyo) participated including budget and economic planning, health, agriculture, and academia. Results: Key motivation to promote personnel performance included conducive working environment, government commitment/funding support and performance-based reward. Common achievements included existence of approved State Strategic Action Plan of Food and Nutrition, yearly workplans, regular quarterly meetings, and periodic public nutrition education. Major challenges included poor political will, unfavourable hierarchical structure, inadequate budgetary allocation, weak coordination/collaboration, poor skills/competencies of nutrition desk officers, and dwindling partners' support. Recommendations included mainstreaming nutrition into government political and development agenda, continued sensitization and orientation of policy actors, re-orientation of nutrition desk officers, strengthen collaboration, entrenching the creation of State Council of Nutrition in subsequent nutrition policy review, enhance public awareness and media roles, and institute Nutrition Community of Practice platform. Conclusion: Remarkable progress and surmountable challenges characterise nutrition programming in southern Nigeria. Experience sharing, better coordination, continuous learning and effective stakeholders' engagement are required to enhance nutrition funding, enabling environment, skills and competencies of nutrition actors.Item Housing Quality of Mothers with Under five children: A comparative study of upland and riverine areas of Rivers State.(Scholarzest, 2024) Asiegbu, U. A.; Ariyo, O.Safe housing is fundamental to healthy living. Poor housing quality increases the burden of malnutrition in children globally and nearly half of the children under the age of five die annually due to malnutrition especially in areas with difficult accessibility. This study was designed to compare the housing quality of mothers with under-five children in the upland area with those in the riverine areas of Rivers state. A cross-sectional study involving a multistage stratified random sampling method to select 316 mother/child pairs in six Local Government Areas of Rivers state was adopted. A pretested semi-structured interviewer-administered questionnaire was used. Descriptive and inferential statistics were used to analyse the data. In the upland area about 60% of the households lived in apartments with shared facilities and about a quarter practiced open defecation (25.2%). While more than three-quarter of the households (76.5%) resided in apartments with shared facilities and open defecation was practiced by more than half (56.0%) of the households in the riverine area. Although borehole use was the predominant source of household water supply, the use of public taps was more pronounced in the riverine (21.4%). Bush refuse dumping was predominant in the upland (56.9%) while the ocean (78.9%) was similarly preferred by households in the riverine area. Most mothers lived in apartments where basic facilities were shared and open defecation was high. Efforts should be geared towards providing sanitary facilities to households especially in the riverine communities and sensitisation programmes should be organised to improve hygiene awareness.Item Region, location, and age-specific comparison of nutritional status of in-school adolescent girls (10-19 years) in Nigeria(World Public Health Nutrition Association (WPHNA), 2024) Olumakaiye, M.F.; Nzeagwu, O.C.; Otitoola, O.C.; Ariyo, O.; Abe, J.; Popoola, B.R.; Gbemileke, A.; Akinyotu, E.O.Background: Nutritional status among female adolescents in Nigeria is becoming a major concern because it determines health outcomes and productivity in their adult years. There is a growing recognition of the potential to promote a healthy start to life for the next generation by addressing health and nutritional risks in adolescents. Objective This study assessed the nutritional status of in-school adolescent girls in Nigeria and made comparisons across regions, locations, and age groups. Methods A multistage stratified random sampling procedure was used to select participants from three geopolitical zones in Nigeria for this descriptive cross-sectional study of 2261 inschool adolescent girls aged 10 -19 years. Body mass index-for-age (BMI), waist-hip-ratio (WHR), and waist-height-ratio (WHtR) were calculated from weight, height, hip, waist, and mid-upper arm circumferences measurements. Results The mean age was 14.9 years (± 1.78 years), the mean body weight was 47.8 kg (± 9.02 kg), compared to a calculated mean ideal weight of 54.5 kg (± 9.05 kg). Using BMI, 9.8% of these adolescent girls were underweight, 7% were either overweight or obese, 47.9% were at risk judging from WHR, 10% had abdominal obesity present using WHtR, 35.7% were malnourished, and 11.8% were obese using MUAC. South East girls were eleven times more likely to have a high BMI (OR=11.341, 95%CI=6.059-21.225) and three times more likely to have a high WHtR (OR=2.870, 95%CI=1.954-4.213) than other regions. The likelihood of being overweight/obese was higher among urban than peri-urban girls; BMI (OR=1.008, 95%CI=0.728-1.395) and MUACoverweight (OR=1.280, 95%CI=0.988-1.657). Older girls, 14- 16yrs; WHtR (OR = 1.426, 95%CI = 0.970-2.097) and 17 -19yrs (OR = 1.024, 95%CI = 0.617- 1.699) were likely to be overweight/obese compared to 10 -13yrs (OR=3.878, 95%CI=2.385- 6.305). Girls 14 -16 were three times and 17-19 were six times more likely to have higher MUAC overweight (OR = 3.878, 95%CI = 2.385-6.305) and (OR=6.371, 95%CI=3.854-10.865), respectively than those at 10-13 years. Conclusions These findings underscore the significant disparities in the nutritional status of adolescent girls across regions, locations, and age ranges in Nigeria. This highlights the urgent need for targeted, region-specific nutrition-sensitive intervention programmes among adolescent girls, potentially leading to improved public health outcomes in Nigeria.