Exploring the relationship between dietary patterns and obesity among Nigerian adults: a cross-sectional study.

BACKGROUND/OBJECTIVE: No previous study has investigated the association between dietary pattern and both general and abdominal obesity risk among adults in Nigeria. This study aimed to evaluate the associations between dietary patterns and the risk of obesity among adult age 18 and above in Ekiti State, Southwestern Nigeria. METHODS AND STUDY DESIGNS: A total of 1003 adults were included in this cross-sectional study (males = 558; females = 445). Body mass index (BMI) and waist-to-hip (WHR) were used to assess general and abdominal obesity respectively and they were categorized using WHO recommendation. Partial correlation analyses were performed to assess the associations of dietary patterns with BMI and WHR. Prevalence ratio between dietary pattern and both general and abdominal obesity were calculated using Robust Poisson Regression. RESULTS: The prevalence of general obesity among adults was 15.9%, (11.6% among men and 20.2% among women); abdominal obesity was 32.3% (28.9% among males and 44.5% among females). Four dietary patterns were identified; diversified traditional pattern; typical traditional pattern; milk and bread pattern and egg and fish pattern. Diversified traditional pattern was negatively associated with BMI (PR = 0.571, 95%CI: 0.360 ~ 0.905, p = 0.017), and typical traditional pattern was positively associated with BMI (PR = 1.561, 95% CI: 1.043 ~ 2.339, p = 0.031) and WHR in females (PR = 1.849, 95% CI: 1.256 ~ 2.721, p = 0.005). In comparison to those in the lowest quartile, adults with the highest quartile of the typical traditional pattern had a higher risk for abdominal obesity (PR = 1.849, 95%CI = 1.256 ~ 2.721, p = 0.020). CONCLUSION: This study reports an alarming increase in Obesity prevalence among Nigeria adults which is greatly influence by their lifestyle and eating pattern. We found out that a typical traditional food pattern was associated with a higher risk of both general and abdominal obesity, but a diverse traditional food pattern was associated to a reduced risk of general obesity.

Barriers to accessing mental health services in The Gambia: patients'/family members' perspectives.

This paper concerns mental health services in The Gambia. It describes local concepts, experiences and knowledge about mental illness and the implications of such beliefs and attitudes for access to mental health services. A pretested questionnaire and interview guide were administered to a sample of patients/family members. Barriers to accessing mental health services were identified. These included beliefs about the causes of mental illness; family decision-making; the scarcity and high cost of services. Obtaining access to mental health services in The Gambia is currently challenging. Importantly, increased community and family education about the causes and treatment of mental illnesses will be required to address these issues.

The Impact of the Presidential Alternative Treatment Program on People Living with HIV and the Gambian HIV Response.

In January 2007, former president of The Gambia Yahya Jammeh created the Presidential Alternative Treatment Program (PATP), which introduced a fraudulent "HIV cure." PATP and the fraudulent HIV herbal cure (PATP cure) were widely advertised in state media through patient testimonials and specially produced broadcasts of Jammeh administering treatment, enticing people living with HIV to join the program. Jammeh faced little to no opposition from within The Gambia. Due to the great power and influence he wielded, PATP was nothing short of a health dictatorship. This paper argues that PATP and the PATP cure violated the human rights of people living with HIV in The Gambia and compromised HIV health service delivery. In addition, during PATP's 10-year operation, the global health community was derelict in its duty to stop Jammeh's promotion and use of the PATP cure and to protect people living with HIV.