Prevalence of anemia and associated factors among adults in a select population in Lagos, Southwest Nigeria.

Background: Anemia is a public health problem affecting people in both the developed and developing world and has serious consequences on health. Objective: This study determines the prevalence of anemia amongst people of different socioeconomic levels, associated factors, and the prevalence of anemia in populations other than children or pregnant women. Methods: This is a descriptive cross-sectional study using a pretested interviewer-administered questionnaire to collect data from 387 residents. A multi-stage random sampling technique was used. Analysis of blood samples using the HemoCue301 system and data analysis using SPSS 20. Chi-square test and binary logistic regression were used to test association and determine predictors of anemia respectively, with P<0.05 considered statistically significant. Results: The mean age of respondents was 35±11.8 years, with 28.9% of respondents being anemic. Female respondents (52.7%) were more than male respondents (47.3%). Female respondents (39.2%) had a higher prevalence of anemia than male respondents (17.5%). There was a significant association between sex, level of education, and anemia status. Being female, having no formal education, or only having a primary school level of education were significant predictors of anemia [odds ratio (OR)=2.55; 95% confidence interval (CI)=1.54, 4.23; P=0.00; OR=12.57; 95%CI=2.39, 66.27; P=0.00; and OR=2.54; 95%CI=1.16, 5.58; P=0.02 respectively]. Conclusion: There was a higher prevalence of anemia among women, younger people, and those with no or only primary levels of formal education. Awareness programs targeted at women and people with lower levels of education are necessary to reduce the overall prevalence of anemia in this region.

Haematological indices and coagulation profile as predictors of disease severity and associations with clinical outcome among COVID-19 patients in Lagos, Nigeria.

Background: This study aims to evaluate the use of haematological indices and coagulation profiles as possible low-cost predictors of disease severity and their associations with clinical outcomes in COVID-19-hospitalized patients in Nigeria. Materials and Methods: We carried out a hospital-based descriptive 3-month observational longitudinal study of 58 COVID-19-positive adult patients admitted at the Lagos University Teaching Hospital, Lagos, Nigeria. We used a structured questionnaire to obtain the participants' relevant sociodemographic and clinical data, including disease severity. Basic haematologic indices, their derivatives, and coagulation profile were obtained from patients' blood samples. Receiver Operating Characteristic (ROC) analysis was used to compare these laboratory-based values with disease severity. A P < 0.05 was considered statistically significant. Results: The mean age of the patients was 54.4 ± 14.8 years. More than half of the participants were males (55.2%, n = 32) and most had at least one comorbidity (79.3%, n = 46). Significantly higher absolute neutrophil count (ANC), neutrophil-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), lower absolute lymphocyte count (ALC) and lymphocyte-monocyte ratio (LMR) were associated with severe disease (P < 0.05). Patients' hemoglobin concentration (P = 0.04), packed cell volume (P < 0.001), and mean cell hemoglobin concentration (P = 0.03) were also significantly associated with outcome. Receiver operating characteristic (ROC) analysis of disease severity was significant for the ANC, ALC, NLR, LMR, and SII. The coagulation profile did not show any significant associations with disease severity and outcomes in this study. Conclusion: Our findings identified haematological indices as possible low-cost predictors of disease severity in COVID-19 in Nigeria.

Résumé Contexte: Cette étude avait pour objectif d'évaluer l'utilité des indices hématologiques et profils de coagulation comme prédicteurs à faible coût de la sévérité de la maladie et leurs associations avec les résultats cliniques chez les patients hospitalisés pour COVID-19 au Nigéria. Méthodes: Nous avons mené une étude longitudinale observationnelle descriptive pendant 3 mois portant sur 58 patients adultes positifs au COVID-19, admis à Lagos University Teaching Hospital, Lagos, Nigéria. Un questionnaire structuré a été établit pour obtenir les données sociodémographiques et cliniques pertinentes des participants, y compris les données sur la sévérité de la maladie. Les indices hématologiques de base, leurs dérivés, et le profil de coagulation ont été obtenus à partir d'échantillons de sang de patients. La courbe caractéristique opérante du récepteur (ROC) a été utilisée pour comparer ces indices biologiques avec la sévérité de la maladie. Une valeur de P < 0.05 a été considéré statistiquement significatif. Résultats: L'âge moyen des patients était 54.4 ± 14.8 ans. Plus de la moitié des participants étaient des hommes (55.2 %, n = 32), et la majorité des participants présentaient au moins une comorbidité (79.3 %, n = 46). Un nombre absolu de neutrophiles (CNA), un rapport neutrophiles-lymphocytes (NLR), et une indice d'inflammation immunitaire systémique (SII) significativement élevé, et un nombre absolu de lymphocytes (ALC) et un rapport lymphocyte-monocytes (LMR) bas étaient associés à un maladie sévère (P < 0.05). La taux d'hémoglobine des patients (P = 0.04), l'hématocrite (P < 0.001), et concentration moyenne d'hémoglobine cellulaire (P = 0.03) étaient également significativement associés avec la sévérité de la maladie. L'analyse ROC de la gravité de la maladie était significative pour le ANC, ALC, NLR, LMR, et SII. Le profil de coagulation n'a montré aucune association significative avec la gravité de la maladie dans cette étude. Conclusion: Nos résultats ont identifié les indices hématologiques comme des prédicteurs potentielle à faible coût de la sévérité du COVID-19 au Nigeria. Mots-clés: Profil de coagulation, COVID-19, indices hématologiques, Nigéria, prédicteur.

Premarital Genotype Screening for Sickle Cell Disease: Knowledge Gaps, Perception and Determinants of Uptake among Final Year Undergraduates of a Tertiary Institution in South-West Nigeria.

Background: Strategies involved in the prevention and management of sickle cell disease include premarital genotype screening and counselling as well as efforts at increasing the knowledge of the population about the condition. Methodology: This is a cross-sectional descriptive study which assessed the knowledge of sickle cell disease and premarital genotype screening, attitudes towards screening and factors associated with uptake of premarital genotype screening among 326 final year students at the University of Ibadan, Oyo State, Nigeria. Results: Respondents were within the age range of 18-24 with a mean age of 23. Majority of the respondents had AA genotype (68.71%). Only 15.95% of the respondents had good knowledge of sickle cell disease. Mean knowledge score was 14 out of 26 with a standard deviation of 4.31. 75.77% of the respondents had good knowledge of premarital genotype screening. 76.07% of the respondents had good attitudes to premarital genotype screening. Mean attitude score was 9.5 out of 12 with a standard deviation of 2.15. Respondents' current level of study (P=0.000) and marital status (P=0.042) were significantly associated with knowledge of sickle cell disease. There was significant association between knowledge of sickle cell disease and knowledge of premarital genotype screening (Fisher's P= 0.000). Knowledge of premarital genotype screening was significantly associated with respondents' current level of study (P=0.004) and attitudes to premarital genotype screening (Fisher's P= 0.000). Conclusion: Significant knowledge gaps were identified in the study population. There is need for continuous assessment of knowledge gaps and educational intervention to decrease the incidence of sickle cell disease.

Correlates of knowledge of genetic diseases and congenital anomalies among pregnant women attending antenatal clinics in Lagos, South-West Nigeria.

INTRODUCTION: genetic diseases and congenital anomalies place a significant burden on the health of new-borns and their mothers. Despite the availability of a variety of prenatal screening tests, mothers' knowledge has been documented to determine uptake. This study aims to assess the knowledge of pregnant women about birth defects and the associated correlates with regard to willingness to do prenatal screening. METHODS: a cross-sectional descriptive study was conducted among 422 antenatal mothers recruited sequentially as they attended antenatal clinics at the Lagos University Teaching Hospital. An interviewer-administered questionnaire was used to determine their knowledge of birth defects and willingness to do prenatal testing. RESULTS: majority of the participants (92.2%) had at least secondary education. The mean total knowledge score of the respondents was 63%. Age and knowledge scores were not significantly correlated (r=-0.071, p=0.14). Being employed predicted higher knowledge scores (95% CI: 0.09, 2.09, p=0.03). Respondents who had primary school education and those who replied "I don't know" to willingness to test had significantly lower knowledge scores (95% CI: -15.01, -1.19, p=0.02 and 95% CI: -4.52, -0.68, p=0.01 respectively). Majority (79.1%) of the respondents were willing to undergo testing. Respondents' level of education was significantly associated with willingness to test (p=0.03). CONCLUSION: the observed knowledge gaps were considerable. There is need for improvement in education, the empowerment of women and access to quality healthcare including prenatal screening.

Knowledge, attitudes, and decision making towards prenatal testing among antenatal clinic attendees in Lagos University Teaching Hospital: an institution-based cross-sectional study.

INTRODUCTION: in Africa, genetic diseases and congenital anomalies remain a significant source of morbidity and mortality. Existing data suggests a gap in the use of prenatal tests among pregnant women to better inform decision making. We examined relationships of socio-demographic factors with willingness to terminate affected pregnancies, and the use of, knowledge of, and attitudes towards prenatal screening/diagnostic tests. METHODS: this was a cross-sectional descriptive study of pregnant women who attended antenatal clinics at the Lagos University Teaching Hospital (N = 422) selected by convenience sampling. Responses were obtained with assisted self-administered structured questionnaires. RESULTS: mean ± S.D. age of the respondents was 32.5 ± 5.3 years. The majority of the participants (92.2%) had at least a secondary education. Ultrasound scans in the second trimester were the most frequently used test (39.1%). Only 77 (18.2%) of the respondents indicated willingness to terminate affected pregnancies. The majority of the respondents had fair knowledge and good attitude scores. Knowledge and attitude scores were significantly correlated (r = 0.25, p < 0.001). Compared to married women, being single was associated with a 2.62-point lower knowledge score (95% CI: -4.63, -0.62, p = 0.01). Compared to women who responded "no" when asked if they were willing to terminate an affected pregnancy, women who responded "maybe" had a 0.81-point lower attitude score (95% CI: -1.45, -0.17, p = 0.01). CONCLUSION: our results suggest important socio-demographic differences in women´s knowledge/ behaviours towards prenatal diagnostic tests. Further research is needed to explore these relationships and broader pregnancy-related ethical beliefs among pregnant women in Lagos.

Health insurance and the financial implications of sickle cell disease among parents of affected children attending a tertiary facility in Lagos, south-west Nigeria.

INTRODUCTION: there is a paucity of data on the financial implications of sickle cell disease on households of affected children and their use of health insurance in Nigeria. This study assessed the awareness of health insurance, patterns of health service utilization and financial implications of sickle cell disease among children seeking care at a tertiary facility in Nigeria. METHODS: a structured questionnaire was administered to parents of 314 children with sickle cell disease attending the pediatric hematology unit of the Lagos University Teaching Hospital between May and December 2019. RESULTS: mean age of the children was 91.5 ± 43.1 months. M: F was 1.17: 1. 45.5% of households earned above NGN 150,000 (USD 417) monthly. 71.3% of the parents had heard of health insurance but only 20.7% were enrolled in a health insurance scheme. Awareness of health insurance was significantly associated with social class (p=0.000) and monthly household income (p=0.000). 60.8% of the parents preferred pre-facility treatment. Social class (p=0.01) and monthly household income (p=0.001) were significantly associated with home treatment. Time on admission ranged from 2-18 days with an average of 4.31 days. Average cost of hospitalization was USD 148 ± USD 14.2 and total cost of care incurred was USD 20,787. Neither age of child (p=0.857), estimated household income (p=0.863) nor social class (p=0.397) was associated with cost of care. CONCLUSION: a high cost of care was observed in our study population underscoring the need for increased awareness and access to health insurance for households of children with sickle cell disease.