Economic and social determinants of health care utilization during the first wave of COVID-19 pandemic among adults in Ghana: a population-based cross-sectional study.

BACKGROUND: The COVID-19 pandemic had socioeconomic effects in Africa. This study assessed the social and economic determinants of healthcare utilization during the first wave of COVID-19 among adults in Ghana. METHODS: Information about individuals residing in Ghana was derived from a survey conducted across multiple countries, aiming to evaluate the impact of the COVID-19 pandemic on the mental health and overall well-being of adults aged 18 and above. The dependent variable for the study was healthcare utilization (categorized as low or high). The independent variables were economic (such as financial loss, job loss, diminished wages, investment/retirement setbacks, and non-refunded travel cancellations) and social (including food scarcity, loss of financial support sources, housing instability, challenges affording food, clothing, shelter, electricity, utilities, and increased caregiving responsibilities for partners) determinants of health. A multinomial logistic regression was conducted to identify factors associated with healthcare utilization after adjusting for confounders (age, gender, access to medical insurance, COVID-19 status, educational background, employment, and marital status of the participants). RESULTS: The analysis included 364 responses. Individuals who encountered a loss of financial support (AOR: 9.58; 95% CI: 3.44-26.73; p < 0.001), a decrease or loss of wages (AOR: 7.44, 95% CI: 3.05-18.16, p < 0.001), experienced investment or retirement setbacks (AOR: 10.69, 95% CI: 2.60-43.88, p = 0.001), and expressed concerns about potential food shortages (AOR: 6.85, 95% CI: 2.49-18.84, p < 0.001) exhibited significantly higher odds of low healthcare utilization during the initial phase of the pandemic. Contrastingly, participants facing challenges in paying for basic needs demonstrated lower odds of low healthcare utilization compared to those who found it easy to cover basic expenses (AOR: 0.19, 95% CI: 0.06-0.67, p = 0.001). CONCLUSION: Economic and social factors were associated with low healthcare utilization in Ghana during the first wave of the pandemic. Investment or retirement loss and financial support loss during the pandemic had the largest effect on healthcare utilization. Further research is needed to understand the connection between concerns about food shortages, welfare losses during pandemics and healthcare utilization during pandemics in Ghana.

Socio-economic factors associated with post-traumatic stress symptoms among adolescents and young people during the first wave of the COVID-19 pandemic.

This study assessed the association between sociodemographic factors and post-traumatic stress symptoms (PTSS) among 18-24-year-olds during the first wave of the COVID-19 pandemic. This was a secondary analysis of data from 4508 individuals collected through an online survey conducted between June and January 2021. PTSS was measured as a dependent variable using the checklist for post-traumatic stress disorder in civilians. Age, birth sex, sexual, level of education, access to emotional and social support, and emotional distress were the independent variables. A multivariate logistic regression analysis was conducted to determine the associations between the dependent and independent variables while controlling for the country related confounding variables. Females (AOR:2.023), sexual minority individuals (AOR:1.868), those who did not disclose their sexual identify (AOR:1.476), those with poor access to emotional and social support (AOR:4.699) and individuals with no formal education (AOR:13.908), and only primary level education (AOR:4.521) had higher odds of PTSS. The study highlights the multifaceted nature of PTSS during the pandemic and suggests the importance of promoting access of young people, especially females, sexual minority individuals and those with low educational status, to emotional/social support to mitigate the probability of PTSS, especially among sexual minority individuals.

Social media information and its association with the adoption of COVID-19 preventive measures in four Latin American countries.

Objective: The study aimed to assess the association between adherence to COVID-19 preventive measures and access to media information related to COVID-19. Methods: A multi-country, cross-sectional study using an online survey was conducted from June to December 2020. The sample included 1,457 participants from Argentina, Brazil, Chile, and Mexico. The outcome variable was self-reported adherence to preventive measures (handwashing, social distancing, self-isolation, use of face masks, and working from home). The explanatory variable was self-report of following media information related to COVID-19 (watching or reading the news, following social media coverage). Multivariable logistic regression analyses were conducted to determine the associations. Results: Following information on social media was positively associated with higher odds of practicing social distancing (AOR=5.39; 95%CI: 3.93-7.30), self-isolation (AOR=1.44; 95%CI: 1.08-1.92), use of face masks (AOR=16.84; 95%CI: 10.03-28.27), handwashing (AOR=6.95; CI 95%: 4.98-9.71), and working from home (AOR=1.85; 95% CI: 1.43-2.41). Differences in the use of social media for COVID-19 information were observed among the four countries. Conclusion: Following social media was positively associated with adherence to COVID-19 preventive measures in Latin America. Social media may be effectively used for COVID-19 behaviour modification in Latin America.

Associations between mental health challenges, sexual activity, alcohol consumption, use of other psychoactive substances and use of COVID-19 preventive measures during the first wave of the COVID-19 pandemic by adults in Nigeria.

BACKGROUND: The aims of this study were to assess: 1) the associations among sexual activity, alcohol consumption, use of other psychoactive substances and mental health during the COVID-19 pandemic; and 2) the associations between COVID-19 preventive measures, alcohol consumption and use of psychoactive substances. METHODS: This was a secondary analysis of data collected from adults in Nigeria between July and December 2020. The variables extracted included change in sexual activity, alcohol consumption and use of other psychoactive substances, COVID-19 preventive behaviors (wearing face masks, washing hands, physical distancing), anxiety, depression, post-traumatic stress disorder (PTSD) and sociodemographic variables (age, sex, education, HIV status, employment status). Multivariable logistic regressions were conducted. A model was run to regress depression, anxiety, PTSD, increased alcohol consumption, and increased use of other psychoactive substances, on increased sexual activity. In separate models, anxiety, depression, and PTSD were regressed on increased alcohol consumption and on increased use of other psychoactive substances. Finally, three models were constructed to determine the associations between increased alcohol consumption and increased use of other psychoactive substances on three separate COVID-19 preventive behaviors. All models were adjusted for sociodemographic variables. RESULTS: Increased alcohol consumption (AOR:2.19) and increased use of other psychoactive substances (AOR: 3.71) were significantly associated with higher odds of increased sexual activity. Depression was associated with significantly higher odds of increased alcohol consumption (AOR:1.71) and increased use of other psychoactive substances (AOR:3.21). Increased alcohol consumption was associated with significantly lower odds of physical distancing (AOR:0.59). CONCLUSION: There was a complex inter-relationship between mental health, sexual health, increased use of psychoactive substances. The consumption of alcohol also affected compliance with physical distancing. Further studies are needed to understand the observed relationships.

Using traditional rhyme (folk song) as a tool for oral hygiene promotion (UTRATOHP) among children in rural communities in Nigeria: A protocol for a randomised controlled trial.

BACKGROUND: Most oral diseases are caused by poor oral hygiene, and with adequate oral hygiene measures, they are easily preventable. The use of folk songs to deliver oral health education may likely hold a huge potential for success and an increased likelihood of acceptability and sustainability among school children. Therefore, an investigation into the effectiveness of methods that would be culturally appropriate and sustainable, such as folk songs, is essential. AIM: To determine the effect of traditional rhyme (folk song) as a tool for oral hygiene education among children in rural communities in Nigeria. MATERIALS AND METHODS: This is a school-based, assessor-blinded, two-arm cluster-randomised controlled trial that will assess the effectiveness of oral hygiene messages delivered through traditional rhyme (folk song) on children's oral hygiene knowledge, attitude, practices, and oral hygiene status in two rural communities (Igboora and Idere) in Nigeria. The study will involve a minimum of 424 participants (aged 7-9 years) selected from eight primary schools using the cluster sampling technique. Four schools will be randomised into the test group to receive oral hygiene messages through folk songs, and the participants will sing the song for two weeks. The other four schools will be assigned to the control group, and the participants will receive the usual oral health talk on oral hygiene practices by a dentist. The participants' oral hygiene knowledge, attitude, practice and status will be assessed at baseline, immediate, six, and twelve-month post-intervention. A modified World Health Organization (WHO) Children's oral health survey questionnaire will be utilised for data collection. Oral examinations will be conducted to assess the participants' dental caries experience and oral hygiene status using the dmft/DMFT and simplified oral hygiene indices, respectively. DISCUSSION: Folk songs are popular means of conveying messages in Nigeria, and using them to deliver oral health messages may be an effective, acceptable, and sustainable method among children. This study will provide empirical information about this innovative intervention to guide policy development, dental public health practice, and future studies. TRIAL REGISTRATION: Pan African Clinical Trial Registry-PACTR202010863892797 (October 2020).

Associations between depression, fear of COVID-19 infection and students' self-care measures used during the first wave of the pandemic.

BACKGROUND: COVID-19 lockdown resulted in the closure of schools with associated problems. The aim of this study was to determine the associations between depression, fear of contracting COVID-19 infection and the use of self-care measures by college students during the first wave of the COVID-19 pandemic. METHODS: This was a cross-sectional study that collected data from undergraduate and postgraduate college students 18 years and older from 152 countries between June and December 2020. Study participants were recruited through crowdsourcing using various social media platforms including Facebook, Twitter, and Instagram, WhatsApp groups and emails to participants in the collaborators' networks. The dependent variables were fear of contracting COVID-19 and depression while the independent variable was students' self-care measures. Multivariable logistic regression models were conducted to assess the associations between the dependent and independent variables. RESULTS: Of the 2840 respondents, 1305 (46.0%) had fears of contracting COVID-19 and 599 (21.1%) reported depression. The most common self-care measures were phone calls with friends/family (60.1%) and video chat (52.8%). Learning a new skill was significantly associated with higher odds of fear of contracting COVID-19 (AOR = 1.669) and lower odds of having depression (AOR = 0.684). Talking to friends/family through video chat (AOR = 0.809) was significantly associated with lower odds of feeling depressed while spending time with pets (AOR = 1.470) and taking breaks from the news/social media (AOR = 1.242) were significantly associated with higher odds of feeling depressed. Students from lower middle-income countries (AOR = 0.330) had significantly lower odds of feeling depressed than students from low-income countries. CONCLUSION: Self-care strategies involving social interactions were associated with less depression. Coping strategies with more cognitive demands may significantly reduce the risk of fear of COVID-19. Special attention needs to be given to students in low-income countries who have higher odds of depression during the pandemic than students from other countries.

Fear of contagion, emotional stress and coping strategies used by adults during the first wave of the COVID-19 pandemic in Nigeria.

BACKGROUND: The COVID-19 pandemic has induced high levels of stress. The aim of the study was to assess the relationship between emotional stress (COVID-19 related fear, anger, frustration, and loneliness) and the use of coping strategies among adults in Nigeria during the COVID-19 pandemic. METHODS: Data from adults aged 18 years and above were collected through an online survey from July to December 2020. The dependent variables were COVID-19 related fear (fear of infection and infecting others with COVID-19), anger, frustration, and loneliness. The independent variables were coping strategies (use of phones to communicate with family and others, video conferencing, indoor exercises, outdoor exercises, meditation/mindfulness practices, engaging in creative activities, learning a new skill, following media coverage related to COVID-19) and alcohol consumption. Five logistic regression models were developed to identify the factors associated with each dependent variables. All models were adjusted for sociodemographic variables (age, sex at birth, and the highest level of education). RESULTS: Respondents who consumed alcohol, followed media coverage for COVID-19 related information, and who spoke with friends or family on the phone had higher odds of having fear of contracting COVID-19 or transmitting infection to others, and of feeling angry, frustrated, or lonely (p < 0.05). Respondents who exercised outdoors (AOR: 0.69) or learned a new skill (AOR: 0.79) had significantly lower odds of having fear of contracting COVID-19. Respondents who practiced meditation or mindfulness (AOR: 1.47) had significantly higher odds of feeling angry. Those who spoke with friends and family on the phone (AOR: 1.32) and exercised indoors (AOR: 1.23) had significantly higher odds of feeling frustrated. Those who did video conferencing (AOR: 1.41), exercised outdoors (AOR: 1.32) and engaged with creative activities (AOR: 1.25) had higher odds of feeling lonely. CONCLUSION: Despite the significant association between emotional stress and use of coping strategies among adults in Nigeria during the COVID-19 pandemic, it appears that coping strategies were used to ameliorate rather than prevent emotional stress. Learning new skills and exercising outdoors were used to ameliorate the fear of contracting COVID-19 in older respondents.

Impact of oral hygiene habits on oral health-related quality of life of in-school adolescents in Ibadan, Nigeria.

Background: Recent evidence has shown that the prevalence of periodontal diseases is still high among adolescents and, thus, there is an impetus to promote good oral hygiene habits among them through schools. There is a need to provide baseline data on the oral hygiene habits of adolescents and how it impacts their oral health-related quality of life for appropriate intervention to be instituted. Moreover, oral health-related quality of life describes how oral health affects the daily activities of individuals; thus, it provides a holistic means of involving individuals in making decisions about their oral health including uptake of oral hygiene habits. Aim: To assess the impact of oral hygiene habits on adolescents' oral health-related quality of life. Methods: A cross-sectional study was conducted among 1,800 adolescents aged 14-18 years attending 36 Senior Secondary Schools in the metropolis of Ibadan, Nigeria. Data were collected using a self-administered questionnaire, which assessed students' sociodemographic characteristics, oral hygiene habits, and oral health-related quality of life with COHIP-SF19. Data obtained was analyzed with SPSS version 25 and the p-value was set at <5%. Results: The mean age of the adolescents was 15.16 (±1.16) years. Many 1,094 (60.3%) cleaned their teeth twice or more often daily with 126 (7.0%) cleaning after meals and 1,519 (84.4%) changing their tooth cleaning agent at three months intervals or less. About 1,215 (67.5%) spent three minutes or longer in cleaning their teeth. Only a few 238 (13.2%) cleaned interdentally and 137 (7.6%) used dental floss. The OHRQoL scores of the adolescents ranged from 9-76. A total of 1,612 (93.5%) had at least an impact on their OHRQoL. Those who cleaned their teeth more frequently (twice or more) were more likely to have better OHRQoL (OR = 1.6, 95% CI = 1.1-2.4, p = 0.025) and those who did not clean interdentally were more likely to have better OHRQoL (OR = 2.8, 95% CI = 1.2-6.5, p = 0.014) than others. Conclusion: The oral hygiene habits of the adolescents were suboptimal and those who cleaned their teeth twice or more often each day had fewer impacts on their OHRQoL, whereas those who engaged in interdental cleaning had higher impacts on their OHRQoL than others.

Associations between Emotional Distress, Sleep Changes, Decreased Tooth Brushing Frequency, Self-Reported Oral Ulcers and SARS-Cov-2 Infection during the First Wave of the COVID-19 Pandemic: A Global Survey.

This study assessed the association between emotional distress, sleep changes, decreased frequency of tooth brushing, and self-reported oral ulcers, and the association between COVID-19 status and decreased frequency of tooth brushing. Using a cross-sectional online survey, data were collected from adults in 152 countries between July and December 2020. Binary logistic regression analyses were conducted to determine the associations between dependent (decreased frequency of tooth brushing, oral ulcers, change in sleep pattern) and independent (tested positive for COVID-19, depression, anxiety, frustration/boredom, loneliness, anger, and grief/feeling of loss) variables after adjusting for confounders (age, sex, level of education, employment status). Of the 14,970 participants data analyzed, 1856 (12.4%) tested positive for COVID-19. Respondents who reported feeling depressed (AoR: 1.375), lonely (AoR: 1.185), angry (AoR: 1.299), and experienced sleep changes (AoR:1.466) had significantly higher odds of decreased tooth brushing frequency. Respondents who felt anxious (AoR: 1.255), angry (AoR: 1.510), grief/sense of loss (AoR: 1.236), and sleep changes (AoR: 1.262) had significantly higher odds of oral ulcers. Respondents who tested positive for COVID-19 had significantly higher odds of decreased tooth brushing frequency (AoR: 1.237) and oral ulcers (AoR: 2.780). These findings highlight that the relationship between emotional distress and oral health may intensify during a pandemic.

"Oral health as an important milieu for social and mental health": Perspectives of adolescents emerging from a qualitative study.

Background: Recent evidence showed that the prevalence of oral diseases is still high among adolescents in many developing countries, including Nigeria. It therefore has becomes pertinent to focus on appropriate oral health interventions to promote oral health among them. This necessitates investigating the perspectives of adolescents, who are the major stakeholders, on the importance of oral health as baseline data needed in planning appropriate primary interventions. Aim: The aim of the study was to explore the perspectives of adolescents on the importance of oral health. Methods: An explorative qualitative study was conducted among adolescents attending senior secondary school I (grade 10) in the metropolis of Ibadan, Nigeria. A total of 12 focus group discussions were conducted among 120 adolescents aged 14 to 19 years. The discussions were transcribed verbatim, and triangulation and organization, as well as thematic analysis, of data were carried out. Results: Some adolescents had positive perceptions of oral health and valued it as highly important, although some had contrary views and believed oral health was unimportant. Oral health is described as being integral to general health, is associated with eating and communication, is a means of survival and confidence building, and is a prelude to attract the opposite gender. Adolescents perceived the need for oral health education and dental treatment. Conclusion: Adolescents have mixed perspectives on the importance of oral health; while some valued it as highly important, others believed it was of no significance. Those who valued oral health as important described it as a milieu for general health, human survival, and social and mental health and thus requested for oral health promotion in schools.

Associations between COVID-19 testing status, non-communicable diseases and HIV status among residents of sub-Saharan Africa during the first wave of the pandemic.

BACKGROUND: This study determined if non-communicable disease status, HIV status, COVID-19 status and co-habiting were associated with COVID-19 test status in sub-Saharan Africa. METHODS: Data of 5945 respondents age 18-years-old and above from 31 countries in sub-Saharan Africa collected through an online survey conducted between June and December 2020, were extracted. The dependent variable was COVID-19 status (testing positive for COVID-19 and having symptoms of COVID-19 but not getting tested). The independent variables were non-communicable disease status (hypertension, diabetes, cancer, heart conditions, respiratory conditions, depression), HIV positive status, COVID-19 status (knowing a close friend who tested positive for COVID-19 and someone who died from COVID-19) and co-habiting (yes/no). Two binary logistic regression models developed to determine associations between the dependent and independent variables were adjusted for age, sex, employment, sub region and educational status. RESULTS: Having a close friend who tested positive for COVID-19 (AOR:6.747), knowing someone who died from COVID-19 infection (AOR:1.732), and living with other people (AOR:1.512) were significantly associated with higher odds of testing positive for COVID-19 infection, while living with HIV was associated with significantly lower odds of testing positive for COVID-19 infection (AOR:0.284). Also, respondents with respiratory conditions (AOR:2.487), self-reported depression (AOR:1.901), those who had a close friend who tested positive for COVID-19 infection (AOR:2.562) and who knew someone who died from COVID-19 infection (AOR:1.811) had significantly higher odds of having symptoms of COVID-19 infection but not getting tested. CONCLUSION: Non-communicable diseases seem not to increase the risk for COVID-19 positive test while cohabiting seems to reduce this risk. The likelihood that those who know someone who tested positive to or who died from COVID-19 not getting tested when symptomatic suggests there is poor contact tracing in the region. People with respiratory conditions and depression need support to get tested for COVID-19.

Factors Associated With Experiences of Fear, Anxiety, Depression, and Changes in Sleep Pattern During the COVID-19 Pandemic Among Adults in Nigeria: A Cross-Sectional Study.

Background: Multiple facets of the pandemic can be a source of fear, depression, anxiety and can cause changes in sleep patterns. The aim of this study was to identify health profiles and the COVID-19 pandemic related factors associated with fear, depression, anxiety and changes in sleep pattern in adults in Nigeria. Methods: The data for this analysis was extracted from a cross-sectional online survey that collected information about mental health and well-ness from a convenience sample of adults 18 years and above resident in Nigeria from July to December 2020. Study participants were asked to complete an anonymous, closed-ended online questionnaire that solicited information on sociodemographic profile, health profiles (high, moderate and low COVID-19 infection risk profile) including HIV status, COVID-19 status, and self-reported experiences of fear, anxiety, depression and changes in sleep patterns. Results: In total, 4,439 participants with mean age of 38.3 (±11.6) years responded to the survey. Factors associated with higher odds of having COVID-19 related fear were health risk (p < 0.05); living with HIV (AOR: 3.88; 95% CI: 3.22-4.69); having COVID-19 symptoms but not tested (AOR: 1.61; 95% CI: 1.30-1.99); having a friend who tested positive to COVID-19 (AOR: 1.28; 95% CI: 1.07-1.53) and knowing someone who died from COVID-19 (AOR: 1.43; 95% CI: 1.24-1.65). The odds of feeling anxious was significantly higher for those with moderate or low health risk profile (p < 0.05); living with HIV (AOR: 1.64; 95% CI: 1.32-2.04); had a friend who tested positive for COVID-19 (AOR: 1.35; 95% CI: 1.08-1.68) or knew someone who died from COVID-19 (AOR: 1.53; 95% CI: 1.28-1.84). The odds of feeling depressed was significantly higher for those with health risk profile (p < 0.05); living with HIV (AOR: 2.49; 95% CI: 1.89-3.28); and respondents who had COVID-19 symptoms but had not taken a test (AOR: 1.41; 95% CI: 1.02-1.94). Factors associated with higher odds of having sleep pattern changes were having moderate and low health risk profiles (p < 0.05). Conclusion: The study findings suggest that the pandemic may cause fear, anxiety, depression and changes in sleep patterns differently for people with different health profile, HIV status and COVID-19 status.

Factors associated with COVID-19 pandemic induced post-traumatic stress symptoms among adults living with and without HIV in Nigeria: a cross-sectional study.

BACKGROUND: Nigeria is a country with high risk for traumatic incidences, now aggravated by the COVID-19 pandemic. This study aimed to identify differences in COVID-19 related post-traumatic stress symptoms (PTSS) among people living and not living with HIV; to assess whether PTSS were associated with COVID-19 pandemic-related anger, loneliness, social isolation, and social support; and to determine the association between PTSS and use of COVID-19 prevention strategies. METHODS: The data of the 3761 respondents for this analysis was extracted from a cross-sectional online survey that collected information about mental health and wellness from a convenience sample of adults, 18 years and above, in Nigeria from July to December 2020. Information was collected on the study's dependent variable (PTSS), independent variables (self-reported COVID-19, HIV status, use of COVID-19 prevention strategies, perception of social isolation, access to emotional support, feelings of anger and loneliness), and potential confounder (age, sex at birth, employment status). A binary logistic regression model tested the associations between independent and dependent variables. RESULTS: Nearly half (47.5%) of the respondents had PTSS. People who had symptoms but were not tested (AOR = 2.20), felt socially isolated (AOR = 1.16), angry (AOR = 2.64), or lonely (AOR = 2.19) had significantly greater odds of reporting PTSS (p < 0.001). People living with HIV (AOR = 0.39), those who wore masks (AOR = 0.62) and those who had emotional support (AOR = 0.63), had lower odds of reporting PTSS (p < .05). CONCLUSION: The present study identified some multifaceted relationships between post-traumatic stress, HIV status, facemask use, anger, loneliness, social isolation, and access to emotional support during this protracted COVID-19 pandemic. These findings have implications for the future health of those affected, particularly for individuals living in Nigeria. Public health education should be incorporated in programs targeting prevention and prompt diagnosis and treatment for post-traumatic stress disorder at the community level.

Impact of the COVID-19 pandemic on student' sleep patterns, sexual activity, screen use, and food intake: A global survey.

BACKGROUND: The education sector experienced substantial impacts during the COVID-19 pandemic resulting from worldwide restrictions. PURPOSE: To examine differences in the sleep patterns, sexual activity, screen use, and food intake of students and non-students during the COVID-19 pandemic. METHODS: This was a global cross-sectional study conducted in the second half of 2020 using multiple social media platforms to recruit study participants globally. A close-ended questionnaire was administered anonymously in English, French, Spanish, Portuguese, and Arabic to adults ages 18 and older. The outcome variables considered in analyses were changes in sleep pattern, sexual activity, screen use, and food intake. The explanatory variable was student status categorized as students vs. non-student. T-test, chi-square, and Mann Whitney U tests were used to assess differences between student and non-student populations. One logistic regression model was built for each outcome variable. Country of residence and country income level were included in the adjusted models. RESULTS: There were 17,008 participants of which 3,793 (22.3%) were students. Of the total sample, 4,889 (28.7%) reported changes in sleep, 4,642 (31.8%) reported increases in sexual activity, 10,278 (70.7%) reported increases in screen use, and 5,662 (40.2%) reported increases in food intake during the pandemic. Compared to non-students, students had significantly higher odds of reporting changes in sleep (AOR = 1.52), increases in sexual activity (AOR = 1.79), and increases in screen use (AOR = 1.36) but lower odds of reporting increase in food intake (AOR = 0.87). CONCLUSION: Students displayed higher risk of experiencing changes in sleep, sexual behavior, and screen use during the COVID-19 pandemic. This has the potential to lead to broader adverse effects on students' overall wellbeing. The findings and implications raise further obligations on the education sector to put extra-curricular support systems in place that address COVID-19 related behavior changes that have the potential to adversely impact students' wellbeing.

Differences in COVID-19 Preventive Behavior and Food Insecurity by HIV Status in Nigeria.

The aim of the study was to assess if there were significant differences in the adoption of COVID-19 risk preventive behaviors and experience of food insecurity by people living with and without HIV in Nigeria. This was a cross-sectional study that recruited a convenience sample of 4471 (20.5% HIV positive) adults in Nigeria. Binary logistic regression analysis was conducted to test the associations between the explanatory variable (HIV positive and non-positive status) and the outcome variables-COVID-19 related behavior changes (physical distancing, isolation/quarantine, working remotely) and food insecurity (hungry but did not eat, cut the size of meals/skip meals) controlling for age, sex at birth, COVID-19 status, and medical status of respondents. Significantly fewer people living with HIV (PLWH) reported a positive COVID-19 test result; and had lower odds of practicing COVID-19 risk preventive behaviors. In comparison with those living without HIV, PLWH had higher odds of cutting meal sizes as a food security measure (AOR: 3.18; 95% CI 2.60-3.88) and lower odds of being hungry and not eating (AOR: 0.24; 95% CI 0.20-0.30). In conclusion, associations between HIV status, COVID-19 preventive behaviors and food security are highly complex and warrant further in-depth to unravel the incongruities identified.

Factors Associated with Financial Security, Food Security and Quality of Daily Lives of Residents in Nigeria during the First Wave of the COVID-19 Pandemic.

An online survey was conducted to identify factors associated with financial insecurity, food insecurity and poor quality of daily lives of adults in Nigeria during the first wave of the COVID-19 pandemic. The associations between the outcome (experience of financial loss, changes in food intake and impact of the pandemic on daily lives) and the explanatory (age, sex, education level, anxiety, depression, HIV status) variables were determined using logistic regression analysis. Of the 4439 respondents, 2487 (56.0%) were financially insecure, 907 (20.4%) decreased food intake and 4029 (90.8%) had their daily life negatively impacted. Males (AOR:0.84), people who felt depressed (AOR:0.62) and people living with HIV -PLHIV- (AOR:0.70) had significantly lower odds of financial insecurity. Older respondents (AOR:1.01) had significantly higher odds of financial insecurity. Those depressed (AOR:0.62) and PLHIV (AOR:0.55) had significantly lower odds of reporting decreased food intake. Respondents who felt anxious (AOR:0.07), depressed (AOR: 0.48) and who were PLHIV (AOR:0.68) had significantly lower odds of reporting a negative impact of the pandemic on their daily lives. We concluded the study findings may reflect a complex relationship between financial insecurity, food insecurity, poor quality of life, mental health, and socioeconomic status of adults living in Nigeria during the COVID-19 pandemic.

Satisfaction with dental condition and oral health-related quality of life of school-age children with dental pain in Ibadan, Nigeria.

OBJECTIVES: The aim of the study was to determine the association between oral health-related quality-of-life domains and satisfaction with dental condition of school-age children with dental pain in Ibadan, Nigeria. METHODS: This cross-sectional study was conducted among 1006 pupils aged 9-12 years who attended 18 randomly selected primary schools in Ibadan, Nigeria. An interviewer-administered questionnaire, Child Oral Impact on Daily Performances inventory in addition to oral examination was used to obtain data. Analysis was done with SPSS 23 and STATA 14 and p-value set at <0.05. RESULTS: The prevalence of self-reported dental pain was 10.2%. The mean Child Oral Impact on Daily Performances inventory score was 2.6(±7.2) overall and 9.8(±12.4) for pupils with pain. There was a greater impact on oral health-related quality of life of respondents who reported dental pain than in others (mean rank = 749.54 vs 475.4, U = 21,162, p < 0.001) compared to those with clinically assessed pain (mean rank = 541.21 vs 502.97, U = 6416, p = 0.489). Those who reported dental pain were more dissatisfied with their dental condition (odds ratio = 7.7, 95% confidence interval = 5.0-12.0, p < 0.001) compared to those with clinically assessed dental pain (odds ratio = 1.3, 95% confidence interval = 0.4-4.9, p = 0.687). The direct effect of pain on satisfaction with dental condition and Child Oral Impact on Daily Performances inventory was ß = 0.74 (standard error = 0.12, 95% confidence interval = 0.50-0.97, p < 0.001) and ß = 0.53 (standard error = 0.05, 95% confidence interval = 0.44-0.63, p < 0.001), respectively. The indirect effect was ß = 0.12 (standard error = 0.039, 95% confidence interval = 0.05-0.20, p = 0.001) and the total effect was ß = 0.86 (standard error = 0.11, 95% confidence interval = 0.64-1.08, p < 0.001); R 2 = 0.21. CONCLUSION: Self-reported dental pain significantly impacted the quality of life of the pupils to cause dissatisfaction with dental condition when compared to clinically assessed pain.

Clinical and sociodemographic factors associated with oral health knowledge, attitude, and practices of adolescents in Nigeria.

OBJECTIVES: The institution of appropriate oral health promotion programs targeted at adolescents in schools in developing countries requires baseline information on their oral health knowledge, attitude, and practices as well as associated factors influencing it, which are unknown. This study assessed clinical and sociodemographic factors associated with oral health knowledge, attitude, and practices of adolescents in Ibadan, Nigeria. METHODS: Two-thousand and ninety-seven students aged 12-18 years were recruited from 30 randomly selected secondary schools in a cross-sectional study conducted in Ibadan, Nigeria. Data were obtained through a questionnaire on oral health knowledge, attitude, and practices, and sociodemographic characteristics. Oral examination was conducted to assess the clinical oral condition of the adolescents. Data were analyzed with SPSS. The higher the percentage scores, the better the oral health knowledge, attitude, and practices, and overall awareness of oral health. RESULTS: The oral health knowledge score ranged from 0% to 60%; mean oral health knowledge score was 15.1% (±6.6%). The oral health attitude score ranged from 0% to 91.3%; mean oral health attitude score was 44.5% (±14.3%). The oral health practices score ranged from 0% to 88.9%, and mean oral health practices score was 42.5% (±13.8%). The mean oral health knowledge, attitude, and practices score was 43.8% (±11.4%). A total of 1537 (73.3%) participants had unhealthy periodontium and 98 (4.7%) had dental caries. Students who were 12-15 years (odds ratio = 1.7, 95% confidence interval = 1.4-2.0, p < 0.001), females (odds ratio = 1.2, 95% confidence interval = 1.0-1.5, p = 0.024), offspring of skilled workers (odds ratio = 1.5, 95% confidence interval = 1.1-2.0, p = 0.010), previously educated about oral health (odds ratio = 1.3, 95% confidence interval = 1.0-1.7, p = 0.023), consulted the dentist (odds ratio = 1.9, 95% confidence interval = 1.2-3.1, p = 0.009), or had unhealthy periodontal condition (odds ratio = 1.2, 95% confidence interval = 1.0-1.5, p = 0.042) were more likely to have higher oral health knowledge, attitude, and practices scores or awareness than others. CONCLUSION: Better knowledge, attitude, and practices score was associated with younger age group, higher occupational class, previous oral health education, dental consultation, and having unhealthy periodontal condition.

Effectiveness of an Oral Health Education Program to Improve Mothers Awareness of Natal Teeth: A Randomized Controlled Study

Abstract Objective: To evaluate the effectiveness of an oral health talk aided by a video on improving the awareness of mothers about natal teeth in two rural communities in southwest Nigeria. Material and Methods: A cluster-randomized controlled trial was conducted among 80 mothers in two rural communities in Nigeria, randomized into study and control groups. Baseline information was obtained with a pre-tested interviewer administered questionnaire. The mothers in the study group participated in an oral health education program comprising of a video show on natal teeth in addition to an oral health talk. The control group did not receive any intervention. Post-intervention data was obtained three weeks afterwards. Data collected was analyzed with SPSS using paired t-test, independent t-test and Chi-square test. Results: The sociodemographic characteristics of participants in both groups were similar. The mean knowledge, attitude and practice percentage scores for the study group were 38.9 ± 26.3% (pre-intervention) and 73.6 ± 26.2% (post-intervention); while for the control group, the values were 43.2 ± 31.4% (pre-intervention) and 43.9 ± 32.4% (post-intervention). The study group, had a 34% increase in knowledge, attitude and practice percentage score (CI=23.7-45.5; t=6.4; p<0.001), while the control group, had an increase of 0.7% (CI=-0.7-2.2; t=1.00; p=0.323). Conclusion: An oral health education program comprising of oral health talk and a video about natal teeth improved the awareness of mothers about natal teeth as a normal phenomenon.