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Iuliano A, Burgess R, Shittu F, King C, Bakare AA, Valentine P, Haruna I, Colbourn T. Linking communities and health facilities to improve child health in low resource settings: a systematic review. Health Policy Plan 2024:czae028. [PMID: 38619140 DOI: 10.1093/heapol/czae028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 02/22/2024] [Accepted: 04/12/2024] [Indexed: 04/16/2024] Open
Abstract
Community-facility linkage interventions are gaining popularity as a way to improve community health in low-income settings. Their aim is to create/strengthen a relationship between community members and local healthcare providers. Representatives from both groups can address health issues together, overcome trust problems, potentially leading to participants' empowerment to be responsible for their own health. This can be achieved via different approaches. We conducted a systematic literature review to explore how this type of intervention has been implemented in rural and low or lower-middle income countries, its various features and how/if it has helped to improve child health in these settings. Publications from three electronic databases (Web of Science, PubMed, Embase) up to 03/02/2022 were screened, with 14 papers meeting the inclusion criteria (rural setting in low/lower-middle income countries, presence of a community-facility linkage component, outcomes of interest related to under-five children's health, peer-reviewed articles containing original data written in English). We used Rosato's integrated conceptual framework for community participation to assess the transformative and community empowering capacities of the interventions, and realist principles to synthesize the outcomes. The results of this analysis highlight which conditions can lead to success of this type of intervention: active inclusion of hard-to-reach groups, involvement of community members in implementation's decisions, activities tailored to the actual needs of interventions' contexts, and usage of mixed methods for a comprehensive evaluation. These lessons informed the design of a community-facility linkage intervention and offer a framework to inform the development of monitor and evaluation plans for future implementations.
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Affiliation(s)
- A Iuliano
- Institute for Global Health, University College London, London, UK
| | - R Burgess
- Institute for Global Health, University College London, London, UK
| | - F Shittu
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - C King
- Institute for Global Health, University College London, London, UK
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - A A Bakare
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - I Haruna
- Save the Children International Nigeria
| | - T Colbourn
- Institute for Global Health, University College London, London, UK
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Salako J, Bakare D, Uchendu OC, Bakare AA, Graham H, Falade AG. Factors associated with immunization status among children aged 12-59 months in Lagelu local government area, Ibadan: a cross-sectional study. Pan Afr Med J 2024; 47:35. [PMID: 38586066 PMCID: PMC10998252 DOI: 10.11604/pamj.2024.47.35.37013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/31/2023] [Indexed: 04/09/2024] Open
Abstract
Introduction childhood deaths from preventable causes remain high in Nigeria. Although vaccines are available to combat many of these diseases, vaccine coverage remains low in many at-risk communities. With this study, we aimed to determine factors that might have impacted the use of immunization services in Ibadan, the capital of Oyo State in southwest Nigeria. Methods we conducted a community-based cross-sectional study in a peri-urban local government area in Ibadan using a multi-stage cluster sampling technique to identify respondents for this study. The interviewer-administered questionnaire was used to obtain information on respondents and child socio-demographic details. We reviewed the child´s vaccine card to determine vaccine status. Data were analyzed using STATA version 14 at a 5% level of significance. Results of the 265 children aged 12 to 59 months who had their vaccine cards appropriately filled, only 65.3% (n=173) received all basic vaccines, while 90.2% (n=239) and 86.8% (n=230) received 3 doses of pentavalent vaccine (PENTA) and pneumococcal conjugate vaccines (PCV-10) respectively. We found a significant difference in the completion of basic vaccination according to the caregiver´s place of residence and the mother´s educational level. Access-related barriers were frequently reported (n=24, 54.5%) as reasons for missing a due vaccine. Conclusion improvement in vaccine coverage in this setting is necessary. Targeted health information for mothers may be a cost-efficient and sustainable approach to improve vaccine coverage for under-five children.
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Affiliation(s)
- Julius Salako
- Department of Health Promotion and Education, University of Ibadan, Ibadan, Nigeria
| | - Damola Bakare
- Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria
| | - Obioma Chukwudi Uchendu
- Department of Community Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ayobami Adebayo Bakare
- Department of Community Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Hamish Graham
- Centre for International Child Health, Murdoch Children´s Research Institute, University of Melbourne, Royal Children´s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria
| | - Adegoke Gbadegesin Falade
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria
- Department of Paediatrics, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Burgess RA, Shittu F, Iuliano A, Haruna I, Valentine P, Bakare AA, Colbourn T, Graham HR, McCollum ED, Falade AG, King C. Whose knowledge counts? Involving communities in intervention and trial design using community conversations. Trials 2023; 24:385. [PMID: 37287035 DOI: 10.1186/s13063-023-07320-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 04/20/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Current debates in Global Health call for expanding methodologies to allow typically silenced voices to contribute to processes of knowledge production and intervention design. Within trial research, this has typically involved small-scale qualitative work, with limited opportunities for citizens to contribute to the structure and nature of the trial. This paper reports on efforts to move past typical formative trial work, through adaptation of community conversations (CCs) methodology, an action-oriented approach that engages large numbers of community members in dialogue. We applied the CC method to explore community perspectives about pneumonia and managing the health of children under-5 in Northern Nigeria to inform our pragmatic cluster randomised controlled trial evaluating a complex intervention to reduce under-5 mortality in Nigeria. METHODS We conducted 12 rounds of community conversations with a total of 320 participants, in six administrative wards in Kiyawa Local Government Area, Jigawa state, our intervention site. Participants were male and female caregivers of children under five. Conversations were structured around participatory learning and action activities, using drawings and discussion to reduce barriers to entry. During activities participants were placed in subgroups: younger women (18-30 years of age), older women (31-49 years) and men (18 years above). Discussions were conducted over three 2-h sessions, facilitated by community researchers. Following an initial analysis to extract priority issues and perspectives on intervention structure, smaller focus group discussions were completed with participants in five new sites to ensure all 11 administrative wards in our study site contributed to the design. RESULTS We identified enabling and limiting factors which could shape the future trial implementation, including complex power relationships within households and wider communities shaping women's health decision-making, and the gendered use of space. We also noted the positive engagement of participants during the CC process, with many participants valuing the opportunity to express themselves in ways they have not been able to in the past. CONCLUSIONS CCs provide a structured approach to deep meaningful engagement of everyday citizens in intervention and trial designs, but require appropriate resources, and commitment to qualitative research in trials. TRIAL REGISTRATION ISRCTN39213655. Registered on 11 December 2019.
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Affiliation(s)
| | - Funmilayo Shittu
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Agnese Iuliano
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Ayobami Adebayo Bakare
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
| | - Tim Colbourn
- Institute for Global Health, University College London, London, UK
| | - Hamish R Graham
- Centre for International Child Health, Murdoch Children's Research Institute, University of Melbourne, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Eric D McCollum
- Department of Pediatrics, School of Medicine, Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University, Baltimore, USA
| | - Adegoke G Falade
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
| | - Carina King
- Institute for Global Health, University College London, London, UK
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Bakare AA, Uchendu OC, Omotayo OE, King C. FEEDING PRACTICES AND NUTRITIONAL STATUS OF UNDER-FIVE CHILDREN IN A PERI-URBAN SETTING IN IBADAN, SOUTHWEST NIGERIA: A COMPARATIVE CROSS-SECTIONAL STUDY. Ann Ib Postgrad Med 2023; 21:52-62. [PMID: 37528822 PMCID: PMC10388425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Abstract
Background Existing literature suggests inequalities in nutritional and feeding practices for children in rural communities compared to their urban counterparts. However, with increasing urbanization and changing social norms, re-assessment of rural-urban differences in feeding practices for under-five children is essential. This study therefore aimed to assess the feeding practices and nutritional status of children in a peri-urban setting in Ibadan. Methods We conducted a community-based cross-sectional comparative study in peri-urban LGA (Lagelu) in Ibadan. Participants were 617 caregivers of underfive children identified, from wards typical of rural and urban settings, through a multistage sampling technique. Caregivers' sociodemographic details, 24-hour dietary recall of the child's feeding, and anthropometric measurements were obtained. Results Nearly half of the children were 2 years or older (rural: n=142, 47.2%; urban: n=147, 46.2%). There was significant difference between settings in terms of maternal age and education, father's education, caregiver's occupation and socioeconomic status. In total, 611 children (99.0%) were breastfed. Of those breastfed, 45% and 39% in rural and urban settings respectively were initiated within an hour of delivery. Children in rural setting had longer duration of breast feeding. However, they are less likely to be exclusively breast fed for 6 - months compared with children whose caregivers are urban dwellers. Dietary diversity was similar in both settings but higher among males. (20.3% male, 11.7% female in rural; 17.3% male and 15.5% female in urban). Overall, 108 (22.3%), 107 (21.9%), 152 (30.6%) and 34 (7.0%) of children aged 6-59 months were cachetic, underweight, stunted, and overweight respectively but commoner among children in rural settings. Conclusion Feeding and nutrition programmes need to apply a gender lens if sustained behavioural interventions on child nutrition are to reach equitable outcomes.
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Affiliation(s)
- A A Bakare
- Department of Community Medicine, University of Ibadan, Ibadan Oyo State Nigeria
- Department of Community Medicine, University College Hospital, Ibadan Oyo State Nigeria
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - O C Uchendu
- Department of Community Medicine, University of Ibadan, Ibadan Oyo State Nigeria
- Department of Community Medicine, University College Hospital, Ibadan Oyo State Nigeria
| | - O E Omotayo
- Department of Paediatrics, University College Hospital, Ibadan Oyo State Nigeria
| | - C King
- Department of Global Public Health, Karolinska Institutet, Sweden
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Bakare AA, Uchendu OC, Omotayo OE, King C. FEEDING PRACTICES AND NUTRITIONAL STATUS OF UNDER-FIVE CHILDREN IN A PERI-URBAN SETTING IN IBADAN, SOUTHWEST NIGERIA: A COMPARATIVE CROSS-SECTIONAL STUDY. Ann Ib Postgrad Med 2023; 21:50-62. [PMID: 37528813 PMCID: PMC10388426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Abstract
Background Existing literature suggests inequalities in nutritional and feeding practices for children in rural communities compared to their urban counterparts. However, with increasing urbanization and changing social norms, re-assessment of rural-urban differences in feeding practices for under-five children is essential. This study therefore aimed to assess the feeding practices and nutritional status of children in a peri-urban setting in Ibadan. Methods We conducted a community-based cross-sectional comparative study in peri-urban LGA (Lagelu) in Ibadan. Participants were 617 caregivers of underfive children identified, from wards typical of rural and urban settings, through a multistage sampling technique. Caregivers' sociodemographic details, 24-hour dietary recall of the child's feeding, and anthropometric measurements were obtained. Results Nearly half of the children were 2 years or older (rural: n=142, 47.2%; urban: n=147, 46.2%). There was significant difference between settings in terms of maternal age and education, father's education, caregiver's occupation and socioeconomic status. In total, 611 children (99.0%) were breastfed. Of those breastfed, 45% and 39% in rural and urban settings respectively were initiated within an hour of delivery. Children in rural setting had longer duration of breast feeding. However, they are less likely to be exclusively breast fed for 6 - months compared with children whose caregivers are urban dwellers. Dietary diversity was similar in both settings but higher among males. (20.3% male, 11.7% female in rural; 17.3% male and 15.5% female in urban). Overall, 108 (22.3%), 107 (21.9%), 152 (30.6%) and 34 (7.0%) of children aged 6-59 months were cachetic, underweight, stunted, and overweight respectively but commoner among children in rural settings. Conclusion Feeding and nutrition programmes need to apply a gender lens if sustained behavioural interventions on child nutrition are to reach equitable outcomes.
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Affiliation(s)
- A A Bakare
- Department of Community Medicine, University of Ibadan, Ibadan Oyo State Nigeria
- Department of Community Medicine, University College Hospital, Ibadan Oyo State Nigeria
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - O C Uchendu
- Department of Community Medicine, University of Ibadan, Ibadan Oyo State Nigeria
- Department of Community Medicine, University College Hospital, Ibadan Oyo State Nigeria
| | - O E Omotayo
- Department of Paediatrics, University College Hospital, Ibadan Oyo State Nigeria
| | - C King
- Department of Global Public Health, Karolinska Institutet, Sweden
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Bakare AA, Olojede OE, King C, Graham H, Uchendu O, Colbourn T, Falade AG, Alvesson HM. Care seeking for under-five children and vaccine perceptions during the first two waves of the COVID-19 pandemic in Lagos State, Nigeria: a qualitative exploratory study. BMJ Open 2023; 13:e069294. [PMID: 36882237 PMCID: PMC10008198 DOI: 10.1136/bmjopen-2022-069294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 02/20/2023] [Indexed: 03/09/2023] Open
Abstract
OBJECTIVE To explore healthcare seeking practices for children and the context-specific direct and indirect effects of public health interventions during the first two waves of COVID-19 in Lagos State, Nigeria. We also explored decision-making around vaccine acceptance at the start of COVID-19 vaccine roll-out in Nigeria. DESIGN, SETTING AND PARTICIPANTS A qualitative explorative study involving 19 semistructured interviews with healthcare providers from public and private primary health facilities and 32 interviews with caregivers of under-five children in Lagos from December 2020 to March 2021. Participants were purposively selected from healthcare facilities to include community health workers, nurses and doctors, and interviews were conducted in quiet locations at facilities. A data-driven reflexive thematic analysis according to Braun and Clark was conducted. FINDINGS Two themes were developed: appropriating COVID-19 in belief systems, and ambiguity about COVID-19 preventive measures. The interpretation of COVID-19 ranged from fearful to considering it as a 'scam' or 'falsification from the government'. Underlying distrust in government fuelled COVID-19 misperceptions. Care seeking for children under five was affected, as facilities were seen as contagious places for COVID-19. Caregivers resorted to alternative care and self-management of childhood illnesses. COVID-19 vaccine hesitancy was a major concern among healthcare providers compared with community members at the time of vaccine roll-out in Lagos, Nigeria. Indirect impacts of COVID-19 lockdown included diminished household income, worsening food insecurity, mental health challenges for caregivers and reduced clinic visits for immunisation. CONCLUSION The first wave of the COVID-19 pandemic in Lagos was associated with reductions in care seeking for children, clinic attendance for childhood immunisations and household income. Strengthening health and social support systems with context-specific interventions and correcting misinformation is crucial to building adaptive capacity for response to future pandemics. TRIAL REGISTRATION NUMBER ACTRN12621001071819.
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Affiliation(s)
- Ayobami Adebayo Bakare
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
| | - Omotayo E Olojede
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria
| | - Carina King
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Hamish Graham
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria
- Centre for International Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Obioma Uchendu
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
- Department of Community Medicine, University of Ibadan College of Medicine, Ibadan, Nigeria
| | - Tim Colbourn
- Institute for Global Health, University College London, London, UK
| | - Adegoke G Falade
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria
- Department of Paediatrics, University of Ibadan College of Medicine, Ibadan, Nigeria
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King C, Siddle M, Adams O, Ahmar S, Ahmed T, Bakare AA, Bakare D, Burgess RA, Colbourn T, McCollum ED, Olowookere T, Salako J, Uchendu O, Graham HR, Falade AG. Prevalence of pneumonia and malnutrition among children in Jigawa state, Nigeria: a community-based clinical screening study. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001640. [PMID: 36645778 PMCID: PMC9577914 DOI: 10.1136/bmjpo-2022-001640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/27/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To estimate the point prevalence of pneumonia and malnutrition and explore associations with household socioeconomic factors. DESIGN Community-based cross-sectional study conducted in January-June 2021 among a random sample of households across all villages in the study area. SETTING Kiyawa Local Government Area, Jigawa state, Nigeria. PARTICIPANTS Children aged 0-59 months who were permanent residents in Kiyawa and present at home at the time of the survey. MAIN OUTCOME MEASURES Pneumonia (non-severe and severe) defined using WHO criteria (2014 revision) in children aged 0-59 months. Malnutrition (moderate and severe) defined using mid-upper arm circumference in children aged 6-59 months. RESULTS 9171 children were assessed, with a mean age of 24.8 months (SD=15.8); 48.7% were girls. Overall pneumonia (severe or non-severe) point prevalence was 1.3% (n=121/9171); 0.6% (n=55/9171) had severe pneumonia. Using an alternate definition that did not rely on caregiver-reported cough/difficult breathing revealed higher pneumonia prevalence (n=258, 2.8%, 0.6% severe, 2.2% non-severe). Access to any toilet facility was associated with lower odds of pneumonia (aOR: 0.56; 95% CI: 0.31 to 1.01). The prevalence of malnutrition (moderate or severe) was 15.6% (n=1239/7954) with 4.1% (n=329/7954) were severely malnourished. Being older (aOR: 0.22; 95% CI: 0.17 to 0.27), male (aOR: 0.77; 95% CI: 0.66 to 0.91) and having head of compound a business owner or professional (vs subsistence farmer, aOR 0.71; 95% CI: 0.56 to 0.90) were associated with lower odds of malnutrition. CONCLUSIONS In this large, representative community-based survey, there was a considerable pneumonia and malnutrition morbidity burden. We noted challenges in the diagnosis of Integrated Management of Childhood Illness-defined pneumonia in this context.
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Affiliation(s)
- Carina King
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Morgan Siddle
- Institute for Global Health, University College London, London, UK
| | - Osebi Adams
- Save the Children International, Abuja, Nigeria
| | | | | | - Ayobami Adebayo Bakare
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.,Department of Community Medicine, University College Hospital Ibadan, Ibadan, Nigeria
| | - Damola Bakare
- Paediatrics, University College Hospital Ibadan, Ibadan, Nigeria
| | | | - Tim Colbourn
- Institute for Global Health, University College London, London, UK
| | - Eric D McCollum
- Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | | | - Julius Salako
- Paediatrics, University College Hospital Ibadan, Ibadan, Nigeria
| | - Obioma Uchendu
- Department of Community Medicine, University College Hospital Ibadan, Ibadan, Nigeria.,Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
| | - Hamish R Graham
- Paediatrics, University College Hospital Ibadan, Ibadan, Nigeria .,International Child Health, MCRI, Royal Children's Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Adegoke Gbadegesin Falade
- Paediatrics, University College Hospital Ibadan, Ibadan, Nigeria.,College of Medicine, University of Ibadan, Ibadan, Nigeria
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Coker MM, Akinyemi RO, Bakare AA, Owolabi MO. Genetic Epidemiology and Associated Diseases of APOL1: A Narrative Review. West Afr J Med 2021; 38:511-519. [PMID: 34174036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND The Apolipoprotein 1 (APOL1) protein is a product of the human APOL1 gene located on chromosome 22q13.1 and performs functions including lipid transport and metabolism, programmed cell death, autophagy and innate immunity against intracellular pathogens. It is unique among its gene family in its possession of a signal peptide that confers on it the ability for export out of the cell and into the blood stream. The aim of this review is to explore the genetic epidemiology and biology of the APOL1 gene, describe its association with different renal and extra-renal disorders and highlight the timelines of the discoveries of the various associations. METHODS A literature search was carried out using combination of terms including "apolipoproteins", "apolipoprotein L", "APOL1", "genetics of APOL1", "Chronic Kidney Disease (CKD) and APOL1"," APOL1 and associated diseases" covering the period January 1990 to April 2020. RESULTS High frequency of the APOL1 gene arose as a result of natural selection in East and West Africa, regions endemic for Trypanosoma brucei infection. High frequencies are also reported among individuals of African ancestry in North America. APOL1 G1 and G2 variants protect against Trypanosoma brucei rhodesiense having overcome their virulence through the serum trypanolytic factor. Although protective against infection from trypanosomes, these alleles have also been shown to increase the risk of several disorders including various forms of chronic kidney diseases, schizophrenia, stroke, cancer, and pre - eclampsia. CONCLUSION The elucidation of the APOL1 gene has deepened understanding of racial disparities in health and disease. Growing understanding of the genetics and functions of APOL1 has potential to enhance translational benefits for development of new biomarkers, preventive and therapeutic interventions in the context of precision medicine.
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Affiliation(s)
- M M Coker
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training
- Centre for Genomic and Precision Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
- Cell Biology and Genetics Unit, Department of Zoology, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - R O Akinyemi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training
- Centre for Genomic and Precision Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
- Neurology Unit, Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - A A Bakare
- Centre for Genomic and Precision Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
- Cell Biology and Genetics Unit, Department of Zoology, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - M O Owolabi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training
- Centre for Genomic and Precision Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
- Neurology Unit, Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
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Walker PJB, Bakare AA, Ayede AI, Oluwafemi RO, Olubosede OA, Olafimihan IV, Tan K, Duke T, Falade AG, Graham H. Using intermittent pulse oximetry to guide neonatal oxygen therapy in a low-resource context. Arch Dis Child Fetal Neonatal Ed 2020; 105:316-321. [PMID: 31462405 PMCID: PMC7363784 DOI: 10.1136/archdischild-2019-317630] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/31/2019] [Accepted: 08/08/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of intermittent pulse oximetry in guiding oxygen therapy in neonates in a low-resource setting. DESIGN AND SETTING Prospective validation study at three hospitals in southwest Nigeria. We performed concealed continuous pulse oximetry on participants to evaluate intermittent SpO2 monitoring. PATIENTS We recruited all preterm or low birthweight neonates, and all term neonates who required oxygen therapy, who were admitted to the neonatal ward(s) of the study hospitals during the study period. MAIN OUTCOME MEASURES Proportion of time preterm/low birthweight neonates on oxygen spent within, above and below the target SpO2 range of 90%-95%; and the proportion of time term neonates and neonates not on oxygen spent within and below the target range of 90%-100%. RESULTS Preterm/low birthweight neonates receiving oxygen therapy (group A) spent 15.7% (95% CI 13.3 to 18.9) of time in the target SpO2 range of 90%-95%. They spent 75.0% (63.6-81.1) of time above 95%, and 2.7% (1.7-5.6) of time below 85%. Term neonates and all neonates not receiving oxygen (group B) spent 97.3% (95% CI 96.4 to 98.6) of time within the target range of 90%-100%, and 0.9% (0.3-1.4) of time below 85%. Guidelines recommended SpO2 monitoring 3 times per day for all patients, however neonates in groups A and B were monitored an average of 4.7 and 5.3 times per day, respectively. CONCLUSIONS To better maintain SpO2 within the target range, preterm/low birthweight neonates on oxygen should have their SpO2 monitored more frequently than the current 4.7 times per day. In all other neonates, however, monitoring SpO2 5.3 times per day appears suitable.
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Affiliation(s)
- Patrick James Berkeley Walker
- Centre for International Child Health, Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia .,Medicine, Nursing & Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Ayobami Adebayo Bakare
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria,University College Hospital Ibadan, Ibadan, Nigeria
| | | | | | | | | | - Kenneth Tan
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia,Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia
| | - Trevor Duke
- Intensive Care Unit and University of Melbourne Department of Paediatrics, Royal Children's Hospital, Parkville, Victoria, Australia,Department of Child Health, School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea
| | - Adegoke Gbadegesin Falade
- College of Medicine, University of Ibadan, Ibadan, Nigeria,Department of Paediatrics, University College Hospital Ibadan, Ibadan, Nigeria
| | - Hamish Graham
- Centre for International Child Health, University of Melbourne, Royal Children's Hospital, Parkville, Victoria, Australia
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10
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Graham HR, Ayede AI, Bakare AA, Oyewole OB, Peel D, Falade AG, Duke T. Oxygen for children and newborns in non-tertiary hospitals in South-west Nigeria: A needs assessment. Afr J Med Med Sci 2016; 45:31-49. [PMID: 28686826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Oxygen is important for the treatment of hypoxaemia associated with pneumonia, malaria, and other medical, obstetric, and surgical conditions. Access to oxygen therapy is limited in many of the high mortality settings where it would be of most benefit. METHODS A needs assessment of 12 non-tertiary hospitals in south-west Nigeria, assessing structural, technical and clinical barriers to the provision of safe and effective oxygen therapy. RESULTS Oxygen supply was reported to be a major challenge by hospital directors. All hospitals had some access to oxygen cylinders, which were expensive and frequently ran out. Nine (75%) hospitals used oxygen concentrators, which were limited by inadequate power supply and lack of maintenance capacity. Appropriate oxygen delivery and monitoring devices (nasal prongs, catheters, pulse oximeters) were poorly available, and no hospitals had clinical guidelines pertaining to the use of -oxygen for children. Oxygen was expensive to patients (median US$20/day) and to hospitals. Estimated oxygen demand is reported using both a constant mean-based estimate and adjustment for seasonal and other variability. CONCLUSIONS Making oxygen available to sick children and neonates in Nigerian hospitals will require: improving detection of hypoxaemia through routine use of pulse oximetry; improving access to oxygen through equipment, training, and maintenance structures; and commitment to building hospital and state structures that can sustain and expand oxygen initiatives.
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11
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Abstract
Some plant extracts can be used in biology and medicine to reveal or identify cellular components and tissues. We investigated the effects of time and concentration on staining of histological sections of rat testes by an acidified extract of Hibiscus sabdariffa. An ethanolic extract of H. sabdariffa was diluted using 1% acetic acid in 70% ethanol to stain histological sections of testes at concentrations of 0.2, 0.1 and 0.05 g/ml for 5, 10, 15, 30, 45 and 60 min. The sections of testes were stained deep red. The staining efficiency of H. sabdariffa was greater at a high concentration and required less time to achieve optimal staining. H. sabdariffa is a strongly basic dye that can be used for various diagnostic purposes. Staining time and concentration must be considered to achieve optimal results.
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Affiliation(s)
- R B Bassey
- Department of Anatomy, Faculty of Basic Medical Sciences, University of Uyo, Akwa Ibom State, Nigeria.
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12
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Efuntoye MO, Bakare AA, Sowunmi AA. Virulence factors and antibiotic resistance in Staphylococcus aureus and Clostridium perfringens from landfill leachate. ACTA ACUST UNITED AC 2011. [DOI: 10.5897/ajmr11.756] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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13
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Abstract
BACKGROUND: In the human species, twin is a type of multiple birth in which the mother gives birth to two offspring from the same pregnancy. The occurrence and frequency of twinning, however, varies across human populations. The maternal age, socio-environmental factors, increase in the use of contraceptives, the race of human population, increase in the spontaneous abortion rate, and seasonal variations are among the factors that could influence twinning rate. Information on twinning rates in southwest Nigeria is limited. AIMS: This study presents information on the frequency of twinning, as well as its analysis by maternal age, in four urban settings in southwest Nigeria. This is with the aim of extending current knowledge on the frequency of twinning in southwest Nigeria and contributing to the demographic studies in the country. MATERIALS AND METHODS: Data on single births and twin births from January 1995 to December 2004 were collected from the Oyo State General Hospital (OSGH), Wesley Guild Hospital (WGH), Obafemi Awolowo University Teaching Hospital (OAUTH), and Ekiti State Specialist Hospital (ESSH) in Ogbomoso, Ilesa, Ile-Ife, and Ado-Ekiti respectively. These were analyzed by year and maternal age groups of 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, and 45-49 years according to the standard method. RESULTS: A frequency of twin births of 46.5 per 1000 deliveries and 46.2 per 1000 deliveries was recorded for Ilesa and Ile-Ife respectively. The frequency recorded for Ogbomoso and Ado-Ekiti was 38.5 and 22.1 per 1000 deliveries respectively. The overall average frequency of 40.2 per 1000 deliveries for the four hospitals ranks among the highest recorded rates of twin births in the world. The maternal age group of 25-29 years had the highest occurrence of twin births, while the lowest was recorded in the 45-49 years age group. CONCLUSION: This analysis reveals high incidence of twinning in the studied areas and supports previous assertion that the southwestern part of Nigeria has the highest twinning rate in the country and in the whole world. It is our opinion that diet, maternal history of twinning, and some socio-environmental factors may have influenced the results.
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Badmus JA, Odunola OA, Bakare AA. Effect of defatted methanolic extract of Holarrhena floribunda leaves in sodium arsenite-induced clastogenecity in Wistar albino rats. Afr J Med Med Sci 2010; 39 Suppl:123-128. [PMID: 22416654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study examined the effect of defatted methanolic extract of Holarrhena floribunda leaves on sodium arsenite-induced clastogenecity and toxicity in male wistar rats. Animals were randomly allotted into six groups of five rats each and treated as follows; Group A (sodium arsenite (NaAsO3)), Group B (100 mg/kg extract), Group C (100 mg/kg extract plus NaAsO3), Group D (200 mg/kg extract), Group E (200 mg/kg extract plus NaAsO3) and Group F had distilled water. Sodium arsenite (2.5 mg/kg) was given intraperitoneally once per week. The extract was administered through oral gavage for 28 consecutive days. Clastogenecity was evaluated by studying micronuclei formation in polychromatic erythrocytes cells (PCEs) in the bone marrow. Plasma levels of Gamma Glutamyl Transferase (ãGT), Aspartate Amino Transferase (AST), Alanine Amino Transferase (ALT) were determined. Hepatic Reduced Glutathione (GSH), Superoxide Dismutase (SOD), Catalase (CAT), protein and lipid peroxidation were determined. Liver histopathological evaluation was also carried out.The results obtained show that NaAsO3-induced micronuclei formation in PCEs was reduced at 100 and 200 mg/kg of the extract by 7.7% and 38.5% respectively while elevated plasma ãGT and ALT levels were significantly ameliorated (P<0.001). There was no significant difference in plasma AST levels and hepatic SOD activities in all the treated groups as compared with the control. Sodium arsenite-induced reduction of GSH concentration was elevated by the extract at 100 and 200 mg/kg by 18.5% and 11.9% respectively. The reduction of CAT activity by NaAsO3 was also ameliorated at 200 mg/kg extract by 23.3%. The extract at 100 mg/kg significantly reduced NaAsO3-induced lipid peroxidation by 16.4% (P < 0.05). Histological examinations showed that the extract at 100 mg/kg protected NaAsO3-induced liver damage. This study revealed that the leaf extract has potential to ameliorate clastogenecity and toxicity induced by sodium arsenite in rats.
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Affiliation(s)
- J A Badmus
- Cancer Research Laboratories, Department of Biochemistry, College of Medicine, University of Ibadan, Ibadan, Nigeria
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15
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Akinboro A, Bakare AA. Cytotoxic and genotoxic effects of aqueous extracts of five medicinal plants on Allium cepa Linn. J Ethnopharmacol 2007; 112:470-5. [PMID: 17572030 DOI: 10.1016/j.jep.2007.04.014] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2006] [Revised: 03/16/2007] [Accepted: 04/12/2007] [Indexed: 05/15/2023]
Abstract
The cytotoxic and genotoxic effects of aqueous extracts of five medicinal plants: Azadirachta indica (A. Juss), Morinda lucida (Benth.), Cymbopogon citratus (DC Stapf.), Mangifera indica (Linn.) and Carica papaya (Linn.) was evaluated using the Allium cepa assay. The extracts were prepared with tap water as practised locally. Onion bulbs were exposed to 1, 5, 10, 25 and 50%; and 1, 2.5, 5, 10 and 20% concentrations (v/v) of each of the extracts for macroscopic and microscopic analyses, respectively. There was concentration-dependent and statistically significant (P<0.05) inhibition of root growth by the extracts when compared with the control. The EC(50) obtained for decoctions of Azadirachta indica. Cymbopogon citratus, Mangifera indica and Carica papaya were 0.6, 3.0, 1.4 and 0.8%, respectively. It was 2.6 and 0.8% for the squeezed extracts of Azadirachta indica and Morinda lucida, respectively. All the tested extracts were observed to have mitodepressive effects on cell division and induced mitotic spindle disturbance in Allium cepa. These results suggest an inhibitory, mitodepressive and turbagenic activities of the aqueous extracts on Allium cepa.
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Affiliation(s)
- A Akinboro
- Cell Biology & Genetics Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria.
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Abstract
BACKGROUND: Human sex ratio at birth differs from one population to the other. This variation has been attributed to cultural practices, seasonal variation, small-family size policy and sex selective technology. Information on secondary sex ratio in Nigeria is limited. AIMS AND OBJECTIVE: To analyzed human sex ratio at birth for samples of the Nigerian population in 4 urban settings in Southwest Nigeria, in order to know the trend and to compare the findings with those of previous reports. MATERIALS AND METHODS: Data were collected from Obafemi Awolowo University (OAU) teaching hospital at Ile Ife and Wesley Guild hospital at Ilesa, Osun state; General hospital at Ogbomoso, Oyo state and Ekiti state specialist hospital at Ado-Ekiti, Ekiti state. The data consisted of 35 209 live single births recorded between 1995 and 2004. Each set of data was analyzed to determine the sex ratio by year, month and quarterly values. Chi-square analysis was used to determine the deviation of the sex ratios for the years from the average value. RESULTS: The annual average ratios of 104.7:100, 102.8:100, 98.9:100 and 100.8:100 were recorded for OAU teaching hospital, Wesley Guild Hospital, General Hospital and Ekiti State specialist hospital, respectively. When pooled together, the average ratio was 102.7:100. This shows some bias for male births. Data also indicates more male birth in the rainy season, suggesting a seasonal variation of sex ratio. CONCLUSION: These findings are representative of the populations in southwest Nigeria and are comparable to values obtained for other regions in Nigeria and other populations of African origin.
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Affiliation(s)
- M A Azeez
- Department of Pure and Applied Biology, Ladoke Akintola University of Technology, P. M. B. 4000, Ogbomoso, Nigeria
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Bakare AA, Mosuro AA, Osibanjo O. Landfill leachate-induced toxicity in mice. J Environ Biol 2003; 24:429-435. [PMID: 15248658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Microbial, plant and studies in aquatic animals have shown that landfill leachate is toxic. However, more information about its effects in terrestrial animals is required. As a part of ongoing research into the toxic effects of landfill leachate in Nigeria, we evaluated the acute effects of raw and simulated leachates from Abadina, Orita-Aperin and Oworonsoki dump sites, all in Southwest Nigeria, in mice. Raw leachates were obtained directly from the dumps while the simulated leachates were obtained from the solid wastes in the laboratory by using the ASTM method. The samples were designated Abadina raw leachate (ARL), Orita-Aperin raw leachate (OARL) and Oworonsoki raw leachate (OWRL); and Abadina simulated leachate (ASL), Orita-Aperin simulated leachate (OASL) and Oworonsoki simulated leachate (OWSL). Their physico-chemical properties were determined in accordance with standard analytical methods. Young male mice (12-15 wk) weighing 24-31 g were exposed to 1%, 5%, 10%, 25%, 50% and 100% concentrations of each test samples for 5 consecutive days and were observed for a period of 96 h for toxic response. Mortality recorded at different times for each sample at the various concentrations was mostly within the last 48 h of the exposure period. The LC50 obtained are 100% for both ARL and OARL, and 50% for OWRL; and 83.50% and 50% for ASL and OWSL, respectively. It was indeterminate for OASL. Apart from this, other toxic effects like weight loss, sluggishness, loss of hair and reduced food intake were observed. The investigated samples were ranked as OWRL > OWSL > ASL > OARL > ARL > OASL. The observed effects were due to the toxic constituents present in the leachate samples. This suggests that the mixtures have the potential to cause harmful effect to public health and our environment through seepage into ground or surface water.
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Affiliation(s)
- A A Bakare
- Cell Biology and Genetics Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria.
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