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Eze C. Sleep health among medical students in Abakaliki Nigeria: A descriptive study. Sleep Med X 2024; 7:100103. [PMID: 38283143 PMCID: PMC10821605 DOI: 10.1016/j.sleepx.2024.100103] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 11/01/2023] [Accepted: 01/04/2024] [Indexed: 01/30/2024] Open
Abstract
Background Sleep health focuses on those measurable characteristics of sleep that are most clearly associated with physical, mental, and neurobehavioral well-being, and not necessarily the absence of sleep disorder. Sleep health is characterised by subjective satisfaction, appropriate timing, adequate duration, high efficiency, and sustained alertness during waking hours. Adequate and restful sleep is particularly crucial for medical students, who face unique challenges due to the demanding nature of their academic and clinical responsibilities. There is limited data on sleep health among medical students in Nigeria. Objectives This research study investigated the pattern of sleep health among medical students in Abakaliki Nigeria. Methods This cross-sectional observational study was undertaken among the medical students of 2 public institutions in Abakaliki Nigeria from 16th to 23rd June 2023. Results Out of the 288 medical students (males- 53.1 %, females- 46.9 %), good sleep health was recorded in 6.6 %. The mean SATED sleep score was 4.9 ± 1.7 (male- 4.9 ± 1.8, female- 4.9 ± 1.6) (p-value = 1) and it was significantly lower among the final-year students. Age difference, sex difference, and presence of chronic headache did not significantly affect the SATED sleep score. The mean sleep duration was 6.1 ± 1.5 hours (male- 6.1 ± 1.6, female- 6.0 ± 1.4). Sleep duration (54.5 %) had the best rating while sleep efficiency (44 %) had the lowest rating among the assessed sleep domains. Conclusion Sleep health is poor among medical students in Abakaliki Nigeria and significantly poorer among final-year medical students.
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Affiliation(s)
- Chukwuemeka Eze
- Neurology Unit, Internal Medicine Department, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, (AEFUTHA), Ebonyi State, Nigeria
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Onoja BA, Oguzie JU, George UE, Asoh KE, Ajayi P, Omofaye TF, Igeleke IO, Eromon P, Harouna S, Parker E, Adeniji AJ, Happi CT. Whole genome sequencing unravels cryptic circulation of divergent dengue virus lineages in the rainforest region of Nigeria. Emerg Microbes Infect 2024; 13:2307511. [PMID: 38240324 PMCID: PMC10829817 DOI: 10.1080/22221751.2024.2307511] [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] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/16/2024] [Indexed: 01/25/2024]
Abstract
Dengue is often misclassified and underreported in Africa due to inaccurate differential diagnoses of nonspecific febrile illnesses such as malaria, sparsity of diagnostic testing and poor clinical and genomic surveillance. There are limited reports on the seroprevalence and genetic diversity of dengue virus (DENV) in humans and vectors in Nigeria. In this study, we investigated the epidemiology and genetic diversity of dengue in the rainforest region of Nigeria. We screened 515 febrile patients who tested negative for malaria and typhoid fever in three hospitals in Oyo and Ekiti States in southern Nigeria with a combination of anti-dengue IgG/IgM/NS1 rapid test kits and metagenomic sequencing. We found that approximately 28% of screened patients had previous DENV exposure, with the highest prevalence in persons over sixty. Approximately 8% of the patients showed evidence of recent or current infection, and 2.7% had acute infection. Following sequencing of sixty samples, we assembled twenty DENV-1 genomes (3 complete and 17 partial). We found that all assembled genomes belonged to DENV-1 genotype III. Our phylogenetic analyses showed evidence of prolonged cryptic circulation of divergent DENV lineages in Oyo state. We were unable to resolve the source of DENV in Nigeria owing to limited sequencing data from the region. However, our sequences clustered closely with sequences in Tanzania and sequences reported in Chinese with travel history to Tanzania in 2019. This may reflect the wider unsampled bidirectional transmission of DENV-1 in Africa, which strongly emphasizes the importance of genomic surveillance in monitoring ongoing DENV transmission in Africa.
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Affiliation(s)
- Bernard Anyebe Onoja
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Judith Uche Oguzie
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer’s University, Ede, Osun State, Nigeria
- African Center of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede, Osun State, Nigeria
| | - Uwem Etop George
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer’s University, Ede, Osun State, Nigeria
- African Center of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede, Osun State, Nigeria
| | - Kaego Emmanuel Asoh
- Department of Medical Laboratory Science, College of Medicine, University of Ibadan, Ibadan, State Nigeria
| | - Philip Ajayi
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | | | | | - Philomena Eromon
- African Center of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede, Osun State, Nigeria
| | - Soumare Harouna
- African Center of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede, Osun State, Nigeria
| | - Edyth Parker
- African Center of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede, Osun State, Nigeria
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | | | - Christian T. Happi
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer’s University, Ede, Osun State, Nigeria
- African Center of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede, Osun State, Nigeria
- Department of Immunology and Infectious Diseases, Harvard T H Chan School of Public Health, Boston, MA, USA
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Happi AN, Ogunsanya OA, Ayinla AO, Sijuwola AE, Saibu FM, Akano K, Nwofoke C, Elias OT, Achonduh-Atijegbe O, Daodu RO, Adedokun OA, Adeyemo A, Ogundana KE, Lawal OZ, Parker E, Nosamiefan I, Okolie J, Parker ZF, McCauley MD, Eller LA, Lombardi K, Tiamiyu AB, Iroezindu M, Akinwale E, Njatou TLFA, Mebrahtu T, Broach E, Zuppe A, Prins P, Lay J, Amare M, Modjarrad K, Collins ND, Vasan S, Tucker C, Daye S, Happi CT. Lassa virus in novel hosts: insights into the epidemiology of lassa virus infections in southern Nigeria. Emerg Microbes Infect 2024; 13:2294859. [PMID: 38088796 PMCID: PMC10810657 DOI: 10.1080/22221751.2023.2294859] [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] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024]
Abstract
Identification of the diverse animal hosts responsible for spill-over events from animals to humans is crucial for comprehending the transmission patterns of emerging infectious diseases, which pose significant public health risks. To better characterize potential animal hosts of Lassa virus (LASV), we assessed domestic and non-domestic animals from 2021-2022 in four locations in southern Nigeria with reported cases of Lassa fever (LF). Birds, lizards, and domestic mammals (dogs, pigs, cattle and goats) were screened using RT-qPCR, and whole genome sequencing was performed for lineage identification on selected LASV positive samples. Animals were also screened for exposure to LASV by enzyme-linked immunosorbent assay (ELISA). Among these animals, lizards had the highest positivity rate by PCR. Genomic sequencing of samples in most infected animals showed sub-lineage 2 g of LASV. Seropositivity was highest among cattle and lowest in pigs. Though the specific impact these additional hosts may have in the broader virus-host context are still unknown - specifically relating to pathogen diversity, evolution, and transmission - the detection of LASV in non-rodent hosts living in proximity to confirmed human LF cases suggests their involvement during transmission as potential reservoirs. Additional epidemiological data comparing viral genomes from humans and animals, as well as those circulating within the environment will be critical in understanding LASV transmission dynamics and will ultimately guide the development of countermeasures for this zoonotic health threat.
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Affiliation(s)
- Anise Nkenjop Happi
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede, Osun State, Nigeria
| | - Olusola Akinola Ogunsanya
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede, Osun State, Nigeria
| | - Akeemat Opeyemi Ayinla
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede, Osun State, Nigeria
| | - Ayotunde Elijah Sijuwola
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede, Osun State, Nigeria
| | - Femi Mudasiru Saibu
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede, Osun State, Nigeria
| | - Kazeem Akano
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede, Osun State, Nigeria
- Redeemer’s University, Ede, Osun, Nigeria
| | - Cecilia Nwofoke
- Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | | | | | - Richard Olumide Daodu
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede, Osun State, Nigeria
| | - Oluwatobi Abel Adedokun
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede, Osun State, Nigeria
| | - Abraham Adeyemo
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede, Osun State, Nigeria
| | | | | | - Edyth Parker
- Scripps Translational Science Institute, La Jolla, CA, USA
| | - Iguosadolo Nosamiefan
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede, Osun State, Nigeria
| | - Johnson Okolie
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede, Osun State, Nigeria
| | - Zahra F. Parker
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Melanie D. McCauley
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Leigh Anne Eller
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Kara Lombardi
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Abdulwasiu Bolaji Tiamiyu
- Henry M. Jackson Foundation Medical Research International Ltd/Gte, Abuja, Nigeria
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Michael Iroezindu
- Henry M. Jackson Foundation Medical Research International Ltd/Gte, Abuja, Nigeria
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Edward Akinwale
- Henry M. Jackson Foundation Medical Research International Ltd/Gte, Abuja, Nigeria
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | | | - Tsedal Mebrahtu
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Erica Broach
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Anastasia Zuppe
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Petra Prins
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Jenny Lay
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Mihret Amare
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Kayvon Modjarrad
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Natalie D. Collins
- Viral Diseases Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Sandhya Vasan
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Cynthia Tucker
- One Health Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Sharon Daye
- One Health Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Christian Tientcha Happi
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede, Osun State, Nigeria
- Redeemer’s University, Ede, Osun, Nigeria
- Department of Immunology and Infectious Diseases, Harvard T H Chan School of Public Health, Boston, MA, USA
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Sanni AO, Jonker A, Were V, Fasanmi OG, Adebowale OO, Shittu A, Jibril AH, Fasina FO. Cost-effectiveness of One Health intervention to reduce risk of human exposure and infection with non-typhoidal salmonellosis (NTS) in Nigeria. One Health 2024; 18:100703. [PMID: 38496340 PMCID: PMC10940793 DOI: 10.1016/j.onehlt.2024.100703] [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] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/04/2024] [Indexed: 03/19/2024] Open
Abstract
Background Non-typhoidal Salmonella infection (NTS) is an important foodborne zoonosis with underappreciated health and economic burdens, and low case fatality. It has global prevalence, with more burdens in under-resourced countries with poor health infrastructures. Using a cohort study, we determined the cost-effectiveness of NTS in humans in Nigeria for the year 2020. Methods Using a customized Excel-based cost-effectiveness analysis tool, structured (One Health) and unstructured (episodic intervention against NTS) in Nigeria were evaluated. Input data on the disease burdens, costs surveillance, response and control of NTS were obtained from validated sources and the public health system. Results The non-complicated and complicated cases were 309,444 (95%) and 16,287 (5%) respectively, and the overall programme cost was US$ 31,375,434.38. The current non-systematic episodic intervention costed US$ 14,913,480.36, indicating an additional US$ 16,461,954 to introduce the proposed intervention. The intervention will avert 4036.98 NTS DALYs in a single year. The non-complicated NTS case was US$ 60/person with significant rise in complicated cases. The cumulative costs of NTS with and without complications far outweighed the program cost for One Health intervention with an incremental cost-effectiveness ratio (ICER) of -US$ 221.30). Conclusions Utilising structured One Health intervention is cost-effective against NTS in Nigeria, it carries additional mitigative benefits for other diseases and is less costly and more effective, indicative of a superior health system approach. Identified limitations must be improved to optimize benefits associated and facilitate policy discussions and resource allocation.
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Affiliation(s)
- Abdullahi O. Sanni
- Department of Veterinary Tropical Diseases, University of Pretoria, Onderstepoort, South Africa
- Agro-Processing, Productivity Enhancement and Livelihood Improvement Support (APPEALS) Project, Lokoja, Nigeria
| | - Annelize Jonker
- Department of Veterinary Tropical Diseases, University of Pretoria, Onderstepoort, South Africa
| | - Vincent Were
- Adaptive Model for Research and Empowerment in Communities (AMREC), Nairobi, Kenya
| | - Olubunmi G. Fasanmi
- Department of Veterinary Laboratory Technology, Federal College of Animal Health & Production Technology, Ibadan, Nigeria
| | - Oluwawemimo O. Adebowale
- Department of Veterinary Public Health and Preventive Medicine, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta, Nigeria
| | - Aminu Shittu
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Abdurrahman H. Jibril
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Folorunso O. Fasina
- Department of Veterinary Tropical Diseases, University of Pretoria, Onderstepoort, South Africa
- Food and Agriculture Organization of the United Nations, Rome, Italy
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5
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Agusi ER, Schön J, Allendorf V, Eze EA, Asala O, Shittu I, Balkema-Buschmann A, Wernike K, Tekki I, Ofua M, Adefegha O, Olubade O, Ogunmolawa O, Dietze K, Globig A, Hoffmann D, Meseko CA. SARS-CoV and SARS-CoV -2 cross-reactive antibodies in domestic animals and wildlife in Nigeria suggest circulation of sarbecoviruses. One Health 2024; 18:100709. [PMID: 38533194 PMCID: PMC10963646 DOI: 10.1016/j.onehlt.2024.100709] [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] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/11/2024] [Indexed: 03/28/2024] Open
Abstract
Anthropogenic exposure of domestic animals, as well as wildlife, can result in zoonotic transmission events with known and unknown pathogens including sarbecoviruses. During the COVID-19 pandemic, SARS-CoV-2 infections in animals, most likely resulting from spill-over from humans, have been documented worldwide. However, only limited information is available for Africa. The anthropozoonotic transmission from humans to animals, followed by further inter- and intraspecies propagation may contribute to viral evolution, and thereby subsequently alter the epidemiological patterns of transmission. To shed light on the possible role of domestic animals and wildlife in the ecology and epidemiology of sarbecoviruses in Nigeria, and to analyze the possible circulation of other, undiscovered, but potentially zoonotic sarbecoviruses in animals, we tested 504 serum samples from dogs, rabbits, bats, and pangolins collected between December 2020 and April 2022. The samples were analyzed using an indirect multi-species enzyme-linked immunosorbent assay (ELISA) based on the receptor binding domain (RBD) of SARS-CoV and SARS-CoV -2, respectively. ELISA reactive sera were further analyzed by highly specific virus neutralization test and indirect immunofluorescence assay for confirmation of the presence of antibodies. In this study, we found SARS-CoV reactive antibodies in 16 (11.5%) dogs, 7 (2.97%) rabbits, 2 (7.7%) pangolins and SARS-CoV-2 reactive antibodies in 20 (13.4%) dogs, 6 (2.5%) rabbits and 2 (7.7%) pangolins, respectively. Interestingly, 2 (2.3%) bat samples were positive only for SARS-CoV RBD reactive antibodies. These serological findings of SARS-CoV and/or SARS-CoV-2 infections in both domestic animals and wildlife indicates exposure to sarbecoviruses and requires further One Health-oriented research on the potential reservoir role that different species might play in the ecology and epidemiology of coronaviruses at the human-animal interface.
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Affiliation(s)
- Ebere R Agusi
- National Veterinary Research Institute, Vom, Nigeria
- University of Nigeria, Nsukka, Nigeria
| | - Jacob Schön
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald, Isle of Riems, Germany
| | - Valerie Allendorf
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald, Isle of Riems, Germany
| | | | | | | | - Anne Balkema-Buschmann
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald, Isle of Riems, Germany
| | - Kerstin Wernike
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald, Isle of Riems, Germany
| | - Ishaya Tekki
- National Veterinary Research Institute, Vom, Nigeria
| | - Mark Ofua
- SaintMarks-Lagos Urban Forest Sanctuary Initiative (LUFASI), Lagos, Nigeria
| | | | | | | | - Klaas Dietze
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald, Isle of Riems, Germany
| | - Anja Globig
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald, Isle of Riems, Germany
| | - Donata Hoffmann
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald, Isle of Riems, Germany
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Sun Y, Keskinocak P, Steimle LN, Kovacs SD, Wassilak SG. Modeling the spread of circulating vaccine-derived poliovirus type 2 outbreaks and interventions: A case study of Nigeria. Vaccine X 2024; 18:100476. [PMID: 38617838 PMCID: PMC11011220 DOI: 10.1016/j.jvacx.2024.100476] [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] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 03/12/2024] [Accepted: 03/15/2024] [Indexed: 04/16/2024] Open
Abstract
Background Despite the successes of the Global Polio Eradication Initiative, substantial challenges remain in eradicating the poliovirus. The Sabin-strain (live-attenuated) virus in oral poliovirus vaccine (OPV) can revert to circulating vaccine-derived poliovirus (cVDPV) in under-vaccinated communities, regain neurovirulence and transmissibility, and cause paralysis outbreaks. Since the cessation of type 2-containing OPV (OPV2) in 2016, there have been cVDPV type 2 (cVDPV2) outbreaks in four out of six geographical World Health Organization regions, making these outbreaks a significant public health threat. Preparing for and responding to cVDPV2 outbreaks requires an updated understanding of how different factors, such as outbreak responses with the novel type of OPV2 (nOPV2) and the existence of under-vaccinated areas, affect the disease spread. Methods We built a differential-equation-based model to simulate the transmission of cVDPV2 following reversion of the Sabin-strain virus in prolonged circulation. The model incorporates vaccinations by essential (routine) immunization and supplementary immunization activities (SIAs), the immunity induced by different poliovirus vaccines, and the reversion process from Sabin-strain virus to cVDPV. The model's outcomes include weekly cVDPV2 paralytic case counts and the die-out date when cVDPV2 transmission stops. In a case study of Northwest and Northeast Nigeria, we fit the model to data on the weekly cVDPV2 case counts with onset in 2018-2021. We then used the model to test the impact of different outbreak response scenarios during a prediction period of 2022-2023. The response scenarios included no response, the planned response (based on Nigeria's SIA calendar), and a set of hypothetical responses that vary in the dates at which SIAs started. The planned response scenario included two rounds of SIAs that covered almost all areas of Northwest and Northeast Nigeria except some under-vaccinated areas (e.g., Sokoto). The hypothetical response scenarios involved two, three, and four rounds of SIAs that covered the whole Northwest and Northeast Nigeria. All SIAs in tested outbreak response scenarios used nOPV2. We compared the outcomes of tested outbreak response scenarios in the prediction period. Results Modeled cVDPV2 weekly case counts aligned spatiotemporally with the data. The prediction results indicated that implementing the planned response reduced total case counts by 79% compared to no response, but did not stop the transmission, especially in under-vaccinated areas. Implementing the hypothetical response scenarios involving two rounds of nOPV2 SIAs that covered all areas further reduced cVDPV2 case counts in under-vaccinated areas by 91-95% compared to the planned response, with greater impact from completing the two rounds at an earlier time, but it did not stop the transmission. When the first two rounds were completed in early April 2022, implementing two additional rounds stopped the transmission in late January 2023. When the first two rounds were completed six weeks earlier (i.e., in late February 2022), implementing one (two) additional round stopped the transmission in early February 2023 (late November 2022). The die out was always achieved last in the under-vaccinated areas of Northwest and Northeast Nigeria. Conclusions A differential-equation-based model of poliovirus transmission was developed and validated in a case study of Northwest and Northeast Nigeria. The results highlighted (i) the effectiveness of nOPV2 in reducing outbreak case counts; (ii) the need for more rounds of outbreak response SIAs that covered all of Northwest and Northeast Nigeria in 2022 to stop the cVDPV2 outbreaks; (iii) that persistent transmission in under-vaccinated areas delayed the progress towards stopping outbreaks; and (iv) that a quicker outbreak response would avert more paralytic cases and require fewer SIA rounds to stop the outbreaks.
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Affiliation(s)
- Yuming Sun
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Pinar Keskinocak
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Lauren N. Steimle
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA, USA
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7
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Oladeji EO, Ezeme C, Baiyewu LA, Okunola MO, Ogunlade SO. The catastrophic cost of motorcycle road traffic injuries: Experience from a major reference centre in a lower-middle income country. Injury 2024; 55:111314. [PMID: 38233327 DOI: 10.1016/j.injury.2024.111314] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/25/2023] [Accepted: 01/02/2024] [Indexed: 01/19/2024]
Abstract
BACKGROUND Motorcycle crashes are an increasing public health problem in low- and middle-income countries (LMICs). An accurate estimation of the economic burden of these crashes could be complex owing to a prevalent system of out-of-pocket (OOP) payment for health care services in these countries. Our study aims to objectively evaluate the cost implication of motorcycle Road Traffic Injuries (RTIs) among road crash victims managed at a major trauma reference hospital in Nigeria. Two economic evaluation methods were used to accurately reflect the cost-of-care (C-o-C) of each victim as well as for cross-validation. METHOD This is a prospective cohort study conducted between August 2020 and May 2021. All patients involved in motorcycle road traffic crashes presenting to the Emergency Department of the University College Hospital, Ibadan, Nigeria, were included in the study. For each patient, all medical expenses from the time of injury (T0) to 30 days after injury (T30) or Time to death (TD) - whichever occurred first, were valued in costs, and added (Activity-based costing or ABC), while also estimating overall cost-of-care (C-o-C) at T30 or TD, using the willingness-to-pay (WTP) method. Following the WHO definition, catastrophic expenditure was defined as expenditure > 25% of the patient's estimated annual household income. RESULTS Of the 150 consecutively managed motorcycle crashes victims during the study period, 112 had complete data. The median monthly household income for the cohort was $121 with 75% of them earning less than $180. The median cost-of-care (C-o-C), by ABC, was $242 ($143 - 828). For individual care items, expenditure on surgical intervention(s) was the highest followed by prosthesis and implant procurement, and radiological investigations. On the other hand, the estimated medical cost was $2356 (IQR $938 - 6475) by WTP. Only 14% had health insurance coverage. The overall expenditure was catastrophic for 46% of the patients. Monthly household income of < $180 (AOR=9.2; 95% CI=2.6-32.8; p < 0.001), absence of health insurance coverage (AOR=10.7; 95% CI=1.1-101.6; p = 0.040), and prolonged hospital stay above 14 days (AOR=25.1; 95% CI=5.5 -115.1; p = 0.001) were predictors of catastrophic expenditure. There was a weak positive correlation between actual cost-of-care using the ABC method and WTP (r = 0.247; p = 0.102). CONCLUSION The aggregate cost of motorcycle RTIs is catastrophic for nearly half of the victims attending the University College Hospital, Ibadan. The willingness-to-pay method, though less tedious is often less reliable in these settings owing to a prevalent OOP payment system. This study identified the need to implement effective financial protection mechanisms against the high OOP expenditure faced by motorcycle crash victims in LMICs.
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Affiliation(s)
- E O Oladeji
- Department of Surgery, University College Hospital Ibadan, Nigeria; Department of Trauma and Orthopaedics, St. Richard's Hospital Chichester, UK
| | - C Ezeme
- Department of Surgery, University College Hospital Ibadan, Nigeria; Department of Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, South Yorkshire, England, UK.
| | - L A Baiyewu
- Department of Surgery, University College Hospital Ibadan, Nigeria; Division of Cardiothoracic Surgery, Department of Surgery, University College Hospital Ibadan, Nigeria; Department of Surgery, College of Medicine, University of Ibadan, Nigeria
| | - M O Okunola
- Department of Orthopaedics and Trauma, University College Hospital Ibadan, Nigeria
| | - S O Ogunlade
- Department of Orthopaedics and Trauma, University College Hospital Ibadan, Nigeria; Department of Surgery, College of Medicine, University of Ibadan, Nigeria
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Olowoyo KS, Esan DT, Adeyanju BT, Olawade DB, Oyinloye BE, Olowoyo P. Telemedicine as a tool to prevent multi-drug resistant tuberculosis in poor resource settings: Lessons from Nigeria. J Clin Tuberc Other Mycobact Dis 2024; 35:100423. [PMID: 38435000 PMCID: PMC10907208 DOI: 10.1016/j.jctube.2024.100423] [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] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
Background This mini review aims to provide an overview of the role of telemedicine in preventing multi-drug resistant tuberculosis (MDR-TB) in Nigeria. The specific objectives include examining the potential benefits of telemedicine, identifying the challenges associated with its implementation, and highlighting the importance of addressing infrastructure limitations and data privacy concerns. Methods This minireview is based on a comprehensive analysis of existing literature, including scholarly articles, and reports,. A systematic search was conducted using electronic databases, such as PubMed and Google Scholar, to identify relevant publications related to telemedicine and MDR-TB prevention in Nigeria. The selected articles were assessed for their relevance, and key findings were synthesized to provide an overview of the role of telemedicine in addressing the challenges of MDR-TB in Nigeria. Results The review demonstrates that telemedicine has the potential to significantly contribute to MDR-TB prevention efforts in Nigeria. The benefits of telemedicine include improved access to specialized care, enhanced patient adherence to treatment, and potential cost savings. However, challenges such as infrastructure limitations and data privacy concerns need to be addressed for successful implementation. Integrating telemedicine into the healthcare system has the potential to strengthen MDR-TB prevention, particularly in underserved areas, including within Nigeria. Specifically, the integration of telemedicine into the healthcare system can enhance access to specialized care, improve patient adherence, and potentially reduce costs associated with MDR-TB management. Conclusions Addressing infrastructure challenges, ensuring data privacy and security, and fostering trust among healthcare providers and patients are critical for successful implementation of telemedicine. Further research and policy frameworks are needed to guide the effective implementation and scale-up of telemedicine in MDR-TB prevention efforts in Nigeria.
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Affiliation(s)
- Kikelomo S. Olowoyo
- Department of Nursing Science, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
- Department of Internal Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Deborah T. Esan
- Faculty of Nursing Sciences, College of Health Sciences, Bowen University, Iwo, Nigeria
| | - Benedict T. Adeyanju
- Department of Obstetrics and Gynecology, Afe Babalola University/ABUAD Multi-System Hospital, Ado-Ekiti, Nigeria
| | - David B. Olawade
- Department of Allied and Public Health, School of Health, Sport and Bioscience, University of East London, London, United Kingdom
| | - Babatunji E. Oyinloye
- Department of Biochemistry, College of Sciences, Afe Babalola University, Ado-Ekiti, Nigeria and Department of Biochemistry and Microbiology, University of Zululand, KwaDlangezwa, South Africa
| | - Paul Olowoyo
- Department of Internal Medicine, Federal Teaching Hospital Ido-Ekiti, Nigeria/Afe Babalola University, Ado-Ekiti, Nigeria
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Abam FI, Inah OI, Nwankwojike BN. Impact of asset intensity and other energy-associated CO 2 emissions drivers in the Nigerian manufacturing sector: A firm-level decomposition (LMDI) analysis. Heliyon 2024; 10:e28197. [PMID: 38571628 PMCID: PMC10987929 DOI: 10.1016/j.heliyon.2024.e28197] [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] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/01/2024] [Accepted: 03/13/2024] [Indexed: 04/05/2024] Open
Abstract
The study considered the impacts of asset intensity and other energy-associated CO 2 emissions drivers in the Nigerian manufacturing sector from 2010 to 2020. The Logarithmic Mean Divisia Index (LMDI) was used to explore the driving factors of CO 2 emissions: asset intensity, economic output, economic structure, energy intensity, energy mix, and carbon emission coefficient. From the results, the CO 2 emissions decreased from 7.49 MtCO 2 in 2010 to 3.22 MtCO 2 in 2020. Furthermore, among the emissions drivers, the energy mix effect increased CO 2 emissions by 0.50 MtCO 2 , followed by asset intensity (0.29 MtCO 2 ) and economic structure (0.11 MtCO 2 ) . The energy intensity, economic output, and emission coefficient effects inhibited CO 2 emissions by -4.64 MtCO 2 , -0.42 MtCO 2 , and -0.01 MtCO 2 respectively. The contribution of the subsectors' emissions shows that the Other Manufacturing subsector emitted 14.62 MtCO 2 , while Chemical and Pharmaceutical emitted 14.61 MtCO 2 , Food, Beverages and Tobacco, 7.55 MtCO 2 , Textile, Apparel, and Footwear, 6.63 MtCO 2 , Basic Metal and Iron and Steel, 5.15 MtCO 2 , Plastic and Rubber Products, 2.99 MtCO 2 , Agro-Allied, 2.71 MtCO 2 , Oil Refining, 2.01 MtCO 2 , and Pulp and Paper Products, 1.76 MtCO 2 . The results indicated that the effect of asset intensity on emission growth is significant and should not be overlooked. Likewise, the effects of CO 2 emission drivers were found to impact differently across the subsectors. The latter suggests that firm-specific indicators in the respective subsectors should be one of the primacies during policy development since the driving factors of CO 2 emissions fluctuate across the subsectors.
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Affiliation(s)
- Fidelis I. Abam
- Energy, Exergy, and Environment Research Group (EEERG), Department of Mechanical Engineering, University of Calabar, Nigeria
| | - Oliver I. Inah
- Mechanical and Industrial Engineering Research Group (MIERG), Department of Mechanical Engineering, Cross River University of Technology, Calabar, Nigeria
| | - Bethrand N. Nwankwojike
- Department of Mechanical Engineering, Michael Okpara University of Agriculture Umudike, Nigeria
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10
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Wagnild JM, Akhter N, Lee D, Jayeola B, Darko DM, Adeyeye MC, Komeh JP, Nahamya D, Kasim A, Hampshire K. The role of constraints and information gaps in driving risky medicine purchasing practices in four African countries. Health Policy Plan 2024; 39:372-386. [PMID: 38300508 PMCID: PMC11005838 DOI: 10.1093/heapol/czae006] [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] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 12/22/2023] [Accepted: 01/30/2024] [Indexed: 02/02/2024] Open
Abstract
Substandard and falsified (SF) medical products pose a major threat to public health and socioeconomic development, particularly in low- and middle-income countries. In response, public education campaigns have been developed to alert consumers about the risks of SF medicines and provide guidance on 'safer' practices, along with other demand- and supply-side measures. However, little is currently known about the potential effectiveness of such campaigns while structural constraints to accessing quality-assured medicines persist. This paper analyses survey data on medicine purchasing practices, information and constraints from four African countries (Ghana, Nigeria, Sierra Leone and Uganda; n > 1000 per country). Using multivariate regression and structural equation modelling, we present what we believe to be the first attempt to tease apart, statistically, the effects of an information gap vs structural constraints in driving potential public exposure to SF medicines. The analysis confirms that less privileged groups (including, variously, those in rural settlements, with low levels of formal education, not in paid employment, often women and households with a disability or long-term sickness) are disproportionately potentially exposed to SF medicines; these same demographic groups also tend to have lower levels of awareness and experience greater levels of constraint. Despite the constraints, our models suggest that public health education may have an important role to play in modifying some (but not all) risky practices. Appropriately targeted public messaging can thus be a useful part of the toolbox in the fight against SF medicines, but it can only work effectively in combination with wider-reaching reforms to address higher-level vulnerabilities in pharmaceutical supply chains in Africa and expand access to quality-assured public-sector health services.
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Affiliation(s)
- Janelle M Wagnild
- Department of Anthropology, Durham University, South Road, Durham DH1 3LE, UK
| | - Nasima Akhter
- Department of Anthropology, Durham University, South Road, Durham DH1 3LE, UK
| | - Diana Lee
- Incidents and Substandard/Falsified Medical Products Team, World Health Organization, Avenue Appia 20, Geneva 1211, Switzerland
| | - Babatunde Jayeola
- Incidents and Substandard/Falsified Medical Products Team, World Health Organization, Avenue Appia 20, Geneva 1211, Switzerland
| | | | - Moji Christianah Adeyeye
- National Agency for Food and Drug Administration and Control, Plot 2032, Olusegun, Obasanjo Way, Zone 7, Wuse, Abuja, Nigeria
| | - James P Komeh
- Pharmacy Board of Sierra Leone, New England Ville, Freetown, Sierra Leone
| | - David Nahamya
- Secretary to the Authority, National Drug Authority, PO Box 23096, Kampala, Uganda
| | - Adetayo Kasim
- Department of Anthropology, Durham University, South Road, Durham DH1 3LE, UK
| | - Kate Hampshire
- Department of Anthropology, Durham University, South Road, Durham DH1 3LE, UK
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11
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Igwesi-Chidobe CN, Ifeanyichukwu CN, Okorie JP, Faisal M, Ozumba BC. Prevalence and biopsychosocial factors associated with a current episode of low back pain amongst adults with previous history of low back pain: a cross-sectional study of market traders in an African population. J Pain 2024:104526. [PMID: 38599267 DOI: 10.1016/j.jpain.2024.104526] [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] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 03/12/2024] [Accepted: 04/01/2024] [Indexed: 04/12/2024]
Abstract
Low back pain (LBP) is the leading cause of years lived with disability globally, with Nigeria having one of the greatest burdens. A current episode of LBP is important in Nigeria, but the associated factors are unknown. This cross-sectional study investigated the prevalence, biomechanical and psychosocial factors associated with a current episode of LBP amongst 700 adult market traders with previous LBP in an urban Nigerian population. Descriptive, bivariate, and multivariate analyses were conducted. The prevalence of a current episode of LBP was 76.4%. Factors associated with an increased risk of a current episode of LBP in a decreasing order of importance were exposure to biomechanical factors (aggregate [total] score) (OR= 1.535; 95% CI= 1.398 - 1.685); anxiety (OR= 1.182; 95% CI=1.089 - 1.282); fear avoidance beliefs (physical activity) (OR= 1.139; 95% CI=1.029 - 1.261); fear avoidance beliefs (work) (OR= 1.105; 95% CI=1.047 - 1.165); whilst factors associated with a reduced risk of a current episode of LBP were ability to take breaks in the job in addition to scheduled breaks (OR= 0.430; 95% CI=0.240 - 0.773) and ability to control the order and pace of tasks (OR= 0.477; 95% CI=0.236 - 0.965). Occupational biomechanical and psychosocial factors were associated with a current episode of LBP in logistic regression models explaining 52.7% and 73.1% of the variation in a current episode of LBP. Occupational biomechanical factors, particularly handling large and bulky objects at arm's length, and kneeling and squatting produced the greatest risk of a current episode of LBP. PERSPECTIVE: Occupational biomechanical factors, occupational psychosocial factors, and personal psychosocial factors such as anxiety and fear avoidance beliefs are associated with a current episode of LBP in Nigeria. Pragmatic public health and occupational health initiatives that modify exposure to these factors may be required in Nigeria.
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Affiliation(s)
- Chinonso Nwamaka Igwesi-Chidobe
- School of Allied Health Professions and Midwifery, Faculty of Health Studies, University of Bradford, United Kingdom; Global Population Health (GPH) Research Group, University of Nigeria, Nsukka, Nigeria.
| | | | - Joshua P Okorie
- Global Population Health (GPH) Research Group, University of Nigeria, Nsukka, Nigeria
| | - Muhammad Faisal
- Biostatistics unit, Faculty of Health Studies, University of Bradford, United Kingdom
| | - Benjamin C Ozumba
- Global Population Health (GPH) Research Group, University of Nigeria, Nsukka, Nigeria; Faculty of Medicine, College of Medicine, University of Nigeria, Enugu Campus, Nigeria
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12
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Mankelkl G, Kinfe B. Factors associated with anemia among reproductive age women in Nigeria; evidenced by the Nigeria malaria indicators survey: spatial and multilevel model analysis. Contracept Reprod Med 2024; 9:12. [PMID: 38566232 PMCID: PMC10988975 DOI: 10.1186/s40834-024-00275-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 03/18/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Anemia is a global public health problem among women of reproductive age group, especially in developing countries, which affect health, social and economic development that result in low physical activity, increased maternal morbidity and mortality and adverse neonatal outcome especially those with severe anemia. However, there is limited reliable and updated data on the spatial variations of anemia and its associated factors among reproductive-age women in Nigeria. METHODS Secondary data analysis was conducted using data from the recent Nigeria malaria indicators survey datasets. The study comprised a total of 14,476 reproductive-age women. Spatial and multilevel mixed effect analysis on determinants factors of anemia among reproductive age women in Nigeria evidenced by the recent Nigerian malaria indicators survey. Finally, the percentage and odd ratio, its 95% confidence intervals, and the result of spatial analysis were reported. RESULT This study includes a total weighted sample of 14,476 reproductive-age women from the Nigeria malaria indicators survey. The prevalence of anemia was 24.6% in Ethiopia. Being between the age range of 30-34 years [AOR: 0.217, 95% CI (0.171, 0.274)], Attending higher education [AOR: 0.848, 95%CI (0.740, 0.972)] and being male headed household [AOR: 0.540, 95% CI (0.471, 0.620)] were protective for anemia. On the other hand being poorest [AOR: 1.542 95%CI (1.299, 1.830)] and being listening radio less than once a week [AOR: 1.013, 95% CI (0.908, 1.131)] were risk for anemia. CONCLUSION In this study Individual level factors were associated with anemia and also there were spatial variations in anemia across the region among reproductive-age women. Empowering women to have better educational status, improving the wealth index, and promoting education about prevention and control strategies of anemia through media especially in developing regions were the key factors to reduce anemia among reproductive age women in Nigeria.
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Affiliation(s)
- Gosa Mankelkl
- Department of Biomedical Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.
| | - Beletu Kinfe
- Department of occupational Health and safety, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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13
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Olorunnado GB, Muhammad HK, Apeh DO, Salubuyi S, Akanya HO, Gbashi S, Kumphanda J, Njobeh PB, Makun HA. Incidence and health risk assessment of hydrogen cyanide and multi-mycotoxins in Nigerian garri. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2024; 41:410-423. [PMID: 38315775 DOI: 10.1080/19440049.2024.2312247] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024]
Abstract
Garri is a granular, starchy food prepared by the fermentation of mashed cassava. Hydrogen cyanide (HCN) and mycotoxins are contaminants in certain foods at different points along the food value chain. The incidence and contamination levels of HCN and multi-mycotoxins in garri from five agroecological zones of Nigeria were determined using a spectrophotometric method and ultra-high-performance liquid chromatography-tandem mass spectroscopy (UHPLC-MS/MS), respectively. The health risk associated with the consumption of contaminated garri was assessed. The health risk assessment model was used to calculate the dietary exposure of humans to the mycotoxins in garri. This was done by estimating the daily intake (EDI), the percentage tolerable daily intake (%TDI), the annual hepatocellular carcinoma (HCC) cases attributable to exposure to aflatoxins (AFs) in garri, as well as the HCC risk. The average intake of garri was estimated at 0.303 kg/day for a Nigerian adult. The incidence of HCN was 98.3% (0.056-2.463 mg/kg), and fermentation reduced the HCN level in garri more than other processing steps. The twenty-one mycotoxins identified and quantified were all within maximum levels, as applicable to those that are regulated by the EU. The %TDI for the other mycotoxins, with the exception of AFs, showed no alarming health risk with garri consumption. Annual HCC cases resulting from AF in garri were estimated at 10-60 cases for HBsAg + ve individuals and 4-23 cases for HBsAg - ve individuals based on 8.1% hepatitis B virus (HBV) incidence. Results further revealed no interdependence between HCN levels and mycotoxin content. This work suggests an unlikely chance of acute toxicity from HCN and major mycotoxins from a garri-based diet in Nigeria. Hence, it is recommended that concerned regulatory bodies maintain the existing permissible limits for HCN in Garri.
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Affiliation(s)
- Gabriel Babatunde Olorunnado
- Department of Biochemistry, Africa Centre of Excellence for Mycotoxin and Food Safety, Federal University of Technology Minna, Minna, Nigeria
- Department of Science, School of Preliminary Studies, Kogi State Polytechnic, Lokoja, Nigeria
| | - Hadiza Kudu Muhammad
- Department of Biochemistry, Africa Centre of Excellence for Mycotoxin and Food Safety, Federal University of Technology Minna, Minna, Nigeria
| | - Daniel Ojochenemi Apeh
- Department of Biochemistry, Confluence University of Science and Technology Osara, Osara, Nigeria
| | - Susan Salubuyi
- Department of Biochemistry, Africa Centre of Excellence for Mycotoxin and Food Safety, Federal University of Technology Minna, Minna, Nigeria
| | - Helmina Olufunmilayo Akanya
- Department of Biochemistry, Africa Centre of Excellence for Mycotoxin and Food Safety, Federal University of Technology Minna, Minna, Nigeria
| | - Sefater Gbashi
- Department of Biotechnology and Food Technology, Faculty of Science, University of Johannesburg, Doornfontein Campus, Gauteng, South Africa
| | - Joseph Kumphanda
- Department of Biochemistry, Africa Centre of Excellence for Mycotoxin and Food Safety, Federal University of Technology Minna, Minna, Nigeria
- Department of Basic Sciences, Malawi University of Science and Technology, Limbe, Malawi
| | - Patrick Berka Njobeh
- Department of Biotechnology and Food Technology, Faculty of Science, University of Johannesburg, Doornfontein Campus, Gauteng, South Africa
| | - Hussaini Anthony Makun
- Department of Biochemistry, Africa Centre of Excellence for Mycotoxin and Food Safety, Federal University of Technology Minna, Minna, Nigeria
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Bigman G, Adebamowo SN, Adebamowo CA. Validity and Reproducibility of a Semiquantitative Food Frequency Questionnaire and Food Picture Book in Nigeria. Curr Dev Nutr 2024; 8:102135. [PMID: 38618557 PMCID: PMC11015507 DOI: 10.1016/j.cdnut.2024.102135] [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] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/09/2024] [Accepted: 03/13/2024] [Indexed: 04/16/2024] Open
Abstract
Background Increasing noncommunicable diseases in Nigeria are partly related to dietary factors. However, the lack of validated nutrition assessment tools hinders the conduct of nutritional epidemiology research in this population. Objectives To develop a Food Frequency Questionnaire (FFQ) and Food Picture Book (FPB) for Nigerian adults, and to assess its reproducibility and validity compared with 24-h dietary recalls (24DRs) during different seasons in the year. Methods We compiled 202 foods for the FFQ through focus groups and consultations with local dietitians. We created an FPB with standardized food portion images to enhance the accuracy of reports of dietary intakes. We administered the FFQs to 205 purposively selected adults in Ibadan, Nigeria at ∼6 monthly intervals between November 2018 and October 2020. We evaluated the FFQ's reproducibility and validity compared with 24DR across the dry and rainy seasons by examining the consumption of common food and mixed dishes. We computed the Spearman's correlation coefficients (SCC), intraclass correlation coefficients (ICC), and Wilcoxon signed-rank tests, and generated Bland and Altman plots. Results Overall, we studied 110 women (53.7%) and 95 men (46.3%) with a mean age of 45.0 ± 13.4 y (mean ± SD). The reproducibility tests showed a mean ± SD SCC of 0.39 ± 0.14 and mean ± SD ICC of 0.32 ± 0.12. Higher mean ± SD SCC values were noted for cereal products (0.43 ± 0.09), starchy roots and tubers (0.45 ± 0.17), and soups (0.44 ± 0.20). Conversely, lower mean ± SD SCC values were observed for milk products (0.29 ± 0.02), solid fats (0.29 ± 0.26), and fish (0.22 ± 0.19). Regarding validity tests, the overall mean ± SD SCC was 0.27 ± 0.16 and mean ± SD ICC was 0.26 ± 0.16. We observed seasonal variations in intakes of fruits, cassava flour-based products, and nuts, although most foods did not show significant differences in intakes between seasons. Conclusions Our FFQ and FPB demonstrated moderate correlations and seasonal variations in intakes of certain foods, emphasizing the need to account for seasonality in dietary intakes in nutritional studies in Nigeria and similar countries.
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Affiliation(s)
- Galya Bigman
- Department of Research, Center for Bioethics and Research, Ibadan, Nigeria
| | - Sally N Adebamowo
- Department of Research, Center for Bioethics and Research, Ibadan, Nigeria
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States
- Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Clement A Adebamowo
- Department of Research, Center for Bioethics and Research, Ibadan, Nigeria
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States
- Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, United States
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15
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Tamambang R, Kusi-Mensah K, Bella-Awusah T, Ogunmola O, Afolayan A, Toska E, Hertzog L, Rudgard W, Evans R, Omigbodun O. Identifying potential catalysts to accelerate the achievement of Sustainable Development Goals (SDGs) among adolescents living in Nigeria. PSYCHOL HEALTH MED 2024; 29:868-887. [PMID: 38305209 DOI: 10.1080/13548506.2023.2289476] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 11/22/2023] [Indexed: 02/03/2024]
Abstract
Investing in adolescents in Africa holds great promise for the development of the continent. The steps involved in identifying factors linked to interventions that may accelerate the attainment of multiple SDGs for adolescents in Nigeria are described. Data from a survey to investigate the well-being of 1800 adolescents aged 10-19 years in Southwest Nigeria was analysed. A four-step process was employed: 1) Mapping of variables deemed as suitable proxies for SDG targets; 2) Mapping hypothesised protective factors (accelerators) from the study instruments. Consequently, SDG targets related to elimination of hunger, good health, gender equality and peace; and seven accelerators (safe schools, parenting support, good mental health, no survival work, food security, stable childhood, and regular physical activity) were identified; 3) evaluating associations using bivariate analysis and multivariable logistic regression, 4) calculating adjusted probabilities. The mean age of the adolescents was 15.02 ± 2.27 years (48.6% female). Good mental health, not doing survival work, safe schools, stable childhood and parental support were significantly associated with at least two SDG targets. For example, food security was significantly associated with the highest number of SDG outcomes: one SDG target related to child survival (no substance use: x2 = 3.39, p = <0.001); three SDG targets related to educational outcomes (school progression: x2 = 5.68, p = 0.017, ability to concentrate in school: x2 = 26.92, p = <0.001, and school attendance: x2 = 25.89, p = <0.001); and four SDG targets related to child protection (no risky sexual behaviours: x2 = 16.14, p = <0.001, no perpetration of violence: x2 = 15.74, p = <0.001, no community violence: x2 = 39.06, p =<0.001, and no sexual abuse: x2 = 7.66, p = 0.006). Interventions centred around good mental health, not doing survival work, safe schools, small family size, stable childhood and parental support are potential accelerators for the attainment of SDG outcomes by adolescents living in Nigeria.
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Affiliation(s)
- Rita Tamambang
- Centre for Child and Adolescent Mental Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Kwabena Kusi-Mensah
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychiatry, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Tolulope Bella-Awusah
- Centre for Child and Adolescent Mental Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Olusegun Ogunmola
- Centre for Child and Adolescent Mental Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Adeola Afolayan
- Centre for Child and Adolescent Mental Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Elona Toska
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
- Department of Social Policy and Intervention, Oxford University, Oxford, UK
| | - Lucas Hertzog
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | | | - Robin Evans
- Department of Statistics, Oxford University, Oxford, UK
| | - Olayinka Omigbodun
- Centre for Child and Adolescent Mental Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
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16
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Chinawa JM, Chukwu B, Chinawa A. Estimation of z-scores of cardiac structures in healthy children in Southeast Nigeria. Ir J Med Sci 2024; 193:689-698. [PMID: 37861940 DOI: 10.1007/s11845-023-03542-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/27/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND The z-scoring system shows the mean deviation of cardiac dimensions from age-specific population. The use of the European-based z-score studies has resulted in misdiagnosis and late treatment of Nigerian children with heart diseases leading to increased mortality and morbidity. OBJECTIVES This study aimed to determine the z‑scores for various cardiac structures and functions among healthy children in Southeast Nigeria. MATERIALS AND METHODS This is a cross-sectional observational study where z-scores of the cardiac structure and function of three hundred healthy children were estimated using echocardiography and compared with the standard Detroit values. RESULT There was a significant positive correlation between age and cardiac valve diameter. The aortic valve strongly correlated positively with age with the Pearson correlation coefficient (ρ) of 0.8 and probability value (P-value) of 0.00. None of the ventricular function variables deviated beyond the +2 or -2 z-score. There was a positive correlation between the z-scores of ventricular function parameters and participants' age, although the strength of the correlation varied. Comparing these values with that of Detroit values, there was a significant difference in the deviation of the mean of the mitral valve and left pulmonary artery diameters from the Detroit values between the males and the females. While the mean z-score mitral valve was 0.8 in males, it was 0.6 in females (P = 0.02). CONCLUSION Z-scores of cardiac structures and function are derived from children in this locale. These values were similar to that of Detroit values except for the mitral valve and left pulmonary artery.
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Affiliation(s)
- Josephat M Chinawa
- Department of Paediatrics, College of Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria.
| | - Bartholomew Chukwu
- Department of Paediatrics, College of Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Awoere Chinawa
- Department of Community Medicine, ESUCOM, Parklane, Enugu, Nigeria
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17
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Davies AA, Adekoya AO, Balogun OJ, Osaigbovo II, Nwosu A, Gbaja-biamila T, Osinupebi O, Gangneux JP, Oladele RO. Prevalence of Chronic Pulmonary Aspergillosis in Two (2) Tuberculosis Treatment Clinics in Lagos, Nigeria: A Prospective Longitudinal Study. Open Forum Infect Dis 2024; 11:ofae090. [PMID: 38567195 PMCID: PMC10986852 DOI: 10.1093/ofid/ofae090] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/13/2024] [Indexed: 04/04/2024] Open
Abstract
Background Chronic pulmonary aspergillosis (CPA) is an underrecognized but common complication of pulmonary tuberculosis. In Nigeria, a tuberculosis-endemic country, there is currently no provision to monitor the development of CPA in patients treated for tuberculosis. This study determined the prevalence and incidence of CPA in Lagos, Nigeria. Methods A prospective longitudinal study of patients with previously managed tuberculosis was conducted between June 2021 and May 2022. The study cohorts were assessed at 3-month intervals, and the following were collected: sociodemographic data, chest radiographic findings, sputum samples for fungal culture, and venous blood samples for Aspergillus immunoglobulin G estimation. CPA cases were determined using the case definition for resource-constrained countries. Descriptive and inferential statistics were used, and significance was set at a probability of 5% (P < .05). Results Of the 141 patients recruited, 79 (56.0%) were in the retreatment and 62 (44.0%) in the posttreatment tuberculosis group. The median age (interquartile range) was 40 (30-52) years, with a male-to-female ratio of 1.1:1. Ninety-seven patients (69%) had a GeneXpert test done, of whom 63 (64.9%) were GeneXpert negative. Cough was the most common symptom, with 15 (11%) patients having hemoptysis. The rate of CPA increased steadily as the study progressed: 44 (31.2%) at commencement, 45 (34.9%) at 3 months, 49 (42.6%) at 6 months, and 51 (54.3%) at 9 months. Thus, the overall prevalence of CPA was 49.7%, and the incidence was 6.1%. Conclusions CPA is common in Nigeria and its true burden may still be underestimated. Increased awareness of CPA as a posttuberculosis lung disease is advocated. Evaluation for CPA should be incorporated in patients' work-up for tuberculosis.
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Affiliation(s)
- Adeyinka A Davies
- Department of Medical Microbiology and Parasitology, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
- Medical Mycology Society of Nigeria, Lagos, Nigeria
| | - Abiola O Adekoya
- Department of Radiology, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
| | | | - Iriagbonse I Osaigbovo
- Medical Mycology Society of Nigeria, Lagos, Nigeria
- Department of Medical Microbiology, School of Medicine, University of Benin, Benin City, Nigeria
| | - Augustina Nwosu
- Medical Mycology Society of Nigeria, Lagos, Nigeria
- Central Research Laboratory, College of Medicine University of Lagos, Lagos, Nigeria
| | - Titilola Gbaja-biamila
- Clinical Sciences Division, Nigeria Institute of Medical Research, Yaba, Lagos, Nigeria
- College of Public Health and Social Justice, Saint Louis University College of Public Health and Social Justice, Missouri, USA
| | - Olubunmi Osinupebi
- Department of Medical Microbiology and Parasitology, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
| | - Jean-Pierre Gangneux
- Laboratoire de Parasitologie et Mycologie, European Excellence Center in Medical Mycology, French National Reference Center for Chronic Aspergillosis, Centre Hospitalier Universitaire de Rennes, Rennes, France
- Université de Rennes, Centre Hospitalier Universitaire de Rennes, Inserm, EHESP, IRSET (Institut de Recherché en Santé, Environnement et Travail) (UMR_S 1085), Rennes, France
| | - Rita O Oladele
- Medical Mycology Society of Nigeria, Lagos, Nigeria
- Department of Medical Microbiology and Parasitology, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
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Dele-Ojo BF, Adesokan A, Fadare JO, Ajayi PO, Raimi TH, Dada SA, Ojo OD, Ogunmodede JA, Ipinnimo TM, Ariyo OE, Godman B. Short-term COVID-19 vaccine adverse effects among adults in Ekiti State, Nigeria. Curr Med Res Opin 2024; 40:621-627. [PMID: 38323854 DOI: 10.1080/03007995.2024.2316217] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 02/05/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND The safety of the COVID-19 vaccines has been a topic of concern globally. This issue of safety is associated with vaccine hesitancy due to concerns about the adverse effects of the vaccines. Consequently, this study determined the short-term safety profile of the Oxford/AstraZeneca COVID-19 vaccine in Ekiti State, Nigeria. METHODS Descriptive cross-sectional study conducted between May and July 2021 among individuals who had received the first dose of the first batch of the Oxford/AstraZeneca COVID-19 vaccine at Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, Nigeria. A Google form was used to collect data on the adverse effects of the vaccine. RESULTS Out of over 1,000 individuals who were approached, 758 respondents completed the study. A large percentage (57.4%) of those who received the vaccines were healthcare workers. Adverse effects were reported in 70.8% of the participants with most manifesting on the first day of the vaccination. The predominant adverse effects were injection site soreness (28.5%), followed by fatigue (18.7%) and muscle pain (8.6%). There was no report of severe adverse effects such as anaphylactic reactions, thrombosis, myocarditis, transient myelitis, or Guillen-Barre syndrome. CONCLUSION This study found that self-reported adverse effects of the Oxford/AstraZeneca COVID-19 vaccine were mild and short in duration. This outcome has promising implications for improving COVID-19 vaccine uptake in the immediate environment and Nigeria.
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Affiliation(s)
- Bolade Folasade Dele-Ojo
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
- Department of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Adedapo Adesokan
- Emergency Medicine Department, Kingsmill Hospital, Sutton-in-Ashfield, Scotland
| | | | - Paul Oladapo Ajayi
- Department of Community Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Taiwo Hussean Raimi
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
- Department of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Samuel Ayokunle Dada
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
- Department of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Owolabi Dele Ojo
- Department of Surgery, Afe Babalola University, Ado-Ekiti, Nigeria
| | | | | | - Olumuyiwa Elijah Ariyo
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Brian Godman
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde, Glasgow, United Kingdom
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Adedeji IA, Lawal SA, Aluko-Arowolo S. Qualitative Analysis of Coping Strategies Among Older Persons During COVID-19 Lockdown in Nigeria: Considerations for Community Health Promotion. Community Health Equity Res Policy 2024; 44:253-263. [PMID: 37118649 PMCID: PMC10149519 DOI: 10.1177/2752535x231173527] [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] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Background: The challenge of COVID-19 and the disease control restrictions in Nigeria directly affected social life. Older adults were disproportionately affected because of social vulnerabilities, socio-economic dependency, and the high risk of COVID-19 infectious disease in the population.Purpose: To this end, the study explored the instrumental coping strategies of older adults duirng the COVID-19 lockdown in Nigeria.Research Design: An exploratory research design using qualitative approach based on in-depth interviews was adopted.Study Sample: Twenty-seven (27) older adults aged 60 years and more in Ibadan, Nigeria were purposively selected for participation in the research.Data Collection and/or Analysis: Community living older adults participated in in-depth telephone interviews during the COVID-19 restrictions. Using Atlas ti 8.4, the 27 transcripts were analyzed and validated through content analysis.Results: Older adults coped with fear, anxiety, depression, and other health challenges, and three major themes emerged as problem-focused coping strategies. Older adults explored spirituality, engaged in their social networks through telephones, and focused on a healthy diet and physical activities.Conclusions: Community health promotion strategies for older adults should explore the identified problem-focused coping strategies to optimize the health and wellbeing of older adults.
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Affiliation(s)
- Isaac A. Adedeji
- Department of Gerontology, Simon Fraser University, Columbia, Canada
| | - Saheed Akinmayowa Lawal
- Department of Public Health, School of Public and Allied Health
Babcock University, Ilishan-Remo, Nigeria
| | - Sola Aluko-Arowolo
- Department of Sociology, Olabisi Onabanjo
University, Ago-Iwoye, Nigeria
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Adeogun AO, Chukwuka AV, Ibor OR, Asimakopoulos AG, Zhang J, Arukwe A. Occurrence, bioaccumulation and trophic dynamics of per- and polyfluoroalkyl substances in two tropical freshwater lakes. Environ Pollut 2024; 346:123575. [PMID: 38365077 DOI: 10.1016/j.envpol.2024.123575] [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] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/04/2024] [Accepted: 02/13/2024] [Indexed: 02/18/2024]
Abstract
We have investigated the occurrence, distribution, and biomagnification of per- and polyfluoroalkyl substances (PFAS) in two tropical lakes (Asejire and Eleyele) of Southwestern Nigeria, with contrasting urban intensities. Over an 8-month period, we sampled sediment and fish species (Clarias gariepinus: CIG; Oreochromis niloticus: ON; Coptodon guineensis: CG; Sarotherodon melanotheron: SM) across trophic levels, and analyzed various PFAS congeners, in addition to a select group of toxicological responses. While herbivores (SM) and benthic omnivores (CIG) at Asejire exhibited elevated levels of PFBS and PFOS, the pelagic omnivores (ON) showed a dominance of PFOS, PFDA, PFHxDA and EtFOSE in the muscle. At the Eleyele urban lake, PFAS patterns was dominated by PFBS, EtFOSE, PFPeS, PFOcDA and PFOS in the herbivores (SM, CG), EtFOSE, PFOS and PFBS in the pelagic omnivore (ON) and benthic omnivore (ClG). The estimated biomagnification factor (BMF) analysis for both lakes indicated trophic level increase of PFOS, PFUnA and PFDA at the suburban lake, while PFOS and EtFOSE biomagnified at the urban lake. We detected the occurrence of diSAMPAP and 9CL-PF3ONS, novel compounds not commonly reported, in PFAS studies at both lakes. The studied toxicological responses varied across trophic groups in both lakes with probable modulations by environmental conditions, trophic structure, and relative PFAS exposures in the lakes. The present study documents, for the first time in Nigeria, or any other African country, the role of urbanization on contaminant load into the environment and their implications for contaminant dynamics within the ecosystem and for aquatic food safety.
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Affiliation(s)
- Aina O Adeogun
- Department of Zoology, University of Ibadan, Ibadan, Nigeria
| | - Azubuike V Chukwuka
- National Environmental Standards and Regulations Enforcement Agency (NESREA), Nigeria
| | - Oju R Ibor
- Department of Zoology and Environmental Biology, University of Calabar, Calabar, Nigeria
| | | | - Junjie Zhang
- Department of Chemistry, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Augustine Arukwe
- Department of Biology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
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Uguru N, Ogu U, Uguru C, Ibe O. Is the national health insurance scheme a pathway to sustained access to medicines in Nigeria? BMC Health Serv Res 2024; 24:403. [PMID: 38553711 PMCID: PMC10981341 DOI: 10.1186/s12913-024-10827-1] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/05/2024] [Indexed: 04/01/2024] Open
Abstract
OBJECTIVE The debate surrounding access to medicines in Nigeria has become increasingly necessary due to the high cost of essential medicine drugs and the prevalence of counterfeit medicines in the country. The Nigerian government has proposed the implementation of the National Health Insurance Scheme (NHIS) to address these issues and guarantee universal access to essential medicines. Access was investigated using the 3 A's (accessibility, affordability, and availability). This paper investigates whether the NHIS is a viable pathway to sustained access to medicines in Nigeria. DESIGN This was a cross-sectional study using a mixed-methods design. Both qualitative and quantitative methods were utilized for the study. SETTING This study was conducted at NHIS-accredited public and private facilities in Enugu State. PARTICIPANTS 296 randomly selected enrollees took part in the quantitative component, while, 6 participants were purposively selected for the qualitative component, where in-depth interviews (IDIs) were conducted face-to-face with NHIS desk officers in selected public and private health facilities. RESULTS The quantitative findings showed that 94.9% of respondents sought medical help. Our data shows that 78.4% of the respondents indicated that the scheme improved their access to care (accessibility, affordability, and availability). The qualitative results from the NHIS desk officers showed that respondents across all the socio-economic groups reported that the NHIS had marginally improved access to medicine over the years. It was also observed that most of the staff in NHIS-accredited facilities were not adequately trained on the scheme's requirements and that most times, essential drugs were not readily available at the accredited facilities. CONCLUSION The study findings revealed that although the NHIS has successfully expanded access to medicines, there remain several challenges to its effective implementation and sustainability. Additionally, the scheme's coverage of essential medicines is could be improved even more, leading to reduced access to needed drugs for many Nigerians. A focus on the 3As for the scheme means that all facility categories (private and public) and their interests (where necessary) must be considered in further planning of the scheme to ensure that things work out well.
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Affiliation(s)
- Nkolika Uguru
- Department of Preventive Dentistry, Faculty of Dentistry, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria.
- Health Policy Research Group, Department of Pharmaco-therapeutics, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria.
| | - Udochukwu Ogu
- Health Policy Research Group, Department of Pharmaco-therapeutics, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria.
| | - Chibuzo Uguru
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Ogochukwu Ibe
- Health Science Centre, University of North Texas, Fort Worth, TX, United States of America
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22
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Udo S, Ogbu PS, Tsaku PA, Tukur A, NewMarch A. An evaluation of mental health integration in the neglected tropical diseases program in Zamfara, North-west Nigeria. Int Health 2024; 16:i52-i59. [PMID: 38547351 PMCID: PMC10977942 DOI: 10.1093/inthealth/ihae003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/18/2023] [Accepted: 01/09/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Mental health and neglected tropical diseases (NTDs) are critical in healthcare systems, especially in low- and middle-income countries. Several policies are planned or designed by health stakeholders to address the mental health needs of people affected by NTDs. Still, the impact of such policies seems to be of no consequence. METHODS The GAD-7 and PHQ-9 tools were used to determine the rate of depression and anxiety, respectively, among people affected by skin NTDs (leprosy and lymphatic filariasis [LF]) in Zamfara State, North-west Nigeria. The study also evaluated the barriers to the uptake of mental health services for people affected by skin NTDs in the state. We assessed 48 people affected by NTDs (leprosy, 32; lymphatic filariasis, 16) along with a corresponding 48 people who served as controls in the study. Qualitative interviews were carried out with the participants to elicit the barriers to mental health services for people affected by NTDs. Additionally, 48 selected healthcare workers from the state were assessed for their skills and capacity to offer mental health services. RESULTS We found anxiety disorder present in 100% of the people living with LF and in 62% of the people living with leprosy. Depression was also found in 56% and 75% of the people living with leprosy and LF, respectively. An assessment of the barriers to the uptake of mental health services reveals that most people with NTDs are constrained by a lack of money to visit hospitals, the fear of stigmatisation and discrimination and long distances to health centres. Regarding the healthcare workers, the skills and capacity to offer mental health services were very low. CONCLUSIONS We conclude that for mental health services to be integrated into the community health system for people with NTDs, there should be a concerted effort by all stakeholders and the intervention should be context specific instead of generalised. CONTEXTE La santé mentale et les maladies tropicales négligées (MTN) sont des problématiques centrales dans la santé, en particulier dans les pays à revenu faible ou intermédiaire. Plusieurs politiques sont conçues par les acteurs de la santé publique pour répondre aux besoins de soins en santé mentale pour les personnes touchées par les MTN. Pourtant, le bilan reste mitigé quant à l'efficacité de ces soins. MÉTHODES Les outils GAD-7 et PHQ-9 ont été utilisés pour déterminer le taux de dépression et d'anxiété chez les personnes atteintes de MTN cutanées (lèpre et filariose lymphatique) dans l'État de Zamfara, au nord-ouest du Nigeria. L'étude a également évalué les obstacles à l'utilisation des services de santé mentale pour les personnes atteintes de MTN cutanées dans l'État. Nous avons évalué 48 personnes atteintes de MTN (lèpre : 32, filariose lymphatique : 16) ainsi que 48 personnes correspondantes qui ont servi de témoins dans l'étude. Des entretiens qualitatifs ont été menés avec les participants afin d'identifier les obstacles aux services de santé mentale pour les personnes atteintes de MTN. En outre, 48 professionnels de la santé sélectionnés dans l'État ont été évalués pour déterminer leurs compétences et leur capacité à offrir des services de santé mentale. RÉSULTATS Nous avons trouvé des troubles anxieux chez 100% des personnes atteintes de filariose lymphatique et chez 62% des personnes atteintes de lèpre. La dépression touche 56% et 75% des personnes vivant avec la lèpre et la filariose lymphatique respectivement. Une évaluation des obstacles à l'utilisation des services de santé mentale révèle que la plupart des personnes atteintes de MTN sont limitées par le manque d'argent pour se rendre à l'hôpital, la peur de la stigmatisation et de la discrimination, et les longues distances à parcourir pour se rendre dans les centres de santé. Les compétences et les capacités des professionnels de la santé à offrir des services de santé mentale sont très faibles. CONCLUSION L'efficacité d'un protocole de soins pour les patients atteints de MTN (traitant la pathologie physique et d'éventuelles pathologies psychiatriques associées) nécessite une intégration des services de santé mentale dans le système de santé communautaire. ANTECEDENTES La salud mental y las enfermedades tropicales desatendidas (ETDs), son fundamentales en los sistemas sanitarios, especialmente en los países de renta baja y media. Las partes interesadas en la sanidad planean o diseñan varias políticas para abordar las necesidades de salud mental de las personas afectadas por ETDs. Sin embargo, el impacto de dichas políticas parece ser nulo. MÉTODOS Se utilizaron las herramientas GAD-7 y PHQ-9 para determinar la tasa de depresión y ansiedad, respectivamente, entre las personas afectadas por ETDs cutáneas (lepra y filariasis linfática) en el Estado de Zamfara, al noroeste de Nigeria. El estudio también evaluó las barreras para la aceptación de los servicios de salud mental por parte de las personas afectadas por ETDs cutáneas en el Estado. Se evaluó a 48 personas afectadas por ETDs (lepra: 32; filariasis linfática: 16) y a otras 48 que sirvieron de control en el estudio. Se llevaron a cabo entrevistas cualitativas con los participantes para determinar las barreras a los servicios de salud mental para las personas afectadas por ETDs. Además, se evaluaron las habilidades y la capacidad para ofrecer servicios de salud mental de 48 profesionales sanitarios del Estado. RESULTADOS Encontramos trastorno de ansiedad presente en el 100% de las personas que vivían con filariasis linfática y en el 62% de las personas que vivían con lepra. También se encontró depresión en el 56% y el 75% de las personas que vivían con lepra y filariasis linfática respectivamente. Una evaluación de los obstáculos para la utilización de los servicios de salud mental revela que la mayoría de las personas con ETDs se ven limitadas por la falta de dinero para acudir a los hospitales, el miedo a la estigmatización, la discriminación y las largas distancias hasta los centros sanitarios. Por parte del personal sanitario, los conocimientos y la capacidad para ofrecer servicios de salud mental eran muy escasos. CONCLUSIONES Para que los servicios de salud mental para personas con ETD se integren en el sistema sanitario comunitario, debe haber una concertación entre todas las partes interesadas y la intervención debe ser específica para cada contexto en lugar de generalizada.
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Affiliation(s)
- Sunday Udo
- Leprosy Mission Nigeria, 12/14 Kings Drive, Fort Royal Homes Estate, Lugbe, Abuja, Nigeria
| | - Pius Sunday Ogbu
- Leprosy Mission Nigeria, 12/14 Kings Drive, Fort Royal Homes Estate, Lugbe, Abuja, Nigeria
| | - Paul A Tsaku
- Leprosy Mission Nigeria, 12/14 Kings Drive, Fort Royal Homes Estate, Lugbe, Abuja, Nigeria
| | - Aliyu Tukur
- Zamfara State Tuberculosis Buruli Ulcer, and Leprosy Control Programme, Gusau, Nigeria
| | - Andrew NewMarch
- Leprosy Mission Australia, 37-39 Ellingworth Parade, Box Hill, VIC 3128 Australia
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Oni TO, Okunlola DA. Contextual determinants of generational continuation of female genital mutilation among women of reproductive age in nigeria: analysis of the 2018 demographic and health survey. Reprod Health 2024; 21:39. [PMID: 38532404 DOI: 10.1186/s12978-024-01778-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 03/21/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Female genital mutilation (FGM) has negative health implications and has long been recognised as violating sexual rights. Despite the huge efforts expended on eradicating FGM, generational continuation of the practice, i.e. the act of mutilated women also mutilating their daughters, persists in Nigeria. This study investigated the individual, household, and community factors associated with generational continuation of FGM among women in Nigeria. METHODS The study analysed data from the 2018 Nigeria Demographic and Health Survey (NDHS). A weighted sample of 3835 women with FGM history and who had given birth to female children was analysed. Models were estimated using mixed-effects multilevel logistic regression with Stata 16.0. RESULTS The results showed that 40.0% of women continued FGM for their daughters. Regional prevalence of FGM continuation ranged from 14.9% in the South-South (the lowest) to 64.3% in the North-West (the highest). Women aged 15-24 years (uaOR = 0.40; 95% CI:0.28-0.57) and rich (uaOR = 0.44; 95% CI:0.35-0.56) had the least likelihood of generational continuation of FGM. In communities with low proportions of women unexposed to the media, the likelihood of FGM continuation was significantly higher (uaOR = 1.85; 95% CI:1.35-2.53). Generational continuation of FGM was significantly lower in communities with moderate proportions of uneducated mothers (aOR = 0.6; 95% CI:0.42-0.86). CONCLUSION FGM continuation was high in Nigeria, and it was most common among older and poor mothers and in communities with large proportions of uneducated women and those unexposed to the media. Existing National Policy and Plan on FGM elimination should be strengthened to target these characteristics.
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Affiliation(s)
- Tosin Olajide Oni
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - David Aduragbemi Okunlola
- Department of Sociology, College of Social Sciences and Public Policy, Florida State University, Tallahassee, Florida, USA
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24
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Orji IA, Baldridge AS, Ikechukwu-Orji MU, Banigbe B, Eze NC, Chopra A, Omitiran K, Iyer G, Odoh D, Alex-Okoh M, Reng R, Hirschhorn LR, Huffman MD, Ojji DB. Evaluation of Primary Healthcare Centers' Service Availability and Readiness for Implementing Diabetes Care in Abuja, Nigeria: A Cross-Sectional, Formative Assessment. Res Sq 2024:rs.3.rs-3959541. [PMID: 38585872 PMCID: PMC10996784 DOI: 10.21203/rs.3.rs-3959541/v1] [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] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Introduction Noncommunicable diseases (NCDs) are associated with a high and rising burden of morbidity and mortality in sub-Saharan Africa, including Nigeria. Diabetes mellitus (DM) is among the leading causes of NCD-related deaths worldwide and is a foremost public health problem in Nigeria. As part of the National Multi-Sectoral Action Plan for the Prevention and Control of NCDs, Nigeria has committed to implementing the World Health Organization (WHO) Package of Essential NCD control interventions. Implementing the intervention requires the availability of essential elements, including guidelines, trained staff, health management information systems, equipment, and medications, in primary healthcare centers (PHCs). This study assessed the availability of the WHO package components and the readiness of PHCs to implement a DM screening, evaluation, and management program. Methods This cross-sectional formative assessment adapted the WHO Service Availability and Readiness Assessment (SARA) tool to survey 30 PHCs selected by multistage sampling for readiness to deliver DM diagnosis and care in Abuja, Nigeria, between August 2021 and October 2021. The service availability and readiness indicator scores were calculated based on the proportion of PHCs with available DM care services, minimum staff requirement, diagnostic tests, equipment, medications, and national guidelines/protocols for DM care within the defined SARA domain. Results All 30 PHCs reported the availability of at least two full-time staff (median [interquartile range] staff = 5 [4-9]), which were mostly community health extension workers (median [interquartile range]) = 3 [1-4]. At least one staff member was recently trained in DM care in only 11 (36%) of the PHCs. The study also reported high availability (100%) of paper-based health management information systems (HMIS) and DM screening services using a glucometer (87%), but low availability of DM treatment (23%), printed job aids (27%), and national guidelines/protocols (0%). Conclusion This systematic assessment of PHCs' readiness to implement a DM screening, evaluation, and management program in Abuja demonstrated readiness to integrate DM care into PHCs in terms of equipment, paper-based HMIS, and nonphysician health workers' availability. However, strategies are needed to promote DM health workforce training, provide DM management guidelines, and ensure a reliable supply of essential DM medications.
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Affiliation(s)
- Ikechukwu A Orji
- Cardiovascular Research Unit, University of Abuja Teaching Hospital, Gwagwalada, Abuja
| | - Abigail S Baldridge
- Department of Medical Social Science, Northwestern University Feinberg School of Medicine and Robert J Havey Institute for Global Health, Feinberg School of Medicine, Chicago, Illinois
| | | | | | - Nelson C Eze
- Department of Public Health, Federal Ministry of Health, Abuja
| | - Aashima Chopra
- Department of Medical Social Science, Northwestern University Feinberg School of Medicine and Robert J Havey Institute for Global Health, Feinberg School of Medicine, Chicago, Illinois
| | - Kasarachi Omitiran
- Cardiovascular Research Unit, University of Abuja Teaching Hospital, Gwagwalada, Abuja
| | - Guhan Iyer
- Cardiovascular Division and Global Health Center, Washington University in St. Louis, St. Louis, Missouri
| | - Deborah Odoh
- Department of Public Health, Federal Ministry of Health, Abuja
| | | | - Rifkatu Reng
- Prof. F. Anuma Diabetes & Endocrine Center, University of Abuja Teaching Hospital, Gwagwalada, Abuja
| | - Lisa R Hirschhorn
- Department of Medical Social Science, Northwestern University Feinberg School of Medicine and Robert J Havey Institute for Global Health, Feinberg School of Medicine, Chicago, Illinois
| | - Mark D Huffman
- Cardiovascular Division and Global Health Center, Washington University in St. Louis, St. Louis, Missouri
| | - Dike B Ojji
- Cardiovascular Research Unit, University of Abuja Teaching Hospital, Gwagwalada, Abuja
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Mmerem JI, Umenzekwe CC, Johnson SM, Onukak AE, Chika-Igwenyi NM, Chukwu SK, Onyeaghala CA, Ozougwu JJ, Alasia D, Ehiakhamen O, Nwankwo HM, Ezejiofor OI, Unigwe US, Iroezindu MO. Mpox and Chickenpox Coinfection: Case Series From Southern Nigeria. J Infect Dis 2024; 229:S260-S264. [PMID: 38058122 DOI: 10.1093/infdis/jiad556] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/25/2023] [Accepted: 12/04/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND We describe clinicoepidemiologic characteristics of mpox-chickenpox coinfection in Nigeria. METHODS A retrospective cohort analysis was performed of confirmed mpox cases in Nigeria from January 2022 to March 2023. Mpox and chickenpox were confirmed by real-time polymerase chain reaction (RT-PCR). RESULTS Of 94 (60.0%) suspected cases, 56 had confirmed mpox, of whom 16 (28.6%) had chickenpox coinfection. The median age of confirmed mpox cases was 29 years (interquartile range, 20-37 years), 24 were men (60.7%), 6 (10.7%) were bisexual, and 5 (8.9%) died. Mpox-chickenpox-coinfected patients had more complications than mpox-monoinfected cases (56.3% vs 22.5%, P = .015). CONCLUSIONS The high frequency of mpox-chickenpox coinfection argues for accelerated access to mpox and chickenpox vaccines in Africa.
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Affiliation(s)
- Juliet I Mmerem
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
| | - Chukwudi C Umenzekwe
- Department of Internal Medicine, Nnamdi Azikwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - Simon M Johnson
- Department of Internal Medicine, Federal University Teaching Hospital, Owerri, Imo State, Nigeria
| | - Asukwo E Onukak
- Department of Internal Medicine, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria
| | - Nneka M Chika-Igwenyi
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Sunday K Chukwu
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Chizaram A Onyeaghala
- Department of Internal Medicine, University of Port-Harcourt Teaching Hospital, Port-Harcourt, Rivers State, Nigeria
| | - Jideofor J Ozougwu
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
- Department of Internal Medicine, Federal University Teaching Hospital, Owerri, Imo State, Nigeria
| | - Datonye Alasia
- Department of Internal Medicine, University of Port-Harcourt Teaching Hospital, Port-Harcourt, Rivers State, Nigeria
| | - Odianosen Ehiakhamen
- National Mpox Emergency Operating Centre, National Centre for Disease Control, Abuja, Nigeria
| | - Henry M Nwankwo
- Department of Internal Medicine, Nnamdi Azikwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - Ogochukwu I Ezejiofor
- Department of Internal Medicine, Nnamdi Azikwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - Uche S Unigwe
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Michael O Iroezindu
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
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Anigilaje EA, Nasir ZA, Walton C. Exposure to benzene, toluene, ethylbenzene, and xylene (BTEX) at Nigeria's petrol stations: a review of current status, challenges and future directions. Front Public Health 2024; 12:1295758. [PMID: 38590813 PMCID: PMC11000709 DOI: 10.3389/fpubh.2024.1295758] [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: 09/17/2023] [Accepted: 02/02/2024] [Indexed: 04/10/2024] Open
Abstract
Introduction In Nigeria, because of increasing population, urbanization, industrialization, and auto-mobilization, petrol is the most everyday non-edible commodity, and it is the leading petroleum product traded at the proliferating Nigeria's petrol stations (NPSs). However, because of inadequate occupational health and safety (OHS) regulatory measures, working at NPSs exposes petrol station workers (PSWs) to a large amount of hazardous benzene, toluene, ethylbenzene, and xylene (BTEX) compounds. Methods Studies on BTEX exposures among Nigerian PSWs are scarce. Thus, constraints in quantifying the health risks of BTEX limit stakeholders' ability to design practical risk assessment and risk control strategies. This paper reviews studies on the OHS of Nigerian PSWs at the NPSs. Results Although knowledge, attitude, and practices on OHS in NPSs vary from one Nigeria's study setting to another, generally, safety practices, awareness about hazards and personal protective equipment (PPE), and the use of PPE among PSWs fell below expectations. Additionally, air quality at NPSs was poor, with a high content of BTEX and levels of carbon monoxide, hydrogen sulfide, particulate matter, and formaldehyde higher than the World Health Organization guideline limits. Discussion Currently, regulatory bodies' effectiveness and accountability in safeguarding OHS at NPSs leave much to be desired. Understanding the OHS of NPSs would inform future initiatives, policies, and regulations that would promote the health and safety of workers at NPSs. However, further studies need to be conducted to describe the vulnerability of PSWs and other Nigerians who are occupationally exposed to BTEX pollution. More importantly, controlling air pollution from hazardous air pollutants like BTEX is an essential component of OHS and integral to attaining the Sustainable Development Goals (SDG) 3, 7, and 11.
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Samuel O, Zewotir T, North D. Application of machine learning methods for predicting under-five mortality: analysis of Nigerian demographic health survey 2018 dataset. BMC Med Inform Decis Mak 2024; 24:86. [PMID: 38528495 DOI: 10.1186/s12911-024-02476-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 03/06/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Under-five mortality remains a significant public health issue in developing countries. This study aimed to assess the effectiveness of various machine learning algorithms in predicting under-five mortality in Nigeria and identify the most relevant predictors. METHODS The study used nationally representative data from the 2018 Nigeria Demographic and Health Survey. The study evaluated the performance of the machine learning models such as the artificial neural network, k-nearest neighbourhood, Support Vector Machine, Naïve Bayes, Random Forest, and Logistic Regression using the true positive rate, false positive rate, accuracy, precision, F-measure, Matthew's correlation coefficient, and the Area Under the Receiver Operating Characteristics. RESULTS The study found that machine learning models can accurately predict under-five mortality, with the Random Forest and Artificial Neural Network algorithms emerging as the best models, both achieving an accuracy of 89.47% and an AUROC of 96%. The results show that under-five mortality rates vary significantly across different characteristics, with wealth index, maternal education, antenatal visits, place of delivery, employment status of the woman, number of children ever born, and region found to be the top determinants of under-five mortality in Nigeria. CONCLUSIONS The findings suggest that machine learning models can be useful in predicting U5M in Nigeria with high accuracy. The study emphasizes the importance of addressing social, economic, and demographic disparities among the population in Nigeria. The study's findings can inform policymakers and health workers about developing targeted interventions to reduce under-five mortality in Nigeria.
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Affiliation(s)
- Oduse Samuel
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, 4001, Durban, South Africa.
| | - Temesgen Zewotir
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, 4001, Durban, South Africa
| | - Delia North
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, 4001, Durban, South Africa
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Omale UI, Okeke IM, Ukpabi OO, Ewah RL, Iyare O, Amuzie CI, Oka OU, Adeke AS, Uduma VU, Nkwo GE, Ikegwuonu CO, Nwali UIA, Nnachi OO. COVID-19 information sources, knowledge, attitude, control practices and the predictors among health workers during the pandemic in Ebonyi state, Nigeria. Sci Rep 2024; 14:7072. [PMID: 38528031 DOI: 10.1038/s41598-024-57647-1] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 03/20/2024] [Indexed: 03/27/2024] Open
Abstract
The COVID-19 pandemic has changed into an endemic COVID-19 disease and health workers continue to be at high risk. The situation requires continued use of COVID-19 control measures by health workers and this will likely depend on their sources of information/knowledge/attitude about COVID-19 and previous use of COVID-19 control measures. We explored the COVID-19 information sources, knowledge, attitude, control practices, and the predictors, among health workers in Ebonyi state, Nigeria. We implemented an online-offline analytical cross-sectional survey from March 12 to May 9, 2022 among all categories of health workers (clinical/non-clinical, public/private) working/living in Ebonyi state who gave consent and were selected via convenience/snowballing sampling. Data was collected with a structured self-administered/interviewer-administered questionnaire via WhatsApp/KoBoCollect. Descriptive/inferential analyses were done including multivariate generalized linear models. 1276 health workers were surveyed. The commonest individual source of information about COVID-19 was health workers (used by 83.8%), followed by radio (67.9%), television (59.6%), family members/relatives/friends (57.9%) etc. The main individual source of information for majority of the participants was health workers (for 35.0%) followed by radio (24.5%), television (14.4%) etc. The most trusted individual source of information for majority of the participants was health workers (for 39.4%) followed by radio (26.0%), television (14.3%) etc. Interpersonal sources were the main/most trusted source of information for the majority (48.0%/49.8%) followed by traditional media (39.4%/40.6%) and internet/social media/SMS (12.6%/9.6%). 42.3%, 81.3%, and 43.0% respectively had good knowledge, good attitude, and good control practice about COVID-19. The most important predictors of the main/most trusted sources of information about COVID-19 were place of work (public/private), level of place of work (primary-secondary/tertiary), age, and years of working experience. Good knowledge about COVID-19, good attitude towards COVID-19, strong COVID-19 experience/perception, working at a tertiary facility, tertiary education, and decrease in years of working experience were strong predictors of good control practice about COVID-19. This study's evidence regarding the commonest/main/most trusted information sources and control practice about COVID-19 should be considered by later COVID-19/similar health emergencies' policy actions to optimise emergency health information dissemination and use of control measures by health workers in Ebonyi state/Nigeria/other similar settings.
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Affiliation(s)
- Ugwu I Omale
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria.
| | - Ifeyinwa M Okeke
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria
| | - Okechukwu O Ukpabi
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria
| | - Richard L Ewah
- Department of Anaesthesia, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria
- Anaesthesia Unit, Department of Surgery, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
| | - Osarhiemen Iyare
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria
| | - Chidinma I Amuzie
- Department of Community Medicine, Federal Medical Centre Umuahia, Umuahia, Abia State, Nigeria
| | - Onyinyechukwu U Oka
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria
| | - Azuka S Adeke
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria
| | - Victor U Uduma
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria
| | - Glory E Nkwo
- Department of Community Medicine, Federal Medical Centre Umuahia, Umuahia, Abia State, Nigeria
| | - Cordis O Ikegwuonu
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria
| | - Ugochi I A Nwali
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria
| | - Olaedo O Nnachi
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria
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Arije O, Madan J, Hlungwani T. Preferences in adolescents and young people's sexual and reproductive health services in Nigeria: a discrete choice experiment. Health Econ Rev 2024; 14:24. [PMID: 38514523 PMCID: PMC10958931 DOI: 10.1186/s13561-024-00497-4] [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] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 01/05/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Barriers to utilization of sexual and reproductive health (SRH) services by adolescents and young people (AYP) have persisted despite evidence that youth-friendly services have a positive effect on contraceptive use, and patient knowledge and satisfaction. OBJECTIVE The objective of this study was to elicit, and derive relative valuations for, attributes of SRH services that adolescents and young people value, and their willingness to pay for these services, in public health facilities. METHODS A discrete-choice-experiment (DCE) that was developed using a mixed methods approach was administered to AYP from Ogun State, Southwest Nigeria. The DCE attributes were: the type of staff; physical environment; health worker attitude; cost; waiting time; contraceptive availability; and opening hours. The choice tasks had two unlabeled alternatives and an opt-out option. Panel mixed logit choice model was used to fit the choice data, along with estimation of willingness to pay (WTP). Also, a latent class logit model was used to detect underlying preference heterogeneity among the respondents. Finally, the uptake of the services in health facilities was investigated by estimating the probabilities for selecting hypothetical health facilities under different scenarios. RESULTS A total of 859 AYP participated resulting in 6872 choice observations. The physical environment attribute had the highest utility rating relative to the other attributes, followed by preference for a doctor and for a service provider who was open and friendly. The cost and time coefficients were negative, revealing preference for lower cost and shorter waiting time. The latent class model had three classes that varied by their background characteristics. Probability of choosing any of the facility alternatives increased with introduction of more favorable facility characteristics. CONCLUSION The pattern of preferences identified are potential targets for service design and delivery optimization that may result in improvements in service acceptability and utilization. These results strengthen the call for involving AYP in decision-making in health interventions for them and developing context-specific SRH programs for AYP in public health facilities.
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Affiliation(s)
- Olujide Arije
- Institute of Public Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
- School of Public Health, University of Witwatersrand, Johannesburg, South Africa.
| | - Jason Madan
- Warwick Medical School, University of Warwick, Warwick, UK
| | - Tintswalo Hlungwani
- School of Public Health, University of Witwatersrand, Johannesburg, South Africa
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Onu JU, Onyeka TC. Digital psychiatry in Nigeria: A scoping review. S Afr J Psychiatr 2024; 30:2115. [PMID: 38628900 PMCID: PMC11019087 DOI: 10.4102/sajpsychiatry.v30i0.2115] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 01/22/2024] [Indexed: 04/19/2024] Open
Abstract
Background Mental healthcare workforce shortage in Nigeria poses a major obstacle to mental health services scale-up. Digital psychiatry may provide a veritable platform to bridge treatment gaps. Aim To provide an overview of quantity and range of peer-reviewed publications on digital psychiatry in Nigeria. Setting A comprehensive literature search encompassed all original, peer-reviewed research articles on digital psychiatry in Nigeria. PubMed, Google Scholar, and a direct exploration of relevant journal article reference lists were utilised. Inclusion criteria covered peer-reviewed original articles conducted in Nigeria between January 2013 and January 2023, regardless of quality. Exclusions comprised case reports, reviews, dissertations, and abstracts. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines were adhered to, while methodological framework of Arksey and O'Malley was used to describe the review. Results Fourteen studies meeting inclusion criteria exhibited two primary research areas: implementation and intervention. Most studies focused on intervention strategies, showcasing efficacy of digital devices in enhancing outcomes in depression and clinic appointments. Implementation studies indicated favorable acceptance by both clients and healthcare practitioners. Conclusion Digital technology seems acceptable to Nigerian patients and clinicians. Policies to operationalise provision of digital healthcare services will have positive impact in addressing unmet mental health needs. Finally, the quality of the evidence from majority of studies has to be enhanced, and additional studies are required to uncover gaps in some regions of the country. Contribution This research demonstrates that, despite some drawbacks, digital methods of providing mental healthcare are practical in Nigeria.
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Affiliation(s)
- Justus U Onu
- Department of Mental Health, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
- Center for Translation and Implementation Research (CTAIR), Faculty of Medical Sciences, University of Nigeria, Enugu, Nigeria
| | - Tonia C Onyeka
- Center for Translation and Implementation Research (CTAIR), Faculty of Medical Sciences, University of Nigeria, Enugu, Nigeria
- Department of Anaesthesia, Pain and Palliative Care Unit, Faculty of Medical Sciences, University of Nigeria, Enugu, Nigeria
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Adiukwu FN, Adedapo OO, Ojeahere MI, Musami UB, Mahmood MY, Saidu Kakangi A, Salihu MO, Pinto da Costa M. Psychotherapy training in postgraduate psychiatry training in Nigeria - Are we doing enough? Glob Ment Health (Camb) 2024; 11:e41. [PMID: 38628158 PMCID: PMC11018554 DOI: 10.1017/gmh.2024.32] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 02/19/2024] [Accepted: 02/27/2024] [Indexed: 04/19/2024] Open
Abstract
Introduction Nigeria, with an estimated 40 million people living with mental disorders, faces a critical shortage of psychiatrists to address the significant burden. Despite psychotherapy being integral to psychiatric training, it lacks structure, consistency and adequate supervision. This is alarming, particularly given the substantial demand for specialized psychotherapeutic support among those with mental illness. Methodology A cross-sectional study utilised an online survey targeting early career psychiatrists recruited from the Early Career Psychiatrists section of the Association of Psychiatrists in Nigeria. Results The questionnaire was distributed to 252 early career psychiatrists across Nigeria, with a 42.9% response rate, of which 50% were male, with 73.2% trainees and 26.8% early career psychiatrists. While 52.8% had received some psychotherapy training, only 2.8% were qualified psychotherapists. Notably, only 27.6% of those with psychotherapy training had over 100 hours of training. Factors such as receiving psychotherapy training during postgraduate training and having supervised psychotherapy training were found significant for having independent psychotherapy training. Conclusions There is little emphasis on psychotherapy training in the postgraduate training in Nigeria. Those who had full training in psychotherapy were self-sponsored. Structured, supervised and mandatory psychotherapy within psychiatry training curriculum is recommended.
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Affiliation(s)
- Frances Nkechi Adiukwu
- Department of Mental Health, College of Health Sciences, University of Port Harcourt, Rivers State, Nigeria
- Department of Neuropsychiatry, University of Port Harcourt Teaching Hospital, Rivers State, Nigeria
| | | | | | - Umar Baba Musami
- Mental Health Department, University of Maiduguri, Maiduguri, Nigeria
- Federal Neuropsychiatric Hospital, Maiduguri, Nigeria
| | | | | | - Mumeen Olaitan Salihu
- Department of Behavioural Sciences, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Mariana Pinto da Costa
- South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
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Uruntie RO, Oputa CH, Peters E, Otovwe A. Effect of educational intervention on the knowledge, attitude and practice of breast self-examination among female students at a private university in Southern Nigeria. BMC Cancer 2024; 24:355. [PMID: 38504148 PMCID: PMC10953241 DOI: 10.1186/s12885-024-12116-w] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 03/12/2024] [Indexed: 03/21/2024] Open
Abstract
INTRODUCTION In Nigeria, breast cancer (BC), a disorder marked by the unchecked growth of breast cells, has been the commonest cancer among women in Nigeria. Breast self-examination (BSE) is one of the suggested methods for screening for the early diagnosis of breast cancer. However, studies have reported inadequate knowledge, negative attitudes and poor practices of BSE among undergraduate female students. The study was designed as an interventional study to examine the effect of educational intervention on knowledge, attitude and practice of breast self-examination among female students in a private university in southern Nigeria. METHODS This pretest posttest design study was carried out on 103 students of Novena University at baseline in 2022, which were chosen through the use of simple random sampling. A validated questionnaire with components on demographics, knowledge, attitude, and BSE practice was used to gather the data. After that, the students participated in three hourly sessions of an educational intervention for two weeks. A month later, the students' data were once again collected, and SPSS 20 software was used to evaluate the results using the mean, paired t test, and logistic regression at the P < 0.05 level of significance. RESULTS The mean age of the respondents was 22.37 ± 1.92 years. Only 53 (51.3%) were aware of BSE. The mean knowledge, attitude and practice of BSE at pretest significantly increased at posttest after the educational intervention (1.58 ± 1.48 vs. 4.31 ± 1.15, 2.37 ± 1.27 vs. 4.80 ± 0.49 and 1.97 ± 0.09 vs. 5.81 ± 3.26, respectively). Furthermore, age and family history of BC were predictors of knowledge (OR = 4.00 95% CI = 0.29-41.99, OR = 141, 95% CI = 0.15-13.18), attitude (OR = 2.39, 95% CI = 0.28-12.32, OR = 1.15, 95% CI = 0.24-8.34) and practice of BSE (OR = 2.66, 95% CI = 0.38-18.41, OR = 1.44, 95% CI = 0.24-8.34) respectively. CONCLUSION The findings showed that using an educational intervention strategy will improve the knowledge, attitude and practice of BSE among undergraduate students.
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Affiliation(s)
| | - Chime Helen Oputa
- Department of Public and Community Health, Novena University, Ogume, Delta State, Nigeria
| | - Esegbue Peters
- Department of Public and Community Health, Novena University, Ogume, Delta State, Nigeria
| | - Agofure Otovwe
- Department of Public Health, Achievers University, Owo, Ondo State, Nigeria.
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Adetutu OM, Oyinlola FF, Oyelakin TE, Ofili FL. Influence of intimate partner violence and male involvement on maternal healthcare services utilisation in Nigeria. Front Glob Womens Health 2024; 5:1353117. [PMID: 38559815 PMCID: PMC10978718 DOI: 10.3389/fgwh.2024.1353117] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 03/05/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Low maternal health care services utilisation, especially antenatal care attendance and skilled birth attendance, has been documented to be responsible for maternal mortality and morbidity in Nigeria. While available evidence suggests mixed findings on uptake of maternal health care services in the context of abusive spousal relationships, male involvement in household and health decision-making has been established to promote uptake of maternal health care services. Yet, studies which consider mediating influence of intimate partner violence on male involvement and maternal health care services uptake are sorely missing in Nigeria. We hypothesised that maternal health care services uptake in abusive marital unions has implications for male involvement in pregnancy care and this has been largely overlooked in Nigeria. Materials and methods This study extracted data from the 2018 Nigeria Demographic and Health Survey (NDHS). The 2018 NDHS is a nationally representative secondary data which collected population, demographic and health information on women, men and households in Nigeria. The secondary data used a two-stage stratified and multistage sampling technique to collect information from the respondents. In this study, data were extracted for women who were sexually active, within the reproductive age (15-49 years) and not pregnant in five years prior the survey (n = 7,847). Results The results indicated (77%) antenatal care attendance and (47%) skilled delivery. The mediating influence of IPV on male involvement resulted in women who experienced sexual violence more likely to use heath facility for antenatal care (OR = 3.20; C.I: 1.20-8.50). Women whose partners were involved in health decision making had lower odds of antenatal care attendance (OR = 0.64; C.I: 0.44-0.94). Also, women whose partners were involved in spending their earnings had lower probability of antenatal care attendance (OR = 0.72; C.I: 0.55-0.96). Yet, the mediating influence of intimate partner violence on male involvement resulted in a lower likelihood of use of skilled delivery for emotionally abused women (OR = 0.58; C.I: 0.39-0.85). Women whose partners were involved in spending their earnings had higher odds of using skilled delivery (OR = 2.15; C.I: 1.79-2.56). Yet, women whose partners were involved in their health decision-making had lower odds of using skilled delivery (OR = 0.46; C.I: 0.34-0.62). Conclusion This study held the philosophical stance that intimate partner violence mediated the influence of male involvement on maternal health care uptake while intimate partner violence had an inconsistent influence on maternal health care uptake. Policies and interventions should aim at addressing deep-rooted gender norms which promote IPV and limit male involvement in pregnancy care in Nigeria. Programme and policy interventions should focus on enhancing socioeconomic status of women.
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Affiliation(s)
- O. M. Adetutu
- Department of Demography and Social Statistics, Faculty of Social Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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Husein M, Moner-Girona M, Falchetta G, Stevanato N, Fahl F, Szabó S. The impacts of incentive policies on improving private investment for rural electrification in Nigeria - A geospatial study. Heliyon 2024; 10:e27440. [PMID: 38486740 PMCID: PMC10937702 DOI: 10.1016/j.heliyon.2024.e27440] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 02/28/2024] [Indexed: 03/17/2024] Open
Abstract
In Nigeria, 86 million people lack electricity access, the highest number worldwide, predominantly in rural areas. Despite government efforts, constrained budgets necessitate private investors, who, without adequate incentives, are hesitant to commit capital due to perceived high risks. This study identifies three existing incentive policies-concessionary loans, capital subsidy, and financing productive use equipment-aimed at promoting rural electrification in Nigeria. Employing geospatial and regulatory analyses, we evaluate their impact on electrification planning across 22,696 population clusters. While all incentives encourage mini-grids and stand-alone systems, results show varied impacts, predominantly favouring mini-grids. Under the baseline, grid extension is optimal for 66% of clusters, followed by mini-grids (27%) and stand-alone systems (7%). Concessionary loans boost mini-grid and Stand-Alone Systems shares by 10% and 5%, respectively. Capital subsidies increase the mini-grid share to 41%, surpassing concessional loans (37%). Financing productive equipment enhances Stand-Alone Systems and mini-grid shares to 15% and 43%. Incentives impact LCOE, CAPEX, and OPEX, with average LCOE reducing to 0.31 EUR/kWh (concessionary loans), 0.30 EUR/kWh (capital subsidy), and 0.27 EUR/kWh (financing productive use). Financing productive uses proves decisively more effective in lowering costs for mini-grids and stand-alone systems than loans or capital subsidies. The important policy implications of this study reinforce the need for tailored incentives for distinct electrification options.
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Affiliation(s)
- Munir Husein
- Center for Clean Energy and Climate Change, Baze University, Abuja, Nigeria
| | | | - Giacomo Falchetta
- International Institute for Applied Systems Analysis, Laxenburg, Austria
- Euro-Mediterranean Center on Climate Change, Venice, Italy
| | | | | | - Sandor Szabó
- European Commission, Joint Research Centre (JRC), Ispra, Italy
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Voorman A, Lyons H, Shuaib F, Adamu US, Korir C, Erbeto T, Bandyopadhyay AS, Okiror S. Impact of Supplementary Immunization Activities using Novel Oral Polio Vaccine Type 2 during a Large outbreak of Circulating Vaccine-Derived Poliovirus in Nigeria. J Infect Dis 2024; 229:805-812. [PMID: 37357964 PMCID: PMC10938209 DOI: 10.1093/infdis/jiad222] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND Novel oral poliovirus vaccine (OPV) type 2 (nOPV2) has been made available for outbreak response under an emergency use listing authorization based on supportive clinical trial data. Since 2021 more than 350 million doses of nOPV2 were used for control of a large outbreak of circulating vaccine-derived poliovirus type 2 (cVDPV2) in Nigeria. METHODS Using a bayesian time-series susceptible-infectious-recovered model, we evaluate the field effectiveness of nOPV2 immunization campaigns in Nigeria compared with campaigns using monovalent OPV type 2 (mOPV2). RESULTS We found that both nOPV2 and mOPV2 campaigns were highly effective in reducing transmission of cVDPV2, on average reducing the susceptible population by 42% (95% confidence interval, 28-54%) and 38% (20-51%) per campaign, respectively, which were indistinguishable from each other in this analysis (relative effect, 1.1 [.7-1.9]). Impact was found to vary across areas and between immunization campaigns. CONCLUSIONS These results are consistent with the comparable individual immunogenicity of nOPV2 and mOPV2 found in clinical trials but also suggest that outbreak response campaigns may have small impacts in some areas requiring more campaigns than are suggested in current outbreak response procedures.
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Affiliation(s)
- Arend Voorman
- The Bill & Melinda Gates Foundation, Seattle, Washington, USA
| | - Hil Lyons
- The Bill & Melinda Gates Foundation, Seattle, Washington, USA
| | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Usman S Adamu
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Charles Korir
- World Health Organization, Nigeria Country Office, Abuja, Nigeria
| | - Tesfaye Erbeto
- World Health Organization, Nigeria Country Office, Abuja, Nigeria
| | | | - Samuel Okiror
- The Bill & Melinda Gates Foundation, Seattle, Washington, USA
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Osaigbovo II, Igbarumah IO, Obaseki DE. Instituting coronavirus disease 2019 testing: opportunities and challenges of molecular laboratory diagnosis in a Southern Nigerian teaching hospital. Int Health 2024:ihae023. [PMID: 38477188 DOI: 10.1093/inthealth/ihae023] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 02/12/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
The coronavirus disease 2019 pandemic emphasised the importance of laboratory preparedness, including molecular diagnostic capacity, in the control of infectious disease outbreaks. This article reflects on diagnostic capacity-building opportunities presented by the pandemic, the challenges experienced along the way and the lessons learned from the perspective of a university teaching hospital in Southern Nigeria. We advocate for these lessons to inform strategic planning for laboratory preparedness at subnational, national and continental levels.
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Affiliation(s)
- Iriagbonse I Osaigbovo
- Departme nt of Medical Microbiology, School of Medicine, College of Medical Sciences, University of Benin, Benin City 300213, Edo state, Nigeria
- Department of Medical Microbiology, University of Benin Teaching Hospital, Benin City 300001, Edo state, Nigeria
| | - Isaac O Igbarumah
- Molecular Diagnostic and Virology Laboratory, University of Benin Teaching Hospital, Benin City 300001, Edo state, Nigeria
| | - Darlington E Obaseki
- Office of the Chief Medical Director, University of Benin Teaching Hospital, Benin City 300001, Edo state, Nigeria
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Olakunde BO, Itanyi IU, Olawepo JO, Liu L, Bembir C, Idemili-Aronu N, Lasebikan NN, Onyeka TC, Dim CC, Chigbu CO, Ezeanolue EE, Aarons GA. Comparative effectiveness of implementation strategies for Accelerating Cervical Cancer Elimination through the integration of Screen-and-treat Services (ACCESS study): protocol for a cluster randomized hybrid type III trial in Nigeria. Implement Sci 2024; 19:25. [PMID: 38468266 PMCID: PMC10926605 DOI: 10.1186/s13012-024-01349-9] [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] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 02/03/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Despite the increased risk of cervical cancer (CC) among women living with HIV (WLHIV), CC screening and treatment (CCST) rates remain low in Africa. The integration of CCST services into established HIV programs in Africa can improve CC prevention and control. However, the paucity of evidence on effective implementation strategies (IS) has limited the success of integration in many countries. In this study, we seek to identify effective IS to enhance the integration of CCST services into existing HIV programs in Nigeria. METHODS Our proposed study has formative and experimental activities across the four phases of the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Through an implementation mapping conducted with stakeholders in the exploration phase, we identified a core package of IS (Core) and an enhanced package of IS (Core+) mostly selected from the Expert Recommendations for Implementing Change. In the preparation phase, we refined and tailored the Core and Core+ IS with the implementation resource teams for local appropriateness. In the implementation phase, we will conduct a cluster-randomized hybrid type III trial to assess the comparative effectiveness of Core versus Core+. HIV comprehensive treatment sites (k = 12) will be matched by region and randomized to Core or Core+ in the ratio of 1:1 stratified by region. In the sustainment phase, we will assess the sustainment of CCST at each site. The study outcomes will be assessed using RE-AIM: reach (screening rate), adoption (uptake of IS by study sites), IS fidelity (degree to which the IS occurred according to protocol), clinical intervention fidelity (delivery of CC screening, onsite treatment, and referral according to protocol), clinical effectiveness (posttreatment screen negative), and sustainment (continued integrated CCST service delivery). Additionally, we will descriptively explore potential mechanisms, including organizational readiness, implementation climate, CCST self-efficacy, and implementation intentions. DISCUSSION The assessment of IS to increase CCST rates is consistent with the global plan of eliminating CC as a public health threat by 2030. Our study will identify a set of evidence-based IS for low-income settings to integrate evidence-based CCST interventions into routine HIV care in order to improve the health and life expectancy of WLHIV. TRIAL REGISTRATION Prospectively registered on November 7, 2023, at ClinicalTrials.gov no. NCT06128304. https://classic. CLINICALTRIALS gov/ct2/show/study/NCT06128304.
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Affiliation(s)
- Babayemi O Olakunde
- Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Abuja, Nigeria
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
| | - Ijeoma U Itanyi
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
- Department of Community Medicine, College of Medicine, University of Nigeria Nsukka, Enugu, Nigeria
| | - John O Olawepo
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
- Department of Health Sciences, Northeastern University, Boston, MA, USA
| | - Lin Liu
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Chinenye Bembir
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
| | - Ngozi Idemili-Aronu
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
- Department of Sociology and Anthropology, University of Nigeria Nsukka, Enugu, Nigeria
| | - Nwamaka N Lasebikan
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
- Oncology Center, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Tonia C Onyeka
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
- Department of Anaesthesia/Pain & Palliative Care Unit, College of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Cyril C Dim
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
- Department of Obstetrics and Gynecology, College of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Chibuike O Chigbu
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
- Department of Obstetrics and Gynecology, College of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Echezona E Ezeanolue
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
- HealthySunrise Foundation, Las Vegas, NV, USA
| | - Gregory A Aarons
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92093-0812, USA.
- UC San Diego ACTRI Dissemination and Implementation Science Center, La Jolla, CA, USA.
- Moores Cancer Center, University of California San Diego, La Jolla, CA, 92093, USA.
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Anosike C, Adibe MO, Ani DN. Extent of community pharmacists' care of clients with depression in Enugu, Nigeria: a cross-sectional survey. Int J Pharm Pract 2024; 32:186-189. [PMID: 38071450 DOI: 10.1093/ijpp/riad088] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 11/27/2023] [Indexed: 03/07/2024]
Abstract
BACKGROUND Community pharmacists play a crucial role in the care of people with depression. This study aimed to evaluate the level of care provided by community pharmacists for clients with depression in Enugu, Nigeria. METHODS A cross-sectional survey was conducted among randomly selected community pharmacists in Enugu, Nigeria. The data obtained were analysed descriptively. KEY FINDINGS Approximately 25% of pharmacists perform depression screening, and 14.4% refer clients to psychiatrists. Pharmacists rarely provide information on antidepressant dosage, side effects, frequency, and duration. CONCLUSION Community pharmacists in Enugu are not providing effective care to depressed patients. Thus, appropriate interventions are recommended.
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Affiliation(s)
- Chibueze Anosike
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, 410001, Enugu State, Nigeria
- Pharmacoeconomics and Mental Health Research Group, University of Nigeria, Nsukka, Nigeria
| | - Maxwell Ogochukwu Adibe
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, 410001, Enugu State, Nigeria
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Odukoya D, Chege W, Scior K. The effect of an e-intervention on intellectual disability stigma among Nigerian and Kenyan internet users: a comparative randomised controlled trial. Front Psychiatry 2024; 15:1331107. [PMID: 38505801 PMCID: PMC10948596 DOI: 10.3389/fpsyt.2024.1331107] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/19/2024] [Indexed: 03/21/2024] Open
Abstract
Introduction The negative consequences of stigma for the wellbeing of people with disabilities have raised public and global health concerns. This study assessed the impact of an e-intervention to reduce intellectual disability (ID) stigma among Nigerian and Kenyan internet-users. Method Participants aged 18+ and citizens of Nigeria and Kenya were recruited through online advertising. Qualtrics, a web survey platform, randomly assigned (1:1) participants to watch either a short experimental or control film, while masked to their assignment. The experimental film featured education about ID and indirect contact. The control film was on an unrelated topic. Their attitudes were measured on three dimensions (affect, cognitions and behaviour) at three time points (baseline, post intervention and one-month follow-up). Between October 2016 and April 2017, 933 participants were randomised, 469 to the experimental condition and 464 to the control condition. Of these, 827 (89%) provided pre-and post-intervention data but only 287 (31%) were retained at follow-up. Results An intent-to-treat analysis revealed that participants in the experimental but not the control condition showed a positive shift in their attitudes towards people with ID over time. Their willingness to interact with people with ID increased post-intervention. Discussion A brief intervention that integrates education and indirect contact can make an effective contribution to efforts to reduce stigma faced by people with ID in Africa. Trial registered with the ISRCTN trial registry (number ISRCTN92574712).
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Affiliation(s)
| | | | - Katrina Scior
- Clinical Educational and Health Psychology, University College London, London, United Kingdom
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40
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Rayner DG, Charles P, Maduagwu S, Odega A, Kalu ME. Prioritizing mobility factors for assessment during the transition of older adults from hospital to home: a cross-sectional survey of physiotherapists in Southeastern Nigeria. Physiother Theory Pract 2024:1-13. [PMID: 38440845 DOI: 10.1080/09593985.2024.2324351] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 02/23/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Assessing all factors influencing older adults' mobility during the hospital-to-home transition is not feasible given the complex and time-sensitive nature of hospital discharge processes. OBJECTIVE To describe the mobility factors that Nigerian physiotherapists prioritize to be assessed during hospital-to-home transition of older adults and explore the differences in the prioritization of mobility factors across the physiotherapists' demographics and practice variables. METHODS This cross-sectional study included 121 physiotherapists who completed an online questionnaire, ranking 74 mobility factors using a nine-point Likert scale. A factor was prioritized if ≥ 70% of physiotherapists rated the factor as "Critical" (scores ≥7) and ≤ 15% of physiotherapists rated a factor as "Not Important" (scores ≤3). We assessed the differences in the prioritization of mobility factors across the physiotherapists' demographics/practice variables using Mann Whitney U and Kruskal-Wallis tests. FINDINGS Forty-three of 74 factors were prioritized: four cognitive, two environmental, one financial, four personal, eighteen physical, seven psychological, and seven social factors. Males and those with self-reported expertise in each mobility determinants more frequently rated factors as critical. CONCLUSION Prioritizing many mobility factors underscores the complex nature of mobility, suggesting that an interdisciplinary approach to addressing these factors may enhance post-hospital discharge mobility outcomes.
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Affiliation(s)
- D G Rayner
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - P Charles
- Medical Rehabilitation Department, Nnamdi Azikiwe University, Awka, Nigeria
| | - S Maduagwu
- Medical Rehabilitation Department, Nnamdi Azikiwe University, Awka, Nigeria
| | - A Odega
- Medical Rehabilitation Department, Nnamdi Azikiwe University, Awka, Nigeria
- Emerging Researchers & Professionals in Aging-African Network, Abuja & Hamilton, Nigeria & Canada
| | - M E Kalu
- Emerging Researchers & Professionals in Aging-African Network, Abuja & Hamilton, Nigeria & Canada
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Canada
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Muhammad ID, Umar UA, Sabo US, Rabiu I, Ahmad AM, Yusuf MA. Female genital schistosomiasis mimicking an ovarian neoplasm: A case report. Parasitol Int 2024; 101:102878. [PMID: 38452972 DOI: 10.1016/j.parint.2024.102878] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 03/02/2024] [Accepted: 03/04/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE A case description of a rare occurrence of female genital schistosomiasis affecting the upper genital tract that presented with features mimicking an ovarian neoplasm. CASE REPORT Female genital schistosomiasis is a neglected clinical manifestation of the water-born parasitic disease which occurs due to the presence of schistosome eggs in the genitalia of women. A 23-year-old nulliparous woman presented with progressive abdominal distension. An abdominopelvic CT scan revealed a multilobulated right adnexal mass with gross ascites. Diagnosis of schistosomiasis was made by histology of biopsied specimens following laparotomy. Cervical colposcopic findings were consistent with female genital schistosomiasis. She was successfully treated with praziquantel. CONCLUSION Female genital schistosomiasis of the upper genital tract can mimic an ovarian malignancy. Hence there is a need for its consideration as a differential diagnosis in patients with non-classical presentations of pelvic tumours in schistosomiasis-endemic areas.
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Affiliation(s)
| | - Usman Aliyu Umar
- Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, Kano, Nigeria; Department of Obstetrics and Gynaecology, College of Health Sciences, Bayero University, Kano, Nigeria.
| | - Umar Suleiman Sabo
- Department of Obstetrics and Gynaecology, Murtala Muhammad Specialist Hospital, Kano, Nigeria.
| | - Ibrahim Rabiu
- Department of Community Medicine, Gombe State University, Gombe, Nigeria.
| | | | - Mustapha Ahmed Yusuf
- Department of Medical Microbiology and Parasitology, College of Health Sciences, Bayero University, Kano, Nigeria.
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Xu H, Li A, Apuke OD. The impact of group music therapy in ameliorating the depression among patients with dementia in care homes: A randomized control trial. Geriatr Nurs 2024; 56:304-311. [PMID: 38417183 DOI: 10.1016/j.gerinurse.2024.02.021] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 01/29/2024] [Accepted: 02/08/2024] [Indexed: 03/01/2024]
Abstract
Despite the increasing use of music therapy to treat patients with dementia, studies focused on developing nations are still in their embryonic stages. In this view, this study examined the impact of group music therapy intervention in ameliorating depression levels among older people in two care homes. A randomized control trial (RCT) was carried out in which a total of 121 patients were randomly divided into control 61 and experimental group 60. After 6 weeks, 12-session experiment which involved passive and active music therapy, it was found that music group therapy intervention reduced the depression level of older persons in the experimental group, compared to those who were not exposed to the music therapy; control group. The music therapy session also influenced the salivary cortisol of the patients as it was shown to reduce their salivary cortisol levels. It was also observed that after three months of follow-up, participants in the experimental group still maintained a low level of depression and salivary cortisol level, but the control group's level was still high, thus, substantiating the effect of music in reducing depression among older people. We encouraged clinicians, nursing practitioners and care homes in Nigeria to incorporate music therapy as part of the treatment offered to patients with dementia.
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Affiliation(s)
- Honghua Xu
- College of Music, Hunan Normal University, Changsha, 410081, China; College of Music, Guizhou University, Guiyang, 550025, China.
| | - Aoyi Li
- Wuhan Conservatory of Music, Wuhan, 430060, China.
| | - Oberiri Destiny Apuke
- Faculty of Communication and Media Studies, Department of Mass Communication, Taraba State University, Jalingo.
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Orjiakor EC. Nurturing Food Security for All: Assessing the Impact of COVID-19 Social Protection Responses Among Vulnerable Population Groups in Nigeria. Ecol Food Nutr 2024; 63:83-97. [PMID: 38276988 DOI: 10.1080/03670244.2024.2307434] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
This study examines the impact of government and humanitarian interventions during COVID-19 on food security among vulnerable populations in Nigeria. Data from a survey conducted by the United Nations High Commissioner for Refugees (UNHCR) in July 2020 was used, with a sample of 4,833 households drawn from various vulnerable groups such as refugees and internally displaced persons (IDPs). Using matching methods, the results indicate that targeted support initiatives helped alleviate immediate food insecurity challenges during the pandemic. This underscores the significance of focused interventions in mitigating the adverse impact of economic shocks on food security for vulnerable populations.
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Yi C, Naixin L, Iyendo TO, Apuke OD. Cognitive behavior, art, and music therapies intervention for treating the depression of children: A randomized control trial. Psychiatry Res 2024; 333:115716. [PMID: 38244284 DOI: 10.1016/j.psychres.2024.115716] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 12/31/2023] [Accepted: 01/02/2024] [Indexed: 01/22/2024]
Abstract
This study compared the effect of interactive media-based cognitive behaviour, art, and music therapies in reducing depression in children who survived abduction in Nigeria. A randomized control trial was conducted using three randomly selected secondary schools in Northern Nigeria. The study sample comprised 450 children randomly divided into a control group of (n = 225) and an experimental group of (n = 225). The treatment group was further divided into three groups; cognitive behavior (n = 75), art (n = 75), and music (n = 75) therapy, respectively. According to the findings of this study, cognitive behaviour, art, and music therapies via interactive media are a successful intervention technique for treating the depression of schoolchildren who survived abduction in Nigeria. However, compared to art and music therapy, cognitive behaviour therapy is more effective at treating depression. To lessen the depression of children who survived kidnapped in Nigeria, we recommend adopting cognitive behavioural therapy.
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Affiliation(s)
- Cao Yi
- Teachers College for Vocational Education, Guangxi Normal University, China.
| | - Lu Naixin
- School of Music, Shandong University of Technology, Shandong Province, 255000, China.
| | - Timothy Onosahwo Iyendo
- Department of Architecture, Faculty of Environmental Sciences, Nile University of Nigeria, Plot 681, Institute Area, Federal Capital Territory, Abuja, Nigeria.
| | - Oberiri Destiny Apuke
- Department of Mass Communication, Taraba State University, PMB, 1167, Jalingo, Nigeria.
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Onwumere-Idolor OS, Kperegbeyi JI, Imonikebe UG, Okoli CE, Ajibo FE, Njoga EO. Epidemiology of multidrug-resistant zoonotic E. coli from beef processing and retail points in Delta State, Nigeria: Public health implications. Prev Vet Med 2024; 224:106132. [PMID: 38335831 DOI: 10.1016/j.prevetmed.2024.106132] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/18/2024] [Accepted: 01/21/2024] [Indexed: 02/12/2024]
Abstract
Some sorbitol non-fermenting E. coli (SN-F E. coli) and all E. coli O157 are zoonotic. Contamination of beef with zoonotic E. coli at the processing or retail point is a significant public health problem. Despite the public health importance of these organisms, there is no published data on the prevalence and antimicrobial resistance (AMR) of zoonotic E. coli from Delta State, Nigeria. Consequently, this study determined the prevalence and AMR of SN-F E. coli and E. coli O157 isolates from meat contact surfaces at the processing and retail points in the study area. The isolation, biochemical and serological characterisations and AMR status of the isolates were performed following standard microbiological methods. Overall prevalence of SN-F E. coli and E. coli O157 were 13.8% (56/406) and 1.5% (6/406), respectively. Majority of the 56 SN-F E. coli (64.3%, 36/56) and all the six E. coli O157 (10.7%, 6/56) detected in this study were found at the meat processing points. Most of the SN-F E. coli were isolated at the slaughterhouse floor (31%), meat hooks (17.2%) and meat sellers' knives (17.2%). The SN-F E. coli exhibited greater AMR to ampicillin (67.9%), gentamycin (64.3%) and tetracycline (50%) than other antimicrobial agents tested. No isolate was resistant to aztreonam. All six E. coli O157 isolates were resistant to enrofloxacin. Overall, 23 AMR patterns, comprised 14 from meat processing points and nine from meat retailing points, were observed from the 56 antimicrobial-resistant SN-F E. coli isolates. All the six E. coli O157 and 73.2% (41/56) of the SN-F E. coli isolates were multidrug-resistant. An overall mean multiple antimicrobial resistance index of 0.6 was recorded. Multidrug-resistant zoonotic E. coli were detected at meat processing and retail points in Delta State, Nigeria. The findings warrant the adoption of One Health control approach, "farm to fork" principle of food safety and prudent use of antimicrobial agents in animal agriculture. These may help to limit beef contamination with multidrug-resistant zoonotic E. coli at the processing and retailing points, for public health safety.
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Affiliation(s)
- Onyinye S Onwumere-Idolor
- Department of Animal Production, Faculty of Agriculture, Delta State University of Science and Technology, Ozoro PMB 005, Delta State, Nigeria
| | - Jameslove I Kperegbeyi
- Department of Animal Production, Faculty of Agriculture, Delta State University of Science and Technology, Ozoro PMB 005, Delta State, Nigeria
| | - Uzezi G Imonikebe
- Department of Animal Production, Faculty of Agriculture, Delta State University of Science and Technology, Ozoro PMB 005, Delta State, Nigeria
| | - Chinwe E Okoli
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Abuja, Abuja 900109, Federal Capital Territory, Nigeria
| | - Festus E Ajibo
- Department of Animal Health and Production, Enugu State Polytechnic, Iwollo PMB 008, Enugu State, Nigeria
| | - Emmanuel O Njoga
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Nigeria, Nsukka 410001, Enugu State, Nigeria; Animal Health Antimicrobial Resistance Surveillance Sentinel Laboratory, Veterinary Teaching Hospital, University of Nigeria, Nsukka 410001, Nigeria; Veterinary Antimicrobial Resistance Research Group, University of Nigeria, Nsukka 410001, Nigeria.
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46
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Ijeomah IM, Temitope FOC, Lander DC, Sheriff AT, Uwem GE, Bernard OA, Oluseyi OA, Elijah OI, Toluwani AG, Arthur OO, Toluwanimi AE, Bolutife PO, Damilola OG, Titilola OO, Oluwadamilola GA, Muhammad AI, Omotosho KI, Johnson AA, Jelle M, Olubusuyi AM. Classic human astrovirus 4, 8, MLB-3, and likely new genotype 5 sublineage in stool samples of children in Nigeria. J Med Virol 2024; 96:e29489. [PMID: 38402605 DOI: 10.1002/jmv.29489] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 02/07/2024] [Accepted: 02/13/2024] [Indexed: 02/27/2024]
Abstract
Human astrovirus (HAstV) is a nonenveloped RNA virus and has been implicated in acute gastroenteritis among children and elderly. However, there exists a substantial dearth of information on HAstV strains circulating in Nigeria. Viral-like particles were purified from archived 254 stool samples of children with acute flaccid paralysis between January and December 2020 from five states in Nigeria, using the NetoVIR protocol. Extracted viral RNA and DNA were subjected to a reverse transcription step and subsequent random polymerase chain reaction amplification. Library preparation and Illumina sequencing were performed. Using the virome paired-end reads pipeline, raw reads were processed into genomic contigs. Phylogenetic and pairwise identity analysis of the recovered HAstV genomes was performed. Six near-complete genome sequences of HAstV were identified and classified as HAstV4 (n = 1), HAstV5 (n = 1), HAstV8 (n = 1), and MLB-3 (n = 3). The HAstV5 belonged to a yet unclassified sublineage, which we tentatively named HAstV-5d. Phylogenetic analysis of open reading frames 1a, 1b, and 2 suggested recombination events inside the MAstV1 species. Furthermore, phylogenetic analysis implied a geographic linkage between the HAstV5 strain from this study with two strains from Cameroon across all the genomic regions. We report for the first time the circulation of HAstV genotypes 4, 8, and MLB-3 in Nigeria and present data suggestive for the existence of a new sublineage of HAstV5. To further understand the burden, diversity, and evolution of HAstV, increased research interest as well as robust HAstV surveillance in Nigeria is essential.
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Affiliation(s)
- Ifeorah M Ijeomah
- Department of Medical Laboratory Sciences and Center for Translation and Implementation Research, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Faleye O C Temitope
- Center for Environmental Health Engineering, Biodesign Institute, Arizona State University, Tempe, Arizona, USA
| | - De Coninck Lander
- Laboratory of Viral Metagenomics, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - Agbaje T Sheriff
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - George E Uwem
- African Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer's University Ede, Ede, Nigeria
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer's University, Ede, Ede, Nigeria
| | - Onoja A Bernard
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Olayinka A Oluseyi
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oni I Elijah
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ajileye G Toluwani
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oragwa O Arthur
- Department of Veterinary Microbiology, Faculty of Veterinary Medicine, University of Jos, Jos, Nigeria
| | - Akinleye E Toluwanimi
- Phytomedicine Unit, Department of Pharmacognosy, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
| | - Popoola O Bolutife
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Osasona G Damilola
- Department of Medical Laboratory Sciences, Faculty of Basic Medical Sciences, Osun State and Hospitals Management Board, Redeemer's University Ede, Ado-Ekiti, Nigeria
| | - Olayinka O Titilola
- National Polio Laboratory, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Ahmed I Muhammad
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Komolafe I Omotosho
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer's University, Ede, Ede, Nigeria
| | - Adeniji A Johnson
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Infectious Disease Institute, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Matthijnssens Jelle
- Laboratory of Viral Metagenomics, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - Adewumi M Olubusuyi
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Infectious Disease Institute, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Verinumbe T, Katomski AS, Turpin G, Syarif O, Looze P, Lalak K, Anoubissi J, Brion S, Dunaway K, Sprague L, Matyushina D, De Leon Moreno CG, Baral SD, Rucinski K, Lyons C. Characterizing the Relationship between HIV Peer Support Groups and Internalized Stigma Among People Living with HIV in Nigeria. AIDS Behav 2024; 28:1068-1076. [PMID: 37889362 DOI: 10.1007/s10461-023-04217-7] [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] [Subscribe] [Scholar Register] [Accepted: 10/14/2023] [Indexed: 10/28/2023]
Abstract
HIV-related stigma remains a significant barrier to implementing effective HIV treatment and prevention strategies in Nigeria. Despite the high uptake of peer support groups among people living with HIV (PLHIV) in Nigeria, the potential role of such peer support on the burden of internalized stigma remains understudied. To address this gap, we conducted a secondary analysis of the PLHIV Stigma Index 2.0, a socio-behavioral survey implemented by PLHIV led-organizations to assess the relationship between group membership and internalized stigma. Internalized stigma was measured using the Internalized AIDS-related Stigma Scale. Multinomial logistic regression was used to measure the association between self-reported engagement in peer support groups and internalized stigma adjusting for age, education, duration since HIV diagnosis, employment, disclosure status, and sex-work engagement. Of the 1,244 respondents in this study, 75.1% were engaged in HIV peer support groups. Over half (55.5%) and about one-fourth (27.3%) demonstrated low/moderate and high levels of internalized stigma, respectively. PLHIV engaged in HIV peer support groups were less likely to report both low/moderate (versus no) (adjusted odds ratio (aOR): 0.47 [95% CI: 0.27 to 0.81]; p = 0.006) and high (versus no) (aOR: 0.30 [95% CI: 0.17 to 0.53]; p < 0.001) levels of internalized stigma compared to those not engaged. In this study, the burden of internalized stigma is high among PLHIV in Nigeria. However, engagement in peer support groups appears to mitigate these stigmas. Stigma mitigation strategies to increase peer support may represent a critical tool in decreasing sustained HIV treatment gaps among PLHIV in Nigeria.
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Affiliation(s)
- Tarfa Verinumbe
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, 1717 East Monument St., Baltimore, MD, 21205, USA.
| | - Anna-Sophia Katomski
- Department of Epidemiology, Johns Hopkins University School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA
| | - Gnilane Turpin
- Department of Epidemiology, Johns Hopkins University School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA
| | - Omar Syarif
- Global Network of People Living with HIV (GNP+), Amsterdam, The Netherlands
| | - Pim Looze
- Global Network of People Living with HIV (GNP+), Amsterdam, The Netherlands
| | - Katarzyna Lalak
- Global Network of People Living with HIV (GNP+), Amsterdam, The Netherlands
| | - Jean Anoubissi
- Global Network of People Living with HIV (GNP+), Amsterdam, The Netherlands
| | - Sophie Brion
- The International Community of Women Living with HIV (ICW), London, UK
| | - Keren Dunaway
- The International Community of Women Living with HIV (ICW), London, UK
| | - Laurel Sprague
- The Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva, Switzerland
| | - Daria Matyushina
- The Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva, Switzerland
| | | | - Stefan D Baral
- Department of Epidemiology, Johns Hopkins University School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA
| | - Katherine Rucinski
- Department of International Health, Johns Hopkins University School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA
| | - Carrie Lyons
- Department of Epidemiology, Johns Hopkins University School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA
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Jegede OA, Olaoye MA, Olagbaju PO, Makinde V, Badawy WM. Radiation risk assessment of quarry pit soil as construction material in Abeokuta, Nigeria: implications for environmental and public health. Isotopes Environ Health Stud 2024; 60:90-102. [PMID: 37997342 DOI: 10.1080/10256016.2023.2285002] [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] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/25/2023] [Indexed: 11/25/2023]
Abstract
ABSTRACTEnvironmental and health risks posed by radionuclides in quarry pit soils are of great concern in environmental health monitoring. The current investigation was aimed at determining the natural radionuclide activity concentration (in Bq kg-1) of the understudied quarry pit granules used as construction materials. The collection and preparation of pit soil samples from Abeokuta quarry sites were done using standard methods, analysis of radiological parameters was carried out using hyperpure germanium (HPGe) spectrometer. Specific activity concentrations of 226Ra, 232Th, and 40K were measured. The values obtained were greater than the world weighted average of 35, 30, and 400 Bq kg-1 for 226Ra, 232Th, and 40K, respectively. The absorbed dose, the annual effective dose, and the radium equivalent were calculated and demonstrated significant values. The radionuclide content of the samples is relatively high and the use of pit soils as a building material, therefore, raises radiological concerns for dwellers in this area and requires periodic monitoring and undergoing a radiation protection program.
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Affiliation(s)
- Oluwaseyi A Jegede
- Center of Applied Radiation Science and Technology, North West University, Mahikeng Campus, South Africa
- Department of Physics, Federal University of Agriculture, Abeokuta, Nigeria
| | - Morohunfoluwa A Olaoye
- Department of Physics, Federal University of Agriculture, Abeokuta, Nigeria
- Department of Physics, Faculty of Science, Lagos State University, Ojo, Nigeria
| | - Peter O Olagbaju
- Department of Physics, Federal University of Agriculture, Abeokuta, Nigeria
- Department of Physics, North West University, Mahikeng Campus, South Africa
| | - Victor Makinde
- Department of Physics, Federal University of Agriculture, Abeokuta, Nigeria
| | - Wael M Badawy
- Radiation Protection and Civil Defense Department, Nuclear Research Center, Egyptian Atomic Energy Authority, Cairo, Egypt
- Frank Laboratory of Neutron Physics, Joint Institute for Nuclear Research, Dubna, Russian Federation
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49
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Ayinde OE, Oyedeji OA, Miranda MJ, Olarewaju AO, Ayinde K. How resilient are farmers in Africa to climate shocks? A case study of Nigerian farmers. J Environ Manage 2024; 355:120471. [PMID: 38457891 DOI: 10.1016/j.jenvman.2024.120471] [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] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/27/2023] [Accepted: 02/20/2024] [Indexed: 03/10/2024]
Abstract
Agriculture in sub-Saharan Africa remains highly vulnerable to climate related shocks, since most production relies on rainfall. It is important to accurately measure the resilience of farmers and farming communities to weather variabilities, for both government policy and farmer management responses. This paper develops a Resilience Index Framework, which is further used to assess the resilience of farmers to climate shocks in Nigeria. We conceptualized our Resilience Index (RI) in this study to be a composite function of 60 indicators encompassing four resilience domains namely, Economic & Financial Resilience (ER); Technical-know-how Resilience (TR); Social Resilience (SR); and Physical Resilience (PR). A three-stage standardization approach to construct the resilience index is taken in this study. In the first stage, each indicator is standardized. In the second stage, the resilience domain is computed by averaging the corresponding standardized indicators. In the final stage, the composite RI is computed by estimating the weighted average of all the resilience domains. The study uses the baseline survey data collected between 2021 and 2022 from a total of 5954 farmers in the rainforest, derived and guinea savannah agroecological zones of Nigeria. The result of the study shows that the majority (96.5%) of the farmers are less resilient to climate shocks, with only 0.9% economically & financially resilient, 1.4% socially resilient, 31.4% technically resilient, and 18.5% physically resilient. Finally, some recommend steps to be taken by the government and relevant stakeholders to improve the resilience of farmers through provision of good infrastructural facilities and subsidized improved resistant seed varieties are proposed.
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Affiliation(s)
- O E Ayinde
- Department of Agricultural Economics & Farm Management, University of Ilorin, Ilorin, Nigeria
| | - O A Oyedeji
- Department of Agricultural Economics & Farm Management, University of Ilorin, Ilorin, Nigeria.
| | - M J Miranda
- Department of Agricultural, Environmental, and Development Economics, The Ohio State University, Columbus, USA
| | - A O Olarewaju
- Department of Agricultural Economics & Farm Management, University of Ilorin, Ilorin, Nigeria
| | - K Ayinde
- Department of Mathematics and Statistics, Northwest Missouri State University, Maryville, USA
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50
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Popoola T, Skinner J, Woods M. 'Every Woman Wants to Know What Came out of Her Body': Grief Experiences of Women After Stillbirth in Nigeria. Omega (Westport) 2024; 88:1275-1289. [PMID: 34996329 DOI: 10.1177/00302228211051823] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Stillbirth commonly affects women in Nigeria, but their experiences of grief following stillbirth is under explored. This study aimed to describe Nigerian women's experiences of grief after stillbirth. Face-to-face, semi-structured interviews were conducted with 20 women in Nigeria who experienced stillbirth. The results from the thematic analysis suggest that mothers had an unmet need to see their stillborn baby, and they experienced communication challenges such as being blindsided/misled about the baby during their interactions with health personnel. The participants experienced emotional and psychological reactions to grief that manifested in the form of emotional pain, sadness, blame and shock, but having a sense of gratitude helped them cope. The findings of this study highlight gaps in bereavement care and suggest the need for basic bereavement training for health personnel.
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Affiliation(s)
- Tosin Popoola
- School of Nursing, Midwifery and Health Practice, Victoria University of Wellington, Wellington Regional Hospital, Wellington, New Zealand
| | - Joan Skinner
- School of Nursing, Midwifery and Health Practice, Victoria University of Wellington, Wellington Regional Hospital, Wellington, New Zealand
| | - Martin Woods
- School of Nursing, Midwifery and Health Practice, Victoria University of Wellington, Wellington Regional Hospital, Wellington, New Zealand
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