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BACKGROUND: Malnutrition is an increasing health problem amongst children, especially in developing countries. This study assessed and compared the feeding pattern, prevalence and determinants of malnutrition amongst primary school children residing in the rural and the urban communities of Ekiti State, Southwest Nigeria. METHODS: The study employed a cross-sectional comparative study design and was carried out amongst 983 children attending primary schools in Ekiti State, 495 of them from urban and 488 from rural communities using an interviewer-administered semi-structured questionnaire and the World Health Organization AnthroPlus version 1.0.4 to collect data on the nutritional status and anthropometric indices of the schoolchildren. A multistage sampling technique was used and data collected were analysed using SPSS 23 with the level of statistical significance set at P < 0.05. RESULTS: A statistically higher proportion of primary school children in the rural communities (24.8%) had a low dietary diversity score than those in the urban communities (8.5%) (P < 0.001). Less than half of the pupils (47.1% in the urban and 48.6% in the rural communities) were malnourished. Lower birth order, respondents from household with poor toilet facility, lower class in school, low education of caregiver, occupation of household head and father as caregiver were factors associated with malnutrition in both urban and rural communities. CONCLUSION: The prevalence of malnutrition was high in both urban and rural primary school children though higher in rural settings. Furthermore, dietary diversity score and feeding pattern were worse in rural than urban communities.
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Desnutrición , Población Rural , Niño , Humanos , Prevalencia , Estudios Transversales , Nigeria/epidemiología , Desnutrición/epidemiología , Conducta Alimentaria , Instituciones AcadémicasRESUMEN
Unplanned and unintended pregnancies have become major medical, social and public health issues worldwide. The objective of this study was to determine sexual exposure, awareness and knowledge of long active reversible contraceptives (LARC) among female undergraduate students in public and private universities in Ekiti State, Southwest Nigeria. A comparative cross-sectional study was carried out among 428 female university undergraduates in Ekiti State (208 students in public and 210 students in private) using a multi-stage sampling technique. Data were obtained using a semi-structured questionnaire and analyzed using IBM SPSS version 23. P-value <0.05 was taken as significant. The mean age of respondents was 21.1±2.5years in public and 19.3±2.1years in private university. 53% of public university students and 30% of private university students have had sexual intercourse. While 41.3% of public university students were aware of LARC, 37.1% of the private university students were aware. The knowledge of LARC among the public university students was lower (23.6%) as compared to those in private university (33.3%). We conclude that while sexual exposure is higher among public university students than in private, the awareness of LARC was higher in public than private universities. Continuous campaign programmes to university students on the benefit of LARC is recommended.
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Anticonceptivos , Estudiantes , Embarazo , Femenino , Humanos , Adolescente , Adulto Joven , Adulto , Estudios Transversales , Nigeria , UniversidadesRESUMEN
Background: Coronavirus disease 2019 (COVID-19) remained a worldwide public health problem. Risk assessment and mapping can be deployed to assist in the control and management of disease outbreaks. Aim: The aim of this study was to conduct COVID-19 risk assessment and mapping in selected communities of Southwest Nigeria. Methods: This was a cross-sectional study of adults, 18 years and above, involving the use of multi-stage sampling. Data collection was done with a pre-tested, structured, interviewer-administered questionnaire. The Statistical Package for the Social Sciences version 23 and Environmental Systems Research Institute ArcGIS desktop version 10.5 were used for data analysis and spatial mapping, respectively. The threshold for statistical significance was set at P < 0.05. Results: The respondents' mean age was 40.6 ± 14.5 years. Self-reported vulnerability factors identified included hypertension, diabetes mellitus, working in hospital facility, cigarette smoking and age ≥60 years amongst others. About a quarter (20.2%) had a high risk of COVID-19 following risk quantification. The risk cuts across geographical locations and socio-economic status. Education was significantly associated with COVID-19 risk. The spatial interpolation map revealed that the farther a community was from the high-burden area, the lower the risk of COVID-19. Conclusion: There was a high prevalence of self-reported COVID-19 risk. Identified communities with COVID-19 high-risk burden in the risk mapping and those with stratified proximity to these areas need to be targeted by the government for a public health awareness campaign.
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COVID-19 , Humanos , Adulto , Persona de Mediana Edad , Nigeria/epidemiología , Estudios Transversales , COVID-19/epidemiología , Factores de Riesgo , Medición de Riesgo , Encuestas y CuestionariosRESUMEN
BACKGROUND AND PURPOSE: To identify the qualitative and quantitative contributions of conventional risk factors for occurrence of ischemic stroke and its key pathophysiologic subtypes among West Africans. METHODS: The SIREN (Stroke Investigative Research and Educational Network) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria. Cases include adults aged ≥18 years with ischemic stroke who were etiologically subtyped using the A-S-C-O-D classification into atherosclerosis, small-vessel occlusion, cardiac pathology, other causes, and dissection. Controls were age- and gender-matched stroke-free adults. Detailed evaluations for vascular, lifestyle, and psychosocial factors were performed. We used conditional logistic regression to estimate adjusted odds ratios with 95% CI. RESULTS: There were 2431 ischemic stroke case and stroke-free control pairs with respective mean ages of 62.2±14.0 versus 60.9±13.7 years. There were 1024 (42.1%) small vessel occlusions, 427 (17.6%) large-artery atherosclerosis, 258 (10.6%) cardio-embolic, 3 (0.1%) carotid dissections, and 719 (29.6%) undetermined/other causes. The adjusted odds ratio (95% CI) for the 8 dominant risk factors for ischemic stroke were hypertension, 10.34 (6.91-15.45); dyslipidemia, 5.16 (3.78-7.03); diabetes, 3.44 (2.60-4.56); low green vegetable consumption, 1.89 (1.45-2.46); red meat consumption, 1.89 (1.45-2.46); cardiac disease, 1.88 (1.22-2.90); monthly income $100 or more, 1.72 (1.24-2.39); and psychosocial stress, 1.62 (1.18-2.21). Hypertension, dyslipidemia, diabetes were confluent factors shared by small-vessel, large-vessel and cardio-embolic subtypes. Stroke cases and stroke-free controls had a mean of 5.3±1.5 versus 3.2±1.0 adverse cardio-metabolic risk factors respectively (P<0.0001). CONCLUSIONS: Traditional vascular risk factors demonstrate important differential effect sizes with pathophysiologic, clinical and preventative implications on the occurrence of ischemic stroke among indigenous West Africans.
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Accidente Cerebrovascular Isquémico/etnología , Accidente Cerebrovascular Isquémico/fisiopatología , África Occidental/etnología , Anciano , Estudios de Casos y Controles , Diabetes Mellitus/etnología , Diabetes Mellitus/fisiopatología , Diabetes Mellitus/prevención & control , Dislipidemias/etnología , Dislipidemias/fisiopatología , Dislipidemias/prevención & control , Femenino , Ghana/etnología , Humanos , Hipertensión/etnología , Hipertensión/fisiopatología , Hipertensión/prevención & control , Accidente Cerebrovascular Isquémico/prevención & control , Masculino , Persona de Mediana Edad , Nigeria/etnología , Obesidad/etnología , Obesidad/fisiopatología , Obesidad/prevención & control , Factores de RiesgoRESUMEN
Objectives: To assess and compare the level of Birth Preparedness and Complications Readiness (BPCR) and determine the predicting effect of socio-demographic factors on it among couples in rural and urban communities of Ekiti State. Design: A community-based comparative cross-sectional study. Setting: The study was conducted in twelve rural and twelve urban communities in Ekiti State. Participants: Couples from rural and urban communities. Female partners were women of reproductive age group (15-49 years) who gave birth within twelve months before the survey. Main outcome measures: Proportion of couples that were well prepared for birth and obstetric emergencies, and its socio-demographic determinants. Results: The proportion of couples that were well prepared for birth and its complications was significantly higher in urban (60.5%) than rural (48.4%) communities. The study also revealed that living above poverty line (95% CI=1.01-3.79), parity and spousal age difference less than five years (95% CI=1.09 - 2.40) were positive predictors of BPCR among respondents. Conclusions: Urban residents were better prepared than their rural counterparts. Living above poverty line, parity, and spousal age difference less than five years were positive predictors of BPCR. There is a need to emphasize on educating couples on the importance of identifying blood donors as a vital component of BPCR. Funding: None declared.
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Población Rural , Población Urbana , Humanos , Adulto , Femenino , Nigeria , Estudios Transversales , Persona de Mediana Edad , Embarazo , Adulto Joven , Adolescente , Masculino , Conocimientos, Actitudes y Práctica en Salud , Complicaciones del Trabajo de Parto , Paridad , Parto/psicología , Parto Obstétrico , Encuestas y CuestionariosRESUMEN
BACKGROUND: Much previous research on exclusive breastfeeding has focused on urban and semi-urban communities, while there is still a paucity of data from rural areas. We assessed the attitude and practice of exclusive breastfeeding and its predictors among mothers attending the under-five welfare clinics in a rural community. METHODS: A cross-sectional study was conducted among consecutively recruited 217 mothers attending the three health facilities under-five welfare clinics in Ido-Ekiti, Southwest, Nigeria. Information was collected with a semi-structured interviewer-administered questionnaire adapted from previously published research works. Descriptive and inferential statistics were carried out using IBM SPSS Statistics for Windows, Version 26.0. RESULTS: More than half of the mothers, 117(53.9%) were ≥30 years old, and 191(88.0%) were married. Almost all, 216 (99.5%) attended an ante-natal clinic; however, 174(80.2%) delivered in the health facility. The respondent's mean ± SD exclusive breastfeeding attitudinal score was 29.94 ± 2.14 (maximum obtainable score was 36), and the proportion of mothers that practiced exclusive breastfeeding was 40.6%. Married mothers were more likely to practice exclusive breastfeeding than their unmarried counterparts (AOR:6.324, 95%CI:1.809-22.114). The common reasons for not practicing exclusive breastfeeding were work schedule 57(26.3%), cultural beliefs and the need to introduce herbal medicine 32(14.7%), and insufficient breast milk 30(13.8%). CONCLUSION: This study revealed a good disposition with a suboptimal practice towards exclusive breastfeeding. Also, being married was a positive predictor of exclusive breastfeeding. Therefore, we recommend policies that will improve exclusive breastfeeding among mothers in rural areas, especially those targeting the unmarried, to achieve the World Health Organization's target.
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Lactancia Materna , Población Rural , Femenino , Humanos , Adulto , Nigeria , Estudios Transversales , Conocimientos, Actitudes y Práctica en Salud , MadresRESUMEN
[This corrects the article DOI: 10.1371/journal.pone.0303492.].
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BACKGROUND: Nutritional imbalance is an underlying cause of 2.6million death annually and a third of child's death globally. This study assessed and compared the nutritional status of primary school children and their caregiver's knowledge on malnutrition in rural and urban communities of Ekiti State. METHODS: This is a cross-sectional comparative study carried out among 983 urban and rural primary school children in Ekiti State (495 in urban and 488 in rural) using interviewer-administered semi-structured questionnaire. A multi-stage sampling technique was used and data collected was analyzed using SPSS 23 with level of statistical significance set at p < 0.05. RESULTS: Underweight and stunting were relatively higher in rural (6.5% and 22.7% respectively) than in urban (6.3% and 19.4% respectively) and these differences are not statistically significant (p = 0.898, p = 0.197). However, wasting, overweight and obesity were higher in urban (12.7%, 6.1% and 7.7% respectively) than rural (11.5%, 3.7% and 7.5% respectively) but the difference is not statistically significant. (p = 0.242). Majority of the caregivers in both settings had good knowledge of malnutrition though higher in urban mothers (89.5%) with statistical significance than their rural counterparts (71.5%). However, there is no significant association between caregiver's knowledge and malnutrition in this study. Being in lower primary school class, relationship with caregiver, educational status of caregiver and occupation of caregiver were the common predictors of malnutrition among the school children in both community settings. CONCLUSION: Generally, the prevalence of malnutrition was high in both urban and rural primary school children in this study. However, while underweight and stunting were more prevalent among the children in the rural communities, wasting, overweight and obesity were more prevalent in the urban. The caregivers in both communities had good knowledge of malnutrition (better in the urban) but this is not good enough to bring a significant relationship with the occurrence of malnutrition in the children. Common predictors of malnutrition in both community settings are being in lower primary school class, relationship with caregiver, educational status of caregiver and occupation of caregiver. It is therefore recommended that regular continuous public enlightenment, nutritional education programmes and other programmes targeted at improving the economic power of the caregivers are measures that will improve the nutritional status of the primary school children.
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Cuidadores , Desnutrición , Estado Nutricional , Población Rural , Población Urbana , Humanos , Femenino , Niño , Masculino , Nigeria/epidemiología , Estudios Transversales , Desnutrición/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Delgadez/epidemiología , Prevalencia , Instituciones Académicas , AdultoRESUMEN
INTRODUCTION: There is increasing evidence in favor of enhancing adherence to antiretroviral therapy (ART) in people living with HIV (PLHIV) through mobile health (mHealth) assessment and intervention. The study aims to establish the willingness to adopt mobile phone technology to enhance adherence to ART among PLHIV. METHODS: The Researchers adopted a cross-sectional survey. Systematic sampling was employed in selecting 237 PLHIV in the HIV clinic for adults at Ido-Ekiti's Federal Teaching Hospital, Nigeria. Data collection was via a 33-item semi-structured questionnaire administered by the interviewer. Information collected via the questionnaire included details on ownership of mobile phone technology, its usage, and willingness to use it to improve adherence to HIV medication. Descriptive statistics coupled with multivariate regression was employed in analyzing data, with the level of significance at 5%. RESULTS: The respondent's had a mean ±SD age of 46.6 ±10 years. Most of the participants were female (77.6%), and have been on ART for over 2years (88.2%). The vast majority of study participants 233 (98.3%) owned a mobile phone. 168 (70.9%) of them were willing to embrace mHealth interventions on medication adherence. Some of the factors influencing the respondent's willingness to receive the intervention were older age (OR = 0.05, 95%Cl:[0.01-0.24]), having formal education (OR = 7.12, 95%Cl:[3.01-16.53]), being diagnosed over 10years ago (OR = 15.63, 95%Cl:[3.02-80.83]) and previous use of phone to send text messages, record video, access the internet, send email and search the internet for health-related information (OR = 2.2, 95%Cl:[1.2-3.9]; OR = 1.8, 95%Cl:[1.0-3.2]; OR = 2.5, 95%Cl:[1.4-4.7]; OR = 2.7, 95%Cl:[1.2-5.5] and OR = 2.0, 95%Cl:[1.0-3.8]) respectively. CONCLUSION: Many of the PLHIV had a cellphone and expressed willingness on their part to use it in receiving reminders to take their medication. Older age, formal education and internet users were significantly more willing to get reminders to take their medication.
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Infecciones por VIH , Cumplimiento de la Medicación , Telemedicina , Centros de Atención Terciaria , Humanos , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/psicología , Masculino , Cumplimiento de la Medicación/psicología , Cumplimiento de la Medicación/estadística & datos numéricos , Persona de Mediana Edad , Adulto , Estudios Transversales , Nigeria , Fármacos Anti-VIH/uso terapéutico , Teléfono Celular , Encuestas y CuestionariosRESUMEN
Introduction: the cost of illness (COI) of non-communicable diseases (NCDs) has detrimental effects on healthcare outcomes in addition to the serious economic impact on patients and their families. This study estimated and compared the COI of NCDs and its predictors in private and public health facilities (HF) in Ado-Ekiti, Nigeria. Methods: the study was carried out in selected HF (39 private; 11 public) using a comparative cross-sectional design with a mixed method of data collection. Quantitative data were collected from 348 hypertensive and/or diabetic patients (173 private; 175 public) using a semi-structured, interviewer-administered questionnaire while qualitative data were from 5 key informant interviews (KII) conducted with HF heads or their representatives. Results: the average monthly COI of NCDs was higher among patients in private (â¦15,750.38±14,286.47 [US$43.75±39.68]) than in public HF (â¦13,283.37±16,432.68 [US$ 36.90±45.65]) (P<0.001), however, the indirect cost was higher in public HF (private, â¦1,561.07 [US$4.34]; public, â¦3,739.26 [US$10.39]) (p<0.001). Predictors of COI of NCDs identified were income and admission in both groups. Additionally, age, payment method, type of NCDs, having two or more complications, and exercise were identified in private while socioeconomic status, length of diagnosis, and alcohol were identified in public HF. The KII revealed a long waiting time for the public HF patients which accounted for the huge indirect cost. Conclusion: the study found a huge indirect cost in the public HF that could be minimized by developing policies that would reduce the waiting time of patients. Government and private interventions targeting identified predictors should be applied to reduce the financial burden of NCD.
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Enfermedades no Transmisibles , Humanos , Nigeria , Estudios Transversales , Costo de Enfermedad , Instituciones de SaludRESUMEN
BACKGROUND: There is increasing evidence suggesting that adolescents are contributing to the populations at risk of malaria. This study determined the prevalence of malaria infection among the adolescents and examined the associated determinants considering socio-demographic, Long Lasting Insecticide Nets (LLINs) usage, and hematological factors in rural Southwestern Nigeria. METHODS: A hospital-based cross-sectional study was conducted between July 2021 and September 2022 among 180 adolescents who were recruited at a tertiary health facility in rural Southwestern Nigeria. Interviewer administered questionnaire sought information on their socio-demographics and usage of LLINs. Venous blood samples were collected and processed for malaria parasite detection, ABO blood grouping, hemoglobin genotype, and packed cell volume. Data were analyzed using SPSS version 20. A p-value <0.05 was considered statistically significant. RESULTS: The prevalence of malaria infection was 71.1% (95% CI: 68.2%-73.8%). Lack of formal education (AOR = 2.094; 95% CI: 1.288-3.403), being a rural residence (AOR = 4.821; 95% CI: 2.805-8.287), not using LLINs (AOR = 1.950; 95% CI: 1.525-2.505), genotype AA (AOR = 3.420; 95% CI: 1.003-11.657), genotype AS (AOR = 3.574; 95%CI: 1.040-12.277), rhesus positive (AOR = 1.815; 95% CI:1.121-2.939), and severe anemia (AOR = 1.533; 95% CI: 1.273-1.846) were significantly associated with malaria infection. CONCLUSION: The study revealed the prevalence of malaria infection among the adolescents in rural Southwestern Nigeria. There may be need to pay greater attention to adolescent populations for malaria intervention and control programs.
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Mosquiteros Tratados con Insecticida , Insecticidas , Malaria , Humanos , Nigeria/epidemiología , Población Rural , Estudios Transversales , Malaria/epidemiología , Malaria/prevención & control , PrevalenciaRESUMEN
BACKGROUND: Early Career Doctors (ECDs) in Nigeria are faced with many individual and systemic problems, which consequently adversely affect their health, well-being, patient care and safety. OBJECTIVE: This study, the second phase of the Challenges of Residency Training and Early Career Doctors in Nigeria (CHARTING II) Study, sought to examine the risk factors and contributors to the health, well-being and burnout amongst Nigerian ECDs. METHODS: This was a study of health, well-being and burnout amongst Nigerian ECDs. Outcome variables included burnout, depression, and anxiety, which were respectively assessed using the Copenhagen Burnout Inventory (CBI) and Oldenburg Burnout Inventory (OLBI), Patient Health Questionnaire (PHQ-9) depression scale, and Generalized Anxiety Disorder (GAD-7) scale. The quantitative data obtained was analysed using the IBM SPSS, version 24. Associations between categorical outcome and independent variables were assessed using chi square, with level of significance set at < 0.05. RESULTS: The mean body mass index (BMI), durations of smoking and alcohol consumption of the ECDs were 25.64 ± 4.43 kg/m2 (overweight range), 5.33 ± 5.65 years and 8.44 ± 6.43 years respectively. Less than a third (157, 26.9%) of the ECDs exercised regularly. The most common disease conditions affecting the ECDs were musculoskeletal (65/470, 13.8%) and cardiovascular diseases (39/548, 7.1%). Almost a third (192, 30.6%) of the ECDs reported experiencing anxiety. Male and lower cadre ECDs were more likely than female and higher cadre ECDs to report anxiety, burnout and depression. CONCLUSION: There is an urgent need to prioritize the health and well-being of Nigerian ECDs, so as to optimize patient care and improve Nigeria's healthcare indices.
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Ansiedad , Agotamiento Psicológico , Femenino , Masculino , Humanos , Nigeria , Trastornos de Ansiedad , Consumo de Bebidas AlcohólicasRESUMEN
Background: The COVID-19 pandemic and its vaccine have been met with varying perceptions that may have both negative and positive effects on the willingness to uptake the COVID-19 vaccine. The study is set to determine the perception and willingness of the household heads to the uptake of COVID-19 vaccine in a rural community in Southwestern, Nigeria. Materials and Methods: A cross-sectional study was carried out among 409 household heads selected through a multistage sampling technique. The instrument of data collection was a semi-structured interviewer-administered questionnaire using the Health Belief model constructs. Data were analyzed with IBM SPSS version 21.0 and Pearson's Chi-square test was used to determine the association between perception and willingness to uptake vaccine. P<0.05 was taken as significant at 95% confidence interval. Results: The majority of the unvaccinated respondents in the study were not willing to take the COVID-19 vaccine (60.1%). There was a poor perception of the susceptibility/severity of unvaccinated respondents to COVID-19 infection and a poor perception of the benefit/barrier to the uptake of the COVID-19 vaccine. Perception of susceptibility and severity of COVID-19 infection were statistically related to the willingness to uptake the COVID-19 vaccine. Conclusion: There should be an increase in awareness campaigns to change the perception of people positively to COVID-19 infection and uptake of the COVID-19 vaccine.
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BACKGROUND: Every minute, six indigenous Africans develop new strokes. Patient-level and system-level contributors to early stroke fatality in this region are yet to be delineated. We aimed to identify and quantify the contributions of patient-level and system-level determinants of inpatient stroke fatality across 16 hospitals in Ghana and Nigeria. METHODS: The Stroke Investigative Research and Educational Network (SIREN) is a multicentre study involving 16 sites in Ghana and Nigeria. Cases include adults (aged ≥18 years) with clinical and radiological evidence of an acute stroke. Data on stroke services and resources available at each study site were collected and analysed as system-level factors. A host of demographic and clinical variables of cases were analysed as patient-level factors. A mixed effect log-binomial model including both patient-level and system-level covariates was fitted. Results are presented as adjusted risk ratios (aRRs) with respective 95% CIs. FINDINGS: Overall, 814 (21·8%) of the 3739 patients admitted with stroke died as inpatients: 476 (18·1%) of 2635 with ischaemic stroke and 338 (30·6%) of 1104 with intracerebral haemorrhage. The variability in the odds of stroke fatality that could be attributed to the system-level factors across study sites assessed using model intracluster correlation coefficient was substantial at 7·3% (above a 5% threshold). Stroke units were available at only five of 16 centres. The aRRs of six patient-level factors associated with stroke fatality were: low vegetable consumption, 1·19 (95% CI 1·07-1·33); systolic blood pressure, 1·02 (1·01-1·04) for each 10 mm Hg rise; stroke lesion volume more than 30 cm3, 1·48 (1·22-1·79); National Institutes of Health Stroke Scale (NIHSS) score, 1·20 (1·13-1·26) for each 5-unit rise; elevated intracranial pressure, 1·75 (1·31-2·33); and aspiration pneumonia, 1·79 (1·16-2·77). INTERPRETATION: Studies are needed to assess the efficacy of interventions targeting patient-level factors such as aspiration pneumonia in reducing acute stroke fatality in this region. Policy directives to improve stroke unit access are warranted. FUNDING: US National Institutes of Health. TRANSLATIONS: For the Twi, Yoruba and Hausa translations of the abstract see Supplementary Materials section.
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Isquemia Encefálica , Neumonía por Aspiración , Accidente Cerebrovascular , Adulto , Humanos , Adolescente , Estudios Prospectivos , Nigeria/epidemiología , Ghana/epidemiología , Hospitales , Neumonía por Aspiración/complicacionesRESUMEN
Introduction Of the 182 million annual pregnancies in developing countries, 76 million are unintended and 66% of these are among non-users of contraception. Unintended pregnancy is a risk factor for abortion, disruption of education, future unemployment, and poor socio-economic status. This study aimed to determine the age of sexual debut, sexual education, abortion, awareness, and prevalence of contraceptives among female undergraduate students in public and private universities in Ekiti State. Methods A comparative cross-sectional study was carried out among 418 [public (208) and private (210)] female university undergraduate students in Ekiti State using a multi-stage sampling technique. Data was gathered using a semi-structured questionnaire and analyzed using SPSS (IBM Corp. Released 2015. IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp). Chi-square was used to assess the association between dependent and independent variables at the bivariate level of analysis. P-value<0.05 was taken as significant. Results The mean age of respondents was 21.1±2.5 years in the public univeristy and 19.3±2.1 years in the private university. About 53.8% of students in the public university have been engaged in sexual intercourse as against 30% of students in the private university. The mean age at first sexual debut was lower in the public university (14.2±4.1 years) than in the private university (16.9±3.3 years) while more public university students (87.5%) had access to sexual education than their counterparts at the private university (79.0%). Of those who had ever been pregnant in public university (18.8%), about four-fifth (81.1%) of them had an abortion while all those who ever got pregnant (15.9%) in private university had an abortion. All the respondents in both universities were aware of contraception with the majority getting to know through social media. The prevalence of contraceptive use was lower among public university students (39.3%) than those in the private university (60.3%). Conclusion Mean age at sexual debut and rate of abortion were lower in public university students than in private. While access to sexual education was higher in the public university than in the private university, the prevalence of contraceptive use was lower in the public university. Therefore it is recommended that the government and other relevant stakeholders need to institute continuous awareness campaign programs to increase contraception uptake and reduce the prevalence and effect of unwanted pregnancy as a result of unprotected sexual activities.
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Background: Hypertension is a serious health problem and it is one of the diseases that impair health-related quality of life. The central tenet of care should be to improve health-related quality of life and overall well-being and not just be limited to improving clinical outcomes. This study assesses and compares health-related quality of life and its predictors among hypertensive patients in two government hospitals in Ekiti State, Nigeria. Methods: This was a comparative cross-sectional study involving 440 hypertensive patients (220 in each group), recruited using a systematic sampling technique within the hospitals. Data on socio-demographic, economic and clinical characteristics including the cost of care for hypertension were collected from the patients. The WHOQoL-BREF questionnaire was used to assess health-related quality of life. Data were entered and analyzed using IBM SPSS Statistics for Windows, Version 22.0. Results: All domains of health-related quality of life were better among patients in federal government teaching hospitals, however, only the physical (T = -7.932, p < 0.001) and overall (T = -2.783, p = 0.006) domains were of statistical significance. An inverse relationship between cost and health-related quality of life was found in the two hospitals (State: r = -0.224, p = 0.001; Federal: r = -0.378, p < 0.001). Identified predictors of health-related quality of life were age, locality of residence, income, number of complications, exercise and smoking in both hospitals. Other predictors were marital status, living arrangement, occupation, number of medications, and involvement in religious and spiritual activities among patients in the state government teaching hospital; household size, length of diagnosis, and indirect cost among patients in the federal government teaching hospital. Conclusion: There is a need to support hypertensive patients in the state government teaching hospitals to reduce the inequality of low health-related quality of life among them. Identified predictors should be taken into consideration when putting in place policies that will improve the health-related quality of life of these patients.
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BACKGROUND: Stroke is a leading cause of disability and mortality worldwide, but little is known about the contribution of secondhand smoke exposure (SHSE) to stroke epidemiology among indigenous Africans. OBJECTIVE: To evaluate the association of SHSE with stroke among indigenous Africans. METHODS: We analyzed the relationship of SHSE with stroke among 2990 case-control pairs of adults who had never smoked (identified in the SIREN study) using conditional logistic regression at a two-sided P < 0.05. RESULTS: Multivariable-adjusted odds ratio and 95% confidence interval; 1.25 (1.04, 1.50; P = 0.02) revealed SHSE was positively associated with stroke independent of stroke subtypes. CONCLUSION: Culturally relevant primary prevention strategies targeted at SHSE might be promising in preventing stroke among Africans.
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Accidente Cerebrovascular , Contaminación por Humo de Tabaco , Adulto , Humanos , Contaminación por Humo de Tabaco/efectos adversos , África Occidental/epidemiología , Población Negra , Accidente Cerebrovascular/epidemiología , Oportunidad RelativaRESUMEN
Background: We evaluated the characteristics of carotid and vertebral atherosclerosis in indigenous West Africans with stroke. Methodology: Of the 3778stroke patients recruited between 01/2014 and 08/2017, 1070 (28.3%) received carotid and vertebral artery evaluation with B-mode Ultrasound. Carotid and vertebral intima-media thickness (IMT) using multiple site technique were measured bilaterally and plaque frequency was determined. Descriptive and comparative analyses between stroke types and vessels were carried out. Results: There were 809 (75.6%) patients with ischemic stroke. The prevalence of intima-media thickening in the study population was 84.0% (898/1070) [95% CI: 81.7-86.1], being higher in the ischemic stroke (688/809, 85.0%) [95% CI: 82.4-87.3] than in the hemorrhagic stroke group (211/261, 80.8%) [95% CI: 75.6-85.2]. Overall prevalence of plaques which was 26.1% [95% CI: 23.5-28.8], was found also to be higher in ischemic than hemorrhagic stroke (29.8%[95% CI: 26.7-33.0] vs. 14.6% [95% CI: 10.8-19.4], p < 0.05). The mean IMT (carotids: 2.01+1.33 mm; vertebrals: 0.96+0.54mm, p<0.001) and prevalence of plaques (carotids: 8.8%; vertebrals: 1.7%,p<0.001) were higher in carotid than vertebral arteries. Age, hypertension, level of formal education, history of smoking, average monthly income, and family histories of hypertension and stroke were associated with intima-media thickening in the carotids (all p< 0.05) in the ischemic stroke patients while family history of hypertension, diabetes mellitus, and level of formal education were independently associated with intima-media thickening in the carotids (all p< 0.05) in the hemorrhagic stroke patients. No CVRF showed an independent association with the presence of plaque in the carotid and vertebral arteries both stroke types. Conclusions: One off our stroke patients in our cohort had atherosclerotic plaques, with ischemic patients being twice as likely to have this burden compared to hemorrhagic patients, and carotid atherosclerosis being five times as frequent as vertebral atherosclerosis.