Uncovering the Burden of Diabetes in Ekiti State, Nigeria: Insights From a Statewide, Household-Based, Cross-Sectional Study.

INTRODUCTION: Diabetes mellitus (DM) is an important global public health challenge, and the burden of the disease is huge, particularly in low- and middle-income countries (LMICs), where the majority of people with this condition reside. Undiagnosed DM is more prevalent in LMICs. The aim of this study is to determine the prevalence and associated factors for DM in Ekiti State. MATERIALS AND METHODS: A cross-sectional, household-based survey using a four-stage multistage sampling design and the World Health Organization (WHO)-STEPS survey manual was conducted from July to September 2020 as a part of the Ekiti State coronavirus disease 2019 (COVID-19) survey. Of the 5,145 sampled households, 4,726 individuals gave consent to participate in the survey. Out of these, 3043 had fasting plasma glucose results available and were included in the analysis. RESULTS: There were 2257 (74.2%) women and 786 (25.8%) men. The prevalence of DM was 6.5% (6.5% in males and 6.6% in females, P = 0.946). Diabetes was found to be more prevalent among those with a secondary school education or higher (10.9%); employed in the formal sector (13.4%); separated, divorced, or widowed (8.5%); with raised blood pressure (9.3%); and who were aged 30-59 years (all P < 0.05). Multivariable logistic regression showed that age, education, occupation, and hypertension were all positively and significantly associated with an increased risk of DM. CONCLUSION: The prevalence of DM in Ekiti State is high, and its predictors include advancing age, hypertension, education, and occupation. This calls for scaling up public health interventions for controlling DM, targeting the identified risk factors among the people of Ekiti.

Childhood diarrhoea in southwestern Nigeria: Predictors of low osmolarity ORS and zinc use among mothers.

Objectives: Diarrhoea is a leading cause of mortality among children in resource-limited countries. However, very scarce literature exists regarding the factors influencing the awareness and use of low osmolarity oral rehydration salts (Lo-ORS) and zinc supplementation in the management of childhood diarrhoea among mothers of children under 5 years of age in southwestern Nigeria. This study, performed in Lagos, Nigeria, aimed to address this lack of knowledge. Methods: Through a cross-sectional survey design, 336 mothers of children under 5 years of age were selected through a multi-stage sampling procedure. Data were collected with a pretested, semi-structured interviewer administered questionnaire and analysed in SPSS version 23. Descriptive and inferential statistical techniques were used for data analysis. Results: A total of 10.4% of the mothers were aware of Lo-ORS, whereas 6.5% had ever used it; 53.3% were aware of zinc supplementation, whereas 42% had ever used it. Awareness was influenced by educational level (AOR: 2.017; 95% CI: 1.123-3.626) and the age of the child (AOR: 2.257; 95% CI: 1.237-4.117) for Lo-ORS, and by average monthly income (AOR: 1.582; 95% CI: 1.144-2.187) for zinc supplementation. The utilisation level was associated with educational level (p = 0.039) and awareness (p < 0.001) for Lo-ORS, and with marital status (p = 0.018) and awareness (p < 0.001) for zinc supplementation. Conclusion: Awareness and use of Lo-ORS was poorer than that of zinc supplementation among the mothers. Efforts to promote awareness regarding these treatments among mothers and health workers should be intensified to promote their use and help bridge the gap between policy change and effectiveness.

Association Between Breakfast Consumption and Anthropometrically Determined Nutritional Status of Secondary-School Adolescents in Lagos, Southwest Nigeria.

Background and Objectives: Breakfast skipping has been associated with obesity among adolescents in some studies but little is known about the relationship between breakfast consumption and obesity among secondary-school adolescents in Nigeria. This study contributes to the empirical literature by analyzing the relationship between breakfast consumption and anthropometrically determined nutritional status of secondary-school adolescents in Lagos, Nigeria. Methods: This was a descriptive cross-sectional study in which multi-stage sampling was used to select 397 secondary-school adolescents (10 to 19 years, mean = 13.8 ± 1.7 years). They were classified into student groups from public or private schools in Lagos. Data were collected using a semi-structured self-administered questionnaire and analyzed using Epi-info version 7. The independent variables were the proportion of adolescents who had a high level of knowledge about breakfast consumption, while the outcome variable was the proportion of adolescents who were overweight or obese. World Health Organization (WHO) AnthroPlus software was used to determine the nutritional status of adolescents. Mean and standard deviations were computed for continuous variables, and frequency tables were generated for categorical variables. Significant associations between variables were obtained using Chi-square with the level of significance set at p < 0.05. Results: Only 17% of the adolescents had good knowledge of breakfast consumption. More than half (57.4%) of the participants ate a daily breakfast. The percentage of adolescents who skipped breakfast was higher among older 16-19 years (52.2%) and middle 13-15 years (43%) than the younger adolescents (34.7%). Girls skipped breakfast more than boys. Most respondents were in the normal Body Mass Index (BMI) ranges for their genders. Prevalence of overweight and obesity were 7.1% and 3.3% among males and 7.1% and 2.8% among females respectively. The mean BMI of those who skipped breakfast (19.33 ± 3.27kg/m2) was significantly higher than the BMI of those who ate breakfast (18.56 ± 3.05 kg/m2) (p=0.019). Most of the adolescents who ate a daily breakfast had mothers who had completed only primary school education although the relationship was not statistically significant (χ2 =5, p=0.172). Conclusion and Global Health Implications: Breakfast knowledge was low, while breakfast consumption was average. Adolescents who skipped breakfast had a significantly higher BMI (19.33 ± 3.27kg/m2) than those who ate breakfast (18.56 ± 3.05 kg/m2) (p=0.019). Nutrition education that emphasizes the importance of breakfast consumption with the purpose of behavioral change should be intensified among adolescents.

Dietary habits, diversity, and predictors among pregnant women attending primary health care centers for antenatal care in Lagos, Nigeria.

BACKGROUND AND AIM: Inadequate nutrition during fetal development resulting from poor dietary habits leads to reprogramming within fetal tissues and poses as a risk factor for non-communicable diseases in later life. This study was conducted to determine the dietary habits, diversity, and predictors among pregnant women in Lagos, Nigeria. METHODS: A descriptive cross-sectional study was conducted using a structured interviewer-administered questionnaire to obtain data from pregnant women attending primary health care centers in Lagos, Nigeria. A multistage sampling method was used to select 350 pregnant women. A food frequency questionnaire was used to assess the dietary habits while dietary diversity was measured using non-quantifiable 24-hour recall. Data were analyzed using Epi-Info version 7.2 computer software. Chi-square and t-test were used to test for associations and P value < 0.05 was considered to be statistically significant. RESULTS: Only 16.7% of respondents consumed five servings of fruits and vegetables daily while the rice was the most frequent meal taken (45.4%). Meat was the commonest animal protein (20.3%) and only 30.8% had a high dietary diversity score (DDS). High DDS was significantly associated with parity of 1-3, living in a duplex or detached house, completion of at least secondary school education, and highly skilled professionals. CONCLUSION: Healthy dietary habits and high DDS were low and associated with low parity and higher socio-economic status. Nutrition intervention that encourages higher dietary diversity is needed especially among women of higher parity and lower socioeconomic status in Lagos.

Awareness and risk burden of diabetes mellitus in a rural community of Ekiti State, South-Western Nigeria.

OBJECTIVE: In recent times, Diabetes Mellitus (DM) has had a rapid increase in developing countries as a result of changing lifestyles among the people. This study was therefore aimed to investigate the level of awareness of DM and its associated risk factors in Afao: a rural community located in Irepodun/Ifelodun Local Government Ekiti State, Nigeria. DESIGN: The study was descriptive cross-sectional in design. A multi-stage sampling technique was applied to recruit respondents who are residents in the community. Two hundred and one individuals were involved in this community-based study. Information was obtained using a modified WHO STEPwise approach to chronic disease risk surveillance. The questionnaire included questions that assessed socio-demographic characteristics, diabetic risk factors and anthropometric measures of respondents. RESULT: Of the 134 (66.7%) respondents aware of DM, only an average of 43.9% had knowledge of its risk factors. Respondent's body mass index was significantly associated (P < 0.01) with knowledge of overweight/obesity as overweight (52.9%), grade 1 obese (62.5%) and morbid obese (100%) respondents had no knowledge of their status as risk factors for DM. Also, respondent's blood pressure status showed a significant association (P = 0.099) with respondent's knowledge of high blood pressure, 62.5% of those unaware of their blood pressure status had no knowledge of high blood pressure as a diabetes risk factor. Respondent's age (P = 0.024) and diet; daily vegetable servings (P = 0.015) and cooking oil (P = 0.05) showed significant association with the occurrence of the disease in 14.4% respondents previously diagnosed. CONCLUSION: This study shows a need to improve on the level of awareness of diabetes risk factors in Afao. Routine measurement of blood glucose levels for adults, community health education and enlightenment strategies through the ministry of health on the awareness of diabetes are highly recommended for the Afao community.

Prevalence and health care seeking behaviour for sexually transmitted infections among in-school adolescents in Ado-Ekiti, South-Western Nigeria.

BACKGROUND: In Nigeria, adolescents are highly vulnerable to sexually transmitted infections (STIs) which have the potential of jeopardising their future reproductive lives if poorly treated. OBJECTIVE: To determine the prevalence and health care seeking behaviour for STIs among secondary school adolescents in Ado, South-Western Nigeria. SUBJECTS: Male and female adolescents aged 10-19 years. METHODS: The study employed a descriptive cross-sectional design. A pre-tested, self-administered, semi-structured questionnaire was used to elicit information from 560 adolescents selected from public and private secondary schools in Ado Local Government Area (LGA) of Ekiti State, using a multistage sampling technique. The data were analyzed using descriptive and inferential statistics. Analyzed data were presented in the form of tables and charts. RESULTS: Two hundred and fifty-one (47.1%) respondents had previous symptoms of STIs. The commonest symptoms among the males were penile discharge (30.5%), painful micturition (30.5%) and stomach pain with swollen testes (25.4%). The commonest symptoms among the females were genital itching (27.6%), genital sores (14.1%) and painful micturition (13.1%). Only 26.7% sought treatment from a health facility; 37.0% did nothing; 15.9% went to patent medicine stores, 10.0% used herbs; the rest did self-medication or prayed. CONCLUSION: The prevalence of STI symptoms among adolescents in Ado-Ekiti is high but their health care seeking behaviour is poor. Health education about the dangers of untreated STI and the importance of seeking treatment early, targeted at adolescents, should be intensified.

Prevalence of menstrual disorders among adolescent girls in Osogbo, South Western Nigeria.

BACKGROUND: Menstrual disorders are common sources of morbidity among adolescent girls and often cause anxiety for these girls and their families. OBJECTIVE: This paper aims to determine the patterns of menstruation as well as the prevalence of menstrual disorders and their consequences among adolescent girls in Osogbo, South Western Nigeria. SUBJECTS: Adolescent school girls aged 10-19 years comprised the sample. METHODS: The study employed a descriptive cross-sectional design. A pre-tested, self administered, semi-structured questionnaire was used to elicit information from 402 adolescents selected from private secondary schools in the Osogbo Local Government Area (LGA) of Osun State, using a multistage sampling technique. Data were analyzed using SPSS version 15. RESULTS: A total of 391 (97.8%) respondents had heard about menstruation before, with the three most important sources of information being their mothers (81.8%), teachers (7.4%), and peer groups (6.1%). The mean age at menarche was 12.5±1.0 years. Menstrual bleeding lasted between 2-7 days in 81.1% and cycle length lasted for 21-35 days in 81.6% of the respondents. The three most important menstrual disorders they experienced were dysmenorrhea (77.8%), menorrhagia (57.4%) and metrorrhagia (18.6%), among others. Menstrual disorders, especially dysmenorrhea, interfered with the daily activities of the respondents. CONCLUSION: The prevalence of menstrual disorders among adolescents in the Osogbo LGA is high. Measures should be undertaken to educate the adolescents and their mothers about menstrual disorders and to mitigate their effects on the social and academic lives of these adolescents.