FACULTY OF PUBLIC HEALTH
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Item Barriers to Acceptance of Post‑partum Family Planning among Women in Montserrado County, Liberia(Nigerian Postgraduate Medical Journal, 2018-07) Kaydor, V. K; Adeoye, I. A.; Olowolafe, T. A.; Adekunle, A. O.Background: Maternal mortality in Liberia is one of the highest in Sub Saharan Africa. Post partum family planning (PPFP) can reduce the risk of maternal mortality by preventing unwanted and closely spaced pregnancies. Yet, the uptake of PPFP is low in Liberia. Objective: We investigated the barriers to acceptance of PPFP use among women in Montserrado County, Liberia. Materials and Methods: Across-sectional facility based survey was conducted using a multistage sampling technique to select 378 women within 12 months’ post partum period. Results: About half of our respondents were were married, 66.4% had at least secondary education and 92.1% were Christians. The most commonly reported barriers were the fear of side effects(22.0%) and the post partum abstinence (22.2%). Binary logistic regression analysis showed that being within the early post partum period, i.e., within the first 6 months (adjusted odds ratio [AOR] = 0.23, 95% confidence interval [CI] [0.09–0.60] and lack of access to PPFP [AOR = 0.22, 95% CI [0.09–0.52]). Importantly, women who were married [AOR = 1.686, 95% CI (0.65, 4.36)] and those who were aware of PPFP [AOR 3.69, 95% CI (1.224, 11.096)] increased the likelihood of using PPFP. Conclusion: Important barriers to the utilisation of PPFP in Liberia were being within early post partum period, lack of access and awareness of PPFP including myths and misconception. Therefore, health communication targeting mothers for PPFP at every contact with maternal and childcare services should be encouragedItem Determinants of Adherence to Antiretroviral Therapy among HIV-Positive Women Accessing Prevention of Mother to Child Transmission Services in Ebonyi State, Nigeria(OMICS GROUP, 2018-01) Agboeze, J.; Ogah, O. E.; Robinson, O.; Matthew, N. I.; Chukwuemeka, U.; Adeoye I. A.Background: Mother-to-child transmission (MTCT) of HIV accounts for over 90% of all pediatrics infection globally. Strict adherence to antiretroviral drugs is needed to achieve maximal reduction of HIV transmission in pregnancy. Objective: To determine the level of adherence among HIV infected pregnant women on Prevention of Mother to Child Transmission. (PMTCT) antiretroviral therapy and to establish the factors that contribute to poor adherence. Methods: A cross sectional study was conducted in which 268 HIV positive pregnant women were recruited by systematic sampling method from PMTCT clinic of Federal Teaching Hospital Abakaliki. Pre tested interviewer administered questionnaire was used for data collection. Information on socio-demographic characteristics, knowledge of PMTCT, barriers to PMTCT and obstetric characteristics were obtained. Knowledge on PMTCT was accessed and a score of <4 out of 5 indicated poor knowledge. Adherence Level was calculated using the respondent self-report using (3 day recall) and a value < 95% indicated poor adherence. Data were analyzed using descriptive statistics, Chi square and logistic regression (p ≤ 0.05). Results: The mean age was 30.7 ± 4.2 years. Two hundred and nineteen (81.7%) of the respondents were married, 124 (46.3%) were traders and 141 (52.6%) had secondary education. The prevalence of good adherence was 89.2% and 227 (89.0%) had good knowledge of PMTCT. Fear of being identified as HIV positive (21%) pregnancy related illness (13.7%) and forgetfulness (12.5%) were the most common reasons for non-adherence. Partner’s support (OR=.03, 95% CI=0.01-0.09, p=0.001), and duration of ART (OR=4.39, 95% CI=1.3-14.5, p=0.019) at bivariate analysis were found to be significantly associated with good adherence. Partners support (OR=0.027, 95%CI=0.01-0.09) retained the association with good adherence after controlling for cofounders. Conclusion: The study identified that stigmatization and pregnancy related illnesses were related to poor adherence while having Partners support improve adherence to HAARTItem Patients’ Perception of Quality of Diabetes Care Received in Ibadan, Nigeria(Faculty of Basic Medical Sciences, University of Ibadan, 2018-07) Falayi, E. O.; Adeoye, I. A.; Adedokun, B. O.; Fasanmade A. Aevaluation of care for diabetes from patients' perspective an important indicator of measuring quality of health services and improving treatment approaches but data of the nature are scarce in Nigeria. The study therefore investigated Patients' Evaluation of the Quality of Diabetes care (PEQD) in Ibadan. This descriptive cross-sectional study recruited 384 diabetic patients from three hospitals where specialised services are offered in Ibadan. A semi-structured pre-tested questionnaire was used to collect data. A 42-point PEQD questionnaire scale was used to collect data and a score of >21 was rated as good Perceived Quality of Care (PQC). Data were analysed using descriptive statistics, chi-square test and logistic regression set at 5% level of statistical significance. Mean age of respondents was 62.5 + 10.8 years and mean diabetes duration was 8.4 + 7.6. Majority (58.3%) of the respondents didn't know the type of diabetes they had. Patients aged less than 60 years were less likely to PQC received as good (OR: 0.21; CI: 0.05 - 0.91) compared to those who were above 60 years. More than half (55.0%) of the respondents perceive quality of care as good. Patients' assessment of the quality of diabetes care received was perceived good. There is need to sustain current satisfactory services in diabetic care and institutionalize periodic survey patients' satisfaction to provide feedback for future quality improvementItem Soil Transmitted Helminthes Infection among Pregnant Women in Peri-Urban Areas of Ibadan, Nigeria: A cross-sectional study(Federal Teaching Hospital, Abakaliki, Nigeria, 2018-04) Umezurike, C. E.; Adeoye, I. A.; Oluwatoba, O. A.; Oluwasola T. A. O.cross sectional facility-based study was conducted among the 326 pregnant women attending antenatal care clinics in six selected Primary Health Care centers, in the peri-urban areas of Ibadan Oyo State. An interviewer administered questionnaire was used to obtain information on the socio-demographic, maternal, environmental characteristics and hygiene practices. Kato-Katz method was used to identify the presence of STH from stool samples. Data were analysed using chi-square and bivariate logistic analysis. RESULTS: The overall prevalence of STH was 13.8%; 95% CI (10.0 -17.7). Ascaris lumbricoides 13.2%: 95% CI (9.5 -16.9) was the most prevalent followed by hookworm infection 0.6% 95% CI (-0.2 – 0.15) and Trichuris trichuria 0.3% 95% CI (- 0.2 – 0.9). Majority of the infection were of light intensity (44 out of 45). Walking bare footed in the home environment increased the likelihood of being infected with STH [OR 1.93 95% CI (1.01 -3.72) p=0.048] compared with women who wore shoes. CONCLUSION: STH infection is prevalent among pregnant women in the peri-urban region of Ibadan. Therefore public health interventions like active surveillance of STH and the prescription of deworming drugs for pregnant women.Item Maternal health care utilization and neonatal mortality in Nigeria: looking beyond the micro-level pathway of influence(Union for African Population Studies Association, 2017-06) Adeoye, I. A.; Quadri, G.; Adedini, S. A.Neonatal mortality is a neglected but largely preventable public health challenge in Nigeria. The country contributes the largest number of neonatal deaths in Africa, and this is an important reason for the failure of the country to meet Millennium Development Goal (MDG4) of reducing child mortality. Maternal health services provide the platform for delivering cost-effective interventions that reduce maternal and child mortality. Thus, we examined the relationship between the utilization of maternal health services and neonatal mortality in Nigeria by carrying out a multilevel Cox proportional regression analysis of the most recent Nigeria Demographic and Health Survey (2013 NDHS) in order to decompose the micro and macro level factors on the pathway of influence for neonatal mortality. Hazards of neonatal death were significantly lower for children whose mothers had 4 or more antenatal visits by skilled providers (HR: 0.78, CI: 0.61-0.98, p<0.05) and whose mothers received postnatal care from skilled provider (HR: 0.41, CI: 0.30-0.56, p<0.05) even after adjusting for other control variables. There was also a significantly elevated hazards of neonatal mortality for mothers in rural areas (HR: 1.44, CI: 1.09-1.90). Our findings highlight the importance of maternal health care services for neonatal mortality reduction especially in the rural areas.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.