Sustainability of Donor-Funded Health-Related Programs Beyond the Funding Lifecycle in Africa: A Systematic Review.

This study aimed to determine if implemented donor-funded health related-programs in Africa were sustained beyond the funding lifecycle and determine their facilitators and impeders. A systematic review was conducted after the documentation of a study protocol. A database search was done across three databases namely Google Scholar, PubMed, and Medline between January 27 and February 15, 2022. All peer-reviewed articles on sustainability of health interventions in Africa published between 2015 and 2021 that provided one or more context-relevant definitions of sustainability were included. Publications with no use of quantitative or qualitative methods and studies with no information on project evaluation after initial implementation were excluded. Screening of titles and abstracts was done, and the full texts of all relevant articles were retrieved. The risk of bias in systematic reviews (ROBIS) tool was used to assess the risk of bias in the systematic review. Overall, 4,876 articles were retrieved, and only nine articles were eligible for inclusion in the review following the removal of duplicates. Overall, sustainability was described in only three of the five regions in Africa. Donor-funded projects were sustained beyond the funding lifecycle in seven (77.8%) studies. Facilitators of sustainability in Africa included community ownership of the project through the engagement of community stakeholders in the design and implementation of such projects, use of locally available resources, sound infrastructure, and the constitution of interdisciplinary team to facilitate capacity building. Impeders to the sustainability of donor-funded projects included weak health systems exemplified in poor documentation and integration of records, lack of financial leadership, shortage of resources, political interference, poor feedback mechanism, and weak donor-community interactions. From the ROBIS tool, a low risk of bias existed in the studies included in the review. Although the included studies appropriately considered the review's research question, seven studies had a low risk of bias in the domains one to three, and two studies had high risk of bias in domain four. To derive maximum benefits from donor-funded health interventions, sustainability of such projects is key. During program planning phase, context-based facilitators of sustainability should be promoted, while impeders are immediately addressed.

A Bone Scan Is Valuable for Primary Staging of Newly Diagnosed Prostate Cancer in a Low-Resource Setting (Nigeria).

Objective: There is a paucity of information on bone scanning for prostate cancer from low-resource countries. This study evaluated the role of bone scan in the primary staging of newly diagnosed prostate cancer in one such setting. Methods: A retrospective analysis of 126 men with newly diagnosed prostate cancer undergoing an initial staging bone scan between January 2017 and December 2020 was carried out at a regional nuclear medicine center in Nigeria. Bone scan results were analyzed according to age, serum level of baseline prostate-specific antigen (PSA), and Gleason score. Equivocal scans and patients with no Gleason score or baseline PSA were excluded from the analysis. p < 0.05 was said to be significant statistically. Results: Of 111 patients (aged 38-84 years, median 66 years), who met the inclusion criteria, 26 (23%) men had evidence of bony metastases as shown by a positive bone scan. Higher PSA levels and Gleason scores were associated with an increased risk of a positive bone scan, p < 0.001. No patient with a PSA level < 20 ng/mL and a Gleason score of < 7 had a positive bone scan. Conclusion: The role of bone scanning in staging newly diagnosed prostate cancer patients in Nigeria is consistent with global reports. Our study confirms that a bone scan finding is well associated with the risk classification using PSA and Gleason score in our population.

Prevalence and Pattern of Internet Addiction Among Adolescents in Ibadan, Nigeria: A Cross-Sectional Study.

Background and objective Despite the potential benefits the Internet offers, it is prone to excessive and uncontrolled use, thus resulting in a condition called Internet addiction (IA). This study aimed to describe the prevalence of Internet addiction (IA) among in-school adolescents in Ibadan, Southwest Nigeria. Materials and methods A descriptive cross-sectional study was conducted among 632 adolescents using a two-stage sampling technique. IA was assessed using the 20-question Internet addiction test (IAT). Responses to each question ranged from "0" (i.e., "never") to "5" (i.e., "always"). Cumulative IAT scores > 50% suggested the presence of IA. Chi-square tests were conducted to determine the association between adolescents' characteristics and IA. Statistically significant variables were pooled into the binary logistic regression model. P-values < 0.05 were statistically significant. Results The mean age of the adolescents was 16.03 ± 1.26 years, and 347 (54.9%) were males. A total of 284 (44.9%) adolescents had IA: 174 (42%) accessed the Internet in both home and school settings (ᵡ2 = 4.103, p = 0.043), and 174 (42%) accessed the Internet at home only (ᵡ2 = 5.003, p = 0.025). Adolescents who accessed the Internet from both home and school settings had higher odds of developing IA (adjusted odds ratio (AOR) = 1.408, 95% confidence interval (CI) = 0.986-2.012, p = 0.060), as well as those who accessed the Internet from home settings only (AOR = 1.404, 95%CI = 1.010-1.953, p = 0.043). Adolescents who gained four to six hours of Internet connection weekly had two times odds of developing IA (AOR = 1.404, 95%CI = 1.010-1.953, p = 0.043), and those who gained more than six hours of Internet connection had more than three times odds of developing IA (AOR = 3.424, 95%CI = 1.937-6.053, p = 0.043). Conclusion To prevent IA, adolescents should develop self-control skills and self-regulation of Internet use. Likewise, Internet access should be restricted from both home and school settings, and adolescents' Internet access should be monitored and regulated from both home and school settings.

Factors Driving the Acquisition of University Postgraduate Degrees among Resident Doctors in Nigeria.

The study examined the characteristics and factors driving the acquisition of postgraduate academic degrees among resident doctors in Nigeria. About 10% of the respondents had a form of university postgraduate degree with majority being master's degree. Having more than seven years of professional practice was the only factor predicting the acquisition of postgraduate academic degrees amongst the respondents [AOR: 0.243 (95% CI: 0.069,0.856; p = 0.028)]. The acquisition of postgraduate degree is not common among the surveyed resident doctors; and those that will acquire it do so in the later part of their career.

Perceptions and Experiences About Device-Emitted Radiofrequency Radiation and Its Effects on Selected Brain Health Parameters in Southwest Nigeria.

Introduction Radiofrequency radiation (RFR) is a form of non-ionising radiation that is used or emitted by a number of technologies and innovative devices including mobile phones and computers and gadgets. Exposure to RFR has been reported to have certain negative effects on human health. It is clear that quality and reliable data will be required with respect to the specific nature of RFR effects on mental health. This research considered the perceptions and exposure-related experiences of people within a Nigerian population with respect to RFR. Methods Structured and validated questionnaires were used to profile self-reported patterns of behaviour and sleep in humans. Questionnaire administration-electronic was opened for exactly one week, consisting of 25 specific questions and five open-ended questions [total = 30 questions]. A total population approach was adopted [N=~240]. Bivariate analysis using Chi-square tests were conducted to determine the association between knowledge of electronic gadgets as a source of radiofrequency radiation and sociodemographic characteristics of respondents. Binary logistic regression was used to determine the factors associated with good knowledge of electronic gadgets as a source of radiofrequency radiation. The level of statistical significance was set at p ≤ 0.05. Results The response rate was approximately 84%. Fatigue/tiredness [69.6%], attention deficit [69.1%] and headache [62.4%] ranked top amongst RFR-associated negative effects on mental health. Among the respondents, 29 (56.9%) among those above 20 years had good knowledge of radiofrequency radiation from electronic gadgets compared to 72 (47.2%) aged 20 years and below (X2 = 1.285, p = 0.257). Also, 45 (59.2%) of persons who lived in a town/village had good knowledge of radiofrequency radiation from electronic gadgets compared to 56 (44.4%) who lived in the city (X2 = 4.135, p = 0.042). Persons who lived in a town/village had nearly two times the odds of having good knowledge of RFR from electronic gadgets. Conclusion The study showed that respondents had experienced significant and negative effects of RFR on their mental health. The current level of knowledge and awareness on the nature of RFR and exposures was just about average, indicating a critical and urgent need to educate the public on the subject.

Evaluation of the effect of border closure on COVID-19 incidence rates across nine African countries: an interrupted time series study.

BACKGROUND: Border closure is one of the policy changes implemented to mitigate against coronavirus disease 2019 (COVID-19). We evaluated the effect of border closure on the incidence rate of COVID-19 across nine African countries. METHODS: An interrupted time series analysis was used to assess COVID-19 incidence rates in Egypt, Tunisia, Democratic Republic of the Congo (DRC), Ethiopia, Kenya, Ghana, Nigeria, Senegal and South Africa (SA). Data were collected between 14 February and 19 July 2020 from online data repositories. The linear trend and magnitude of change were evaluated using the itsa function with ordinary least-squares regression in Stata with a 7-d deferred interruption point, which allows a period of diffusion post-border closure. RESULTS: Overall, the countries recorded an increase in the incidence rate of COVID-19 after border closure. However, when compared with matched control groups, SA, Nigeria, Ghana, Egypt and Kenya showed a higher incidence rate trend. In contrast, Ethiopia, DRC and Tunisia showed a lower trend compared with their controls. CONCLUSIONS: The implementation of border closures within African countries had minimal effect on the incidence of COVID-19. The inclusion of other control measures such as enhanced testing capacity and improved surveillance activities will reveal the effectiveness of border closure measures.

The effects of the COVID-19 pandemic on food losses in the agricultural value chains in Africa: The Nigerian case study.

The Coronavirus disease (COVID-19) pandemic has wrecked great havoc in many spheres of life, including the educational, health, economic, and agricultural sectors. To break the transmission chain of SARS-CoV-2, public health safety measures such as social distancing, regular hand hygiene, border closure, restrictions on internal movement, and lockdown were implemented. Some of these measures have however contributed to reduced economic power, shortage of labor for agricultural production, and huge losses in the agricultural sector. To avert the effects of the COVID-19 pandemic on food losses in the agricultural value chain in Nigeria, much precedence should be placed on adequate stakeholder engagement. Amid the COVID-19 pandemic, logistics for unhindered agricultural trade should be put in place. In addition, policy makers should implement the institutionalization and implementation of social protection system in Nigeria. To address the financial difficulties during the COVID-19 pandemic, provision of loans and grants should be commenced in an organized fashion.

COVID-19 health literacy, coping strategies and perception of COVID-19 containment measures among community members in a southwestern state in Nigeria.

INTRODUCTION: This study aimed to describe COVID-19 health literacy, coping strategies and perception of COVID-19 containment measures among community members in a Southwestern state in Nigeria. METHODS: A descriptive cross-sectional design was used to enroll 691 respondents from households in Akure, Ondo state using a multi-stage sampling technique. Data were collected using an interviewer-administered questionnaire between 1st and 9th October, 2020. Bivariate Chi-square tests were conducted on respondents' COVID-19 health literacy while multivariate logistic analysis was performed on significant variables. Statistical significance levels were set at p<0.05. RESULTS: Respondents' mean age was 29.93±10.66 years, 352 (50.9%) were males. Also, 292 (49.7%) had high levels of trust in the World Health Organization regarding COVID-19 information, and 31 (33.3%) in the first wealth quintile had good health literacy (χ2=10.459, p=0.033). Respondents below 20 years were twice more likely to have good COVID-19 health literacy (OR=2.304, 95%CI=1.316-4.034, p=0.004). Also, respondents aged 21-29 years were three times more likely to have good COVID-19 health literacy (OR=2.587, 95%CI=1.559-4.293, p≤0.001). CONCLUSIONS: Available media platforms should be actively engaged by the national government to ensure that community members especially the rich are equipped with good health literacy.

Extent of misuse and dependence of codeine-containing products among medical and pharmacy students in a Nigerian University.

BACKGROUND: Misuse and dependency of opioids especially codeine-containing products is of increasing global concern. Inappropriate use of opioids among healthcare students could affect quality of service and ethical conducts of these future professionals, thereby putting the society at risk. This study aimed to evaluate knowledge and perception of medical and pharmacy students in a Nigerian tertiary University on use of opioids with focus on codeine-containing products. METHODS: A cross-sectional survey among 335-medical and 185-pharmacy students from University of Ibadan, Nigeria, between September and December 2018, using a self-administered semi-structured questionnaire. RESULTS: A total of 178 (34.2%) in multiple responses had used opioid-containing products among the respondents, of this, 171 (96.1%) used codeine-containing formulation. Precisely, 146 (28.1%) of the students had used codeine-containing products before, of this, 16 (11.0%) used the products for non-medical or recreational purpose regarded as a misuse/abuse. In all, 201 (38.7%) had good knowledge of opioid use, with 51 (34.9%) among those who had used opioids and 150 (40.1%) among those who had not used opioids (X2 = 1.186; p = 0.276). Majority (469; 90.2%) had good perception of risks associated with opioid use; comprising (130; 89.0%) among those who had taken opioids and (339; 90.6%) among those who had not taken opioids before (X2 = 0.304; p = 0.508). Logistic-regression shows that students who experienced some side effects to be experienced again 22.1 [AOR = 22.1, 95% CI: (5.98-81.72)] as well as those pressured into using codeine-containing products 10.6 [AOR = 10.6, 95% CI: (1.36-82.39)] had more tendency of misuse. CONCLUSION: There is a potential for misuse of codeine-containing products among medical and pharmacy students. Peer-influence and experience of some side effects are possible predictors of misuse among the students. Thus, healthcare students' curriculum should incorporate preventive programme, while public education and policy that favours peer-support programme on medication misuse is advocated for healthcare students.

Urban-rural differences in immunisation status and associated demographic factors among children 12-59 months in a southwestern state, Nigeria.

Vaccine preventable diseases (VPDs) are a leading course of child under-five mortality in sub-Saharan Africa. A target of 95% immunization coverage is necessary for the sustained control of VPDs. This study aims to determine the immunization status and its associated demo-graphic factors among children 12-59 months old in Akinyele Local Government area (LGA), Oyo State, Nigeria. A community-based cross-sectional study was carried out in one urban and one rural ward of Akinyele LGA. Fourhundred and forty-four (449) Under-five children were selected by multistage sampling technique. Data were collected from caregivers using interviewer administered questionnaires. Odds ratios at 95% CIand Chi square at 5% significant level were computed to identify the factors associated with non or partial immunisation. Multiple logistics regression at 5% significance level was done to determine the socio-demographic determinants of immunisation status. Overall, 449 children aged 12-59 months were surveyed of which 213(47.4%) were males and 236(52.6%) were from urban area. Overall, 365(81.3%) was fully immunized, 75(16.7%) was partially immunized and 9(2.0%) had never been immunized. Predictors of a child being partially or un-immunised were being in the fourth wealth quintile (AOR 7.9; 95%CI: 2.7-18.0), poorest wealth quintile (AOR 14.5; 95%CI 4.2-20.5), having a mother with no education (AOR 6.4; 95%CI: 2.9-14.1) and a mother that practiced Islam (AOR: 2.2; 95%CI: 1.3-3.7). Immunisation coverage was somewhat high but still suboptimal among the study population. Strategies that improve female literacy and those that target religious institutions may be effective in improving immunisation uptake.

Knowledge of spacer device, peak flow meter and inhaler technique (MDIs) among health care providers: an evaluation of doctors and nurses.

BACKGROUND: Metered dose inhalers are cornerstone in effective management of bronchial asthma when correctly used. Most studies hitherto have focused on assessing patient's knowledge of inhaler technique. We sought to assess the knowledge of inhaler technique, spacer device and peak flow meter among doctors and nurses in a tertiary healthcare institution in Nigeria. METHOD: A cross sectional survey of nurses and doctors from emergency department, family and internal medicine; who were attending a continuous professional development lecture, was carried out. From a total of 100 questionnaires administered, we retrieved 87 of which 75 were completed, giving a response rate of 75%. It was a self-administered questionnaire. Data was analysed with SPSS version 21.0. Descriptive statistics were done. Association was examined using chi-square test. RESULT: Mean age of respondent was 35.8 years ± 8.7, 47(62.7%) were < 40 years, 33(44%) were male, nurses were 30(40.0%). Only 28(37.3%) had ever used a peak flow meter. Only 4(14.3%) used peak flow meter frequently, while 12(26.7%) checked patient's inhaler technique often. Only 9 out of the 75 (12%) participants all of who are doctors knew at least 3 essential steps of the techniques in using the metered dose inhaler correctly. None of the participants got all the steps for the use of pMDI totally correct. CONCLUSION: Knowledge regarding the use of the metered dose inhaler and spacer device was poor. Health practitioners should have constant reminders in the form of continuous medical education to update their knowledge regarding correct inhaler technique. FUNDING: self-funded.

Intellectual Impairment in Patients with Newly Diagnosed HIV Infection in Southwestern Nigeria.

Neurocognitive impairment is a detrimental complication of HIV infection. Here, we characterized the intellectual performance of patients with newly diagnosed HIV infection in southwestern Nigeria. We conducted a prospective study at Owo Federal Medical Center by using the adapted Wechsler Adult Intelligence Scale (WAIS). The raw scores were converted to standardized scores (z-scores) and correlated with clinical and laboratory findings. Fifty-eight HIV positive patients were recruited; 72% were in WHO stages 3 and 4. We detected a high rate of intellectual impairment in HIV positive patients and controls (63.8% and 10%, resp.; P < 0.001). HIV positive patients performed worse throughout the subtests of both verbal and performance intelligence quotients. Presence of opportunistic infections was associated with worse performance in the similarities and digit symbol tests and performance and full scale scores. Lower body weight correlated with poor performance in different WAIS subtests. The high rate of advanced disease stage warrants measures aimed at earlier diagnosis and treatment. Assessment of neurocognitive performance at diagnosis may offer the opportunity to improve functioning in daily life and counteract disease progression.