Asymptomatic bacteriuria in patients with type 2 diabetes mellitus in rural southwestern Nigeria: a cross-sectional study.

OBJECTIVES: We aimed to identify the prevalence, bacterial isolates, antimicrobial susceptibility profile, and factors associated with asymptomatic bacteriuria (ASB) in patients with type 2 diabetes mellitus (T2DM) in rural southwestern Nigeria. METHODS: We performed a hospital-based cross-sectional study of patients with T2DM and ASB. Demographic and clinical data were collected using questionnaires. Urine samples were cultured using standard laboratory procedures, and bacterial colonies were isolated and antimicrobial sensitivity was performed using the disc diffusion technique. Relationships between variables were assessed using adjusted odds ratios (AORs) and 95% confidence intervals (CIs). RESULTS: Of the 280 participants, 73 (26.1%) had ASB (95% CI: 20.9%-31.2%). The most commonly identified isolate was E. coli (45/73; 61.7%), 100.0% of which were sensitive to cefuroxime but resistant to ciprofloxacin. Female sex (AOR, 6.132; 95% CI: 2.327-16.157), living below the poverty line (AOR, 2.066; 95% CI: 1.059-4.029), uncontrolled blood glucose (AOR, 2.097; 95% CI: 1.000-4.404), and a history of indwelling urethral catheterization (AOR, 14.521; 95% CI: 4.914-42.908) were associated with ASB. CONCLUSION: The findings suggest that cefuroxime should be used as an empirical treatment, pending urine culture and sensitivity, and that efforts should be made to prevent ASB in rural southwestern Nigeria.

Malaria infection and its association with socio-demographics, long lasting insecticide nets usage and hematological parameters among adolescent patients in rural Southwestern Nigeria.

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.

Malaria among the elderly in five communities of Osun East district, Southwest Nigeria: Prevalence and association with non-communicable diseases.

Objective: The level of immunity against pathogens decreases with old age. As a result, the elderly may be regarded to be at increased risk of malaria morbidity and fatality. There is paucity of studies on malaria among the elderly population in Osun East district, Southwest Nigeria. This study aimed to determine the prevalence of malaria and its association with medical comorbidities among the elderly. Methods: A descriptive cross-sectional study was carried out, which involved 972 adult residents of five communities in Osun State, who were selected using a multistage random sampling technique. Data was collected with aid of a structured questionnaire. The medical history of respondents and anthropometric measures were obtained. The presence of malaria parasitaemia in the respondents was determined by rapid diagnostic test (RDT). Appropriate descriptive and inferential analyses were done. Results: Out of the 972 respondents, 504 (51.9%) were 60 years and above. The overall prevalence of malaria RDT positivity was 4%. The positivity rate was higher among the elderly (4.6%) compared to those less than 60 years (3.4%), albeit not statistically significant (p = 0.36). Among these elderlies, 52.6% and 16.1% used insecticide-treated nets and insecticide sprays, respectively. There was no association between the prevalence of malaria positivity and comorbid conditions, such as hypertension (p = 0.37), overweight/obesity (p = 0.77), or diabetes (p = 0.15). Malaria positivity rate was also not significantly associated with the use of insecticide-treated nets (p = 0.64) or insecticide sprays (p = 0.45). Conclusion: The malaria positivity rate was higher among the elderly in the study area, although not statistically significant. The prevalence was not associated with comorbid medical conditions.

Prevalence of asymptomatic malaria infection by microscopy and its determinants among residents of Ido-Ekiti, Southwestern Nigeria.

BACKGROUND: Asymptomatic malaria infections have received less attention than symptomatic malaria infections in major studies. Few epidemiological studies on asymptomatic malaria infections have often focused on pregnant women and children under-five years of age as the most vulnerable groups. However, there is limitation on data regarding asymptomatic infections among the old adult populations, particularly in the study area. Therefore, this study determined the prevalence of asymptomatic malaria infection by microscopy and its determinants among residents of Ido- Ekiti, Southwestern Nigeria. METHODS: A hospital-based cross-sectional study was conducted between July and September 2021 among 232 consenting apparently healthy individuals aged 40 years and above who were recruited during a free health screening program using a standardised interviewer-administered questionnaire. The questionnaire sought information on respondents' socio-demographics, presence and types of co-morbidity, and the prevention methods being adopted against malaria infection. Venous blood samples were collected and processed for asymptomatic infections using Giemsa-stained blood smear microscopy. Data were analysed using SPSS version 21. Multivariate logistic regression was used to identify factors associated with asymptomatic infections. RESULTS: Of the total 232 respondents, 19.0% (48/232) were confirmed to be infected with Plasmodium falciparum (95% confidence interval (CI): 14.1% - 24.6%). Lack of formal education (Adjusted odds ratio (AOR): 5.298, 95% (CI): 2.184-13.997), being diabetic (AOR: 4.681, 95% CI: 1.669-16.105), and not sleeping under Long Lasting Insecticide Net (LLINs) (AOR: 4.594, 95% CI: 1.194-14.091), were the determinants of asymptomatic Plasmodium falciparum infection. CONCLUSION: The prevalence of asymptomatic Plasmodium falciparum was 19%. Lack of formal education, being diabetic, and not sleeping under LLINs were the determinants of asymptomatic infections.

Unmet needs for family planning and its determinants among women of reproductive age in Ilesha Southwest Nigeria: A cross-sectional study.

Background: A high rate of unintended pregnancy is said to be driving population growth, particularly in Sub-Saharan Africa, where approximately half of all pregnancies are unintended, coming too soon or even unwanted. Most of these unintended pregnancies could have been prevented with effective family planning services. There, however, remains an unmet gap between the women's reproductive intention and their contraceptive behaviour. Objectives: This study determined the prevalence of unmet needs for family planning and examined its determinants among women of reproductive age group at a tertiary health facility in Southwest Nigeria. Design: This was a hospital-based cross-sectional study. Methods: Two hundred eighty-five sexually active women were recruited using a pre-tested, semi-structured, validated, interviewer-administered questionnaire. The questionnaire assessed the respondent's socio-demographic characteristics, obstetrics and gynaecological history, and contraceptive history. Relevant clinical parameters were measured and recorded. Data were analysed using SPSS version 21. Multivariable logistic regression analysis was done using a 5% significance level to identify the determinants of unmet needs for family planning. Results: The prevalence of unmet family planning needs for prevention, spacing and limiting were 28.8%, 33.1% and 38.1%, respectively, with 58.2% overall prevalence of unmet needs. The commonest reason for the non-uptake of contraceptives among those with unmet need was the fear of side effects (66.3%). The odds of having unmet needs for family planning were higher for respondents with four or fewer children (adjusted odds ratio (AOR): 7.731; 95% confidence interval (CI): 28.504-2.907, p = 0.002) and those with one partner (AOR: 2.008; 95% CI: 3.669-1.090, p = 0.025). Conclusion: A high rate of unmet family planning needs was found in the study. This requires specific interventions and policies towards increasing contraceptive uptake, such as intensified health education aimed at allaying fears related to the side effects.

Malaria infection and its association with socio-demographics, preventive measures, and co-morbid ailments among adult febrile patients in rural Southwestern Nigeria: A cross-sectional study.

Objectives: The study determined the prevalence of malaria infection and its association with socio-demographics, environmental, housing, and co-morbid ailment factors. Methods: The study was a cross-sectional of 330 consented adult febrile patients who were recruited at a tertiary health facility in rural Southwestern Nigeria. The standardized interviewer-administered questionnaire sought information on their socio-demographics, environmental, housing, and co-morbid ailment factors. Venous blood samples were collected and processed for malaria parasite detection, retroviral screening, glycated hemoglobin, and hemoglobinopathy. Data were analyzed using SPSS version 20. The strength of the association between independent and dependent variables was measured using odds ratio and 95% confidence interval with a significant level (p value <0.05). Results: The prevalence of malaria parasitemia was 63.3% (95% confidence interval: 57.9%-68.5%). Being a farmer (p = 0.002), lack of formal education (p = 0.043), low-income earners (p = 0.031), presence of bushes (p = 0.048), stagnant water (p = 0.042), not sleeping under long-lasting insecticide-treated nets (p < 0.001), and sickle cell disease (p = 0.041) were significantly associated with malaria infection. Conclusion: The study revealed that there is a high prevalence of malaria infection in rural Southwestern Nigeria. There may be a need to pay greater attention to adult populations in rural areas for malaria intervention and control programs.

Agreement among rapid diagnostic tests, urine malaria tests, and microscopy in malaria diagnosis of adult patients in southwestern Nigeria.

OBJECTIVE: We determined the malaria prevalence and ascertained the degree of agreement among rapid diagnostic tests (RDTs), urine malaria tests, and microscopy in malaria diagnosis of adults in Nigeria. METHODS: This was a cross-sectional study among 384 consenting patients recruited at a tertiary health facility in southwestern Nigeria. We used standardized interviewer-administered questionnaires to collect patients' sociodemographic information. Venous blood samples were collected and processed for malaria parasite detection using microscopy, RDTs, and urine malaria tests. The degree of agreement was determined using Cohen's kappa statistic. RESULTS: The malaria prevalence was 58.3% (95% confidence interval [CI]: 53.0-63.1), 20.6% (95% CI: 16.6-25.0), and 54.2% (95% CI: 49.0-59.2) for microscopy, RDTs, and urine malaria test, respectively. The percent agreement between microscopy and RDTs was 50.8%; the expected agreement was 45.1% and Cohen's kappa was 0.104. The percent agreement between microscopy and urine malaria tests was 52.1%; the expected agreement was 50.7% and Cohen's kappa was 0.03. CONCLUSION: The malaria prevalence was dependent on the method of diagnosis. This study revealed that RDTs are a promising diagnostic tool for malaria in resource-limited settings. However, urine malaria test kits require further improvement in sensitivity prior to field use in malaria-endemic settings.

The Influence of Socio-Demographic Characteristics on Caregivers' Burden and Quality Of Life of Elderly Diabetics Attending a Nigerian Tertiary Hospital.

Background: Caregivers' burden and health-related quality-of-life (HRQoL) associated with Diabetes Mellitus (DM) are affected by several factors, including socio-demographic characteristics of the patients and their caregivers. Unfortunately, studies evaluating the influence of socio-demographic characteristics on caregivers and patients with DM in this environment are limited. This study therefore aimed at assessing the level of the burden imposed on the primary caregivers, the level of HRQoL of Individuals with Diabetes Mellitus (IDM) and the influence of socio-demographic characteristics on these variables among IDM attending the Family Medicine clinic of Wesley Guild Hospital, Ilesa, Osun State, Nigeria. Methodology: Seventy-eight consenting IDM and their corresponding primary caregivers were recruited over 13-weeks in this hospital-based cross-sectional descriptive study. The Well-Being Questionnaire and Zarit Burden Interview were administered on IDM and their corresponding caregivers to assess HRQoL and burden of care. Data were analysed on SPSS 17 using descriptive statistics and Pearson chi-square test at p<0.05. Results: Mean ages of respondents were 70.4±6.33 and 23.7±7.58 years for diabetics and caregivers, respectively. The majority of the diabetic respondents were females (61.5%), married (66.7%), and retired (64.1%). The majority of the caregivers were females (87.2%), petty traders/students (71.8%) and unmarried (87.2%). Over half (51.3%) of the diabetic respondents and their caregivers had 'good' HRQoL and 'high' caregivers' burden. Conclusion: The caregiver being a female, having primary education, being single and having a nuclear family relation of the IDM influenced good HRQoL, whereas being a low-income earner and an uneducated IDM influenced high caregivers' burden.

Landfill air and odour emissions from an integrated waste management facility.

A mixture of gases and obnoxious odours are major components of landfill emission. A dispersion modelling on air pollutants and odour emissions anticipated from a proposed Integrated Waste Management Facility was conducted considering five operating scenarios. Impacts of the predicted ground level concentrations of air pollutants (including carbon monoxide, CO; oxides of nitrogen, NOX; sulphur dioxide, SO2; particulate matter, PM and hydrocarbons, HC) and odour on ambient air quality were investigated using the 10-min 1 OU/m3 odour limit, CH4 Lower Explosive Limit (LEL) and the daily limits of CO, NOx, SO2, PM and HC. The anticipated maximum ground level concentration of emitted odour and CH4 are 0.0040 OU/m3 and 0.0349 ppm, respectively. Simultaneous operations of all the major components of the facility will generate the daily maximum concentrations of 7.34, 2.60, 7.31, 29.72 and 0.42 µg/m3, for CO, NOX, SO2, PM and HC, respectively. Generally, the facility impacts on ambient air quality will be within the acceptable limit.

In-school adolescents' weight status and blood pressure profile in South-western Nigeria: urban-rural comparison.

BACKGROUND: Obesity is a risk factor for hypertension. The study observed the relationship between adolescent weight status and blood pressure (BP) and the determinants of the BP pattern in urban and rural areas. METHODS: This was a cross-sectional study of 1000 randomly selected respondents (500 from urban and 500 from rural areas) who had anthropometry and BP measurements done. The pattern of BP measurements based on the weight status by location was observed. Statistical inferences were drawn via Chi-square and logistic regression. RESULTS: The mean age for all the respondents was 13.73 years ±2.04 (13.63 ± 2.05 for urban and 13.82 ± 2.03 for rural). Systolic and diastolic BP generally increased with increasing respondents' age, with mean pressures higher in urban areas. About 3% were obese, while 7.7% were overweight. The overall prevalence of high BP was 4.1%, with two-thirds coming from urban areas. On logistic regression analysis, the significant variables associated with high BP include being female (AOR 2.067, 95%CI1.007-4.243, p = 0.048), overweight (AOR 5.574, 95%CI 2.501-12.421, p = 0.0001) and obese (AOR 12.437, 95%CI 4.636-33.364, p = 0.0001). CONCLUSION: High BP was associated with being female, overweight and obesity in both urban and rural areas. Urgent measures are needed to address increasing prevalence of overweight and obesity among adolescents and consequent high blood pressure.