FACULTY OF PUBLIC HEALTH
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Item Mapping local patterns of childhood overweight and wasting in low- and middle income countries between 2000 and 2017(Elsevier, 2020) Kinyoki, J. R.; Lazzar-Atwood, A.; Lain Hay, S.; Oluwasanu, M. MA double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic.Item Contextual factors influencing the roles of patent medicine vendors in the provision of injectable contraception services in Nigeria(Springer Nature, 2023) Adebayo, A. M.; Oluwasanu, M. M.; Okunade, F. T.; Ajayi, O. O.; Akindele, A. O.; Ajuwon, A. J.Background Patent medicine vendors (PMVs) play vital roles in the delivery of family planning services in Nigeria and other developing countries. There is a growing recognition of the need to integrate them into the formal health care system as a strategy to increase the contraceptive prevalence rate and achieve universal health coverage.Though promising, the success of this proposition is largely dependent on a critical analysis of the factors which influence their operations. This study was designed to identify the contextual factors influencing the provision of injectable contraceptive services by PMVs and the broader effects of their activities on the health system to inform similar interventions in Nigeria. Methods This was a qualitative study guided by the UK Medical Research Council’s Framework for Complex Interventions. Twenty-seven in-depth interviews were conducted among officials of the association of PMVs, health workers, government regulatory officers and programme implementers who participated in a phased 3-year (2015–2018) intervention designed to enhance the capacity of PMVs to deliver injectable contraceptive services. The data were transcribed and analyzed thematically using NVIVO software. Results The contextual factors which had implications on the roles of PMVs were socio-cultural and religious, the failing Nigerian health system coupled with government regulatory policies. Other factors were interprofessional tensions and rivalry between the PMVs and some categories of health care workers and increasing donors’ interest in exploring the potentials of PMVs for expanded healthcare service provision. According to the respondents, the PMVs bridged the Nigerian health system service delivery gaps serving as the first point of contact for injectable contraceptive services and this increased contraceptive uptake in the study sites. A negative effect of their operation is the tendency to exceed their service provision limits, which has spurred a planned tiered PMV accreditation system. Conclusions This study has highlighted the contextual factors which define the roles and scope of practice of PMVs involved in injectable contraceptive service provision. Strategies and interventions aimed at expanding the healthcare delivery roles of PMVs must be encompassing to address the broader contextual factors which underpin their capacities and functions.Item Intention and Concerns about HPV Vaccination among In-School Adolescents in Ibadan, Oyo State, Nigeria(Nigerian Medical Association, 2023) Adeniyi, F. I.; John‑Akinola, Y. O.; Oluwasanu, M. M.; Oluwasanu, M. M.Background: Human papillomavirus (HPV) is a very common sexually transmitted infection responsible for some cancers including cervical cancer. Despite nearly half of the Nigerian population being at risk (women <25), vaccination uptake against the infection is still less than 5%. Methodology: This cross-sectional descriptive survey was conducted using a multi-stage sampling technique. A semi-structured questionnaire was administered to 300 in-school adolescents aged 15-19 years, across 15 private and public secondary schools in Ibadan-North and Ibadan North-West of Oyo State, whose parents gave consent. The data was analysed using descriptive and inferential statistics in SPSS v21. Cronbach’s alpha coefficient was used to measure internal consistency reliability while categorical tables were compared using chi-square and regression analysis with a p-value <0.05. Results: The mean age of respondents was 15.8 ± 0.84 years. Half of them were females (52.3%) and also attended private schools (56.3%). Very few of the respondents had heard about HPV (21.0%) and HPV vaccine (12.7%), however, more than half had heard about cervical cancer (55.3%). Few respondents had good knowledge (11.0%) and positive perception (27.0%) of HPV, cervical cancer and HPV vaccine. The major source of information was social media (46.2%). Half of the respondents reported intention to take the vaccine if recommended by their family doctor (56.3%) and if given parental approval (52.0%), however, many (60.7%) were concerned about the vaccine’s side effects.Conclusion: Findings show that parents and health workers influence adolescents’ HPV vaccination uptake.The study thus recommends the prioritization of parental involvement in HPV vaccination. Parents and health workers should therefore be targeted as key stakeholders in driving the awareness of HPV and uptake of HPV vaccine among adolescents.Item Temporal trends in overweight and obesity and chronic dease risks among adolescents and young adults: A ten-year review at a tertiary institution in Nigeria(Public Library of Science (PLoS), 2023) Oluwasanu, A. O.; Akinyemi. J. O.; Oluwasanu, M. M.; Oseghe, O. B.; Oladoyinbo, O. L.; Bello, J.; Ajuwon, A. J.; Jegede, A. S.; Danaei, G.; Akingbola, O.There is an increasing prevalence of obesity among college/university students in low- and middle-income countries, similar to the trend observed in high-income countries. This study aimed to describe the trend and burden of overweight/obesity and emerging associated chronic disease risks among students at the University of Ibadan (UI), Nigeria. This is a ten-year retrospective review of medical records of students (undergraduate and post-graduate) admitted between 2009 and 2018 at UI. Records of 60,168 participants were analysed. The Body Mass Index (BMI) categories were determined according to WHO standard definitions, and blood pressure was classified according to the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7). The mean age of the participants was 24.8, SD 8.4 years. The majority were ≤ 40 years (95.1%). There was a slight male preponderance (51.5%) with a male-to-female ratio of 1.1:1; undergraduate students constituted 51.9%. The prevalence of underweight, overweight, and obesity were 10.5%, 18.7% and 7.2%, respectively. We found a significant association between overweight/obesity and older age, being female and undergoing postgraduate study (p = 0.001). Furthermore, females had a higher burden of coexisting abnormal BMI characterised by underweight (11.7%), overweight (20.2%) and obese (10.4%). Hypertension was the most prevalent obesity-associated non-communicable disease in the study population, with a prevalence of 8.1%. Also, a third of the study population (35.1%) had prehypertension. Hypertension was significantly associated with older age, male sex, overweight/obesity and family history of hypertension (p = 0.001). This study identified a higher prevalence of overweight and obesity than underweight among the participants, a double burden of malnutrition and the emergence of non-communicable disease risks with potential lifelong implications on their health and the healthcare system. To address these issues, cost-effective interventions are urgently needed at secondary and tertiary-level educational institutions.Item Cervical cancer and human papillomavirus vaccine knowledge, utilisation, prevention educational interventions and policy response in Nigeria: a scoping review(SAGE Publishing, 2022) John-Akinola, Y. O.; Ndikom, C. M.; Oluwasanu, M. M.; Adebisi, T.; Odukoya, O.Purpose: This review evaluated the knowledge, utilisation, prevention education, and policy response across the six geopolitical regions of Nigeria to inform national efforts for the prevention and control of cervical cancer. Methods: A keyword-based systematic search was conducted in PubMed/MEDLINE (NCBI), Google Scholar, and AJOL electronic databases, including a manual scan of papers, journals and websites to identify relevant peer-reviewed studies. Articles were screened and assessed for eligibility. Results: Many (158) articles were downloaded and after duplicates were removed, 110 articles were included in the final analysis. These were made up of qualitative, quantitative (cross-sectional), intervention and policy studies. Studies have generally reported poor knowledge and awareness of cervical cancer screening but those carried out in urban areas demonstrated a slightly higher level of awareness of Human Papilloma Virus (HPV) vaccine, HPV vaccination uptake and utilization of cervical cancer preventive services than the rural studies. The studies did not show strong government support or policies in relation to cervical cancer control. Conclusion: Knowledge and uptake of cervical cancer preventive services across diverse groups in Nigeria remain poor. These could be linked to socio-cultural factors, the lack of an organised cervical cancer screening programme and low financial resource pool for cervical cancer prevention. Therefore, it is necessary to increase government, donor prioritisation and political support in order to ensure increased investment and commitment to cervical cancer elimination in Nigeria.Item Prevalence of physical activity and dietary patterns as risk factors for cardiovascular diseases among semi-urban dwellers in Ibadan, Nigeria(African Health Sciences Publishing Association, 2022) Aduroja, P. E.; John‑Akinola, Y. O.; Oluwasanu. M. M.; Oladepo, O.Background: Physical inactivity and unhealthy diet are leading risk factors for cardiovascular diseases globally. Limited studies have assessed the prevalence of these risk factors in community-based settings in Nigeria. Objectives: This study assessed the prevalence of physical activity and the dietary pattern of residents in selected semi-urban communities in Ibadan, Nigeria. Methods: This was a cross-sectional study carried out among 500 randomly selected residents from two semi-urban communities. Multi-stage random sampling technique was used to select households and participants. Data were collected using a pretested modified version of the WHO STEPS instrument. Descriptive and inferential statistical analyses were determined at 5% level of significance. Results: The mean age was 35.36 ± 12.24 and a mean household size of 4.07 ± 1.85. Majority (87.2%) of the respondents engaged in low physical activity (< 150-300 min/wk). Consumption of fruits and vegetables was low among respondents at 33% and 36.4% respectively. The employment status of respondents was significantly related to expected workplace physical activity level (χ2=11.27; P=0.024). Conclusions: This study highlights the need for the development and implementation of community-driven, multi-layered public health promotion initiatives across different settings.Item Breast cancer in adolescents and young adults less than 40Years of age in Nigeria: a retrospective analysis(Hindawi Limited, 2022) Ntekim, A.; Oluwasanu, M.; Odukoya, O.Background. Breast cancer among adolescents and young adult (AYA) females aged 15-39 years is associated with different patterns of aggressiveness, as well as psychosocial and economic issues. At present, the burden of breast cancer among this age group is unknown in Nigeria. There is a need to determine the proportion of AYA with breast cancer in Nigeria. This will inform the development of breast cancer care programs appropriate for this age group. Objective. The objective of this study was to highlight the burden of breast cancer with an emphasis on AYAs in Nigeria and its implications. Methods. A retrospective review of data from cancer registries in Nigeria between 2009 and 2016 was carried out. Results. Among AYA females in Nigeria, breast cancer was by far the most common cancer, constituting 50% of all cancers and 51% (2798 of 5469) of all breast cancer cases. IA third (30.8%) of breast cancer cases in all centers studied were AYAs. Conclusion. The high proportion of AYA with breast cancer is an important feature suggesting that urgent actions are required to ensure early detection and improve breast cancer care among this age group.Item Oncology Training Needs Assessment Among Health Care Professionals in Nigeria(American Society of Clinical Oncology (ASCO), 2022) Adejumo, P. O.; Oluwasanu, M. M.; Ntekim, A.; Awolude. O. A.; Kotila, O. A.; Aniagwu T.; Brown B. J.; Dzekem, B. S.; Duncan, S.; Tito Ilori, M.; Ajani O.; Lee, S. M.; Babalola. C. P.; Ojengbede, O.; Huo. D.; Hammad, N.; Olopade, O. I.PURPOSE This study investigated the status of training and preparedness for oncology practice and research and degree of interprofessional collaboration among health care professionals in the six geopolitical regions of Nigeria. METHODS A convergent parallel mixed methods design was used. Three hundred seventeen respondents completed a three-part, online questionnaire. Self-rated competencies in oncology research (26 items), oncology practice (16 items), and interprofessional collaboration (nine items) were assessed with a one- to fivepoint Likert scale. Six key informant and 24 in-depth interviews were conducted. Descriptive statistics, analysis of variance, and pairwise t-test were used to analyze the quantitative data, whereas thematic analysis was used for the qualitative data. RESULTS Respondents were mostly female (65.6%) with a mean age of 40.5 6 8.3 years. Respondents include 178 nurses (56.2%), 93 medical doctors (29.3%), and 46 pharmacists (14.5%). Self-assessed competencies in oncology practice differed significantly across the three groups of health care professionals (F = 4.789, P = .009). However, there was no significant difference across professions for competency in oncology research (F = 1.256, P = .286) and interprofessional collaboration (F = 1.120, P = .327). The majority of respondents (267, 82.4%) felt that educational opportunities in oncology-associated research in the country are inadequate and that this has implications for practice. Key training gaps reported include poor preparedness in data analysis and bioinformatics (138, 43.5%), writing clinical trials (119, 37.5%), and writing grant/research proposals (105, 33.1%). Challenges contributing to gaps in cancer research include few trained oncology specialists, low funding for research, and inadequate interprofessional collaboration. CONCLUSION This study highlights gaps in oncology training and practice and an urgent need for interventions to enhance interprofessional training to improve quality of cancer care in Nigeria. These would accelerate progress toward strengthening the health care system and reducing global disparities in cancer outcomes.Item Prevalence and factors Associated with alcohol Use in selected urban communities in Ibadan, Nigeria(SAGE Publications, 2023) Aremu,T.; Anibijuwon, I. B.; John‑Akinola, Y. O.; Oluwasanu, M.; Oladepo O.Nigeria is ranked high among African countries in the consumption of alcohol and the national adult per capita consumption was estimated at 12.3litres. Harmful alcohol use is the sixth leading cause of disability and deaths in Nigeria. This study assessed the prevalence and factors associated with alcohol use in selected urban communities in Ibadan, Nigeria. This community-based cross sectional study was conducted among 500 respondents in two selected urban communities in Ibadan, Nigeria. The World Health Organization STEPS tool was used to collect data on socio-demographic characteristics of respondents and the history of alcohol use. Alcohol users were categorized into ever consumed, current consumers, consumers within last 12 months, and frequent consumers within 30 days (low, medium, and high consumers).Chi-square analysis was used to identify factors associated with the different categories of alcohol consumption. The mean age of the respondents was 35.36_12.24 years. Almost one third of the participants (29.0%) reported they had ever consumed alcohol and (13.6%) had consumed alcohol within 30 days prior to the study. Factors significantly associated with the ever-use of alcohol were gender (p¼0.000), and income (p¼0.000). Current use of alcohol had a statistically significant relationship with male gender (p¼0.000). The prevalence of high alcohol use is low in the sample of urban communities studied, and factors influencing include sex, marital status, level of education, income. These results should inform policy decisions to address the alcohol use in urban communities in Southwest Nigeria.Item 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.