Disparities in Incidences of Cesarean Section Among Women With Gestational Diabetes Mellitus in the United States.

Background In this study, we explored the interaction between women's race/ethnicity and insurance type and determined how these interactions affect the incidences of cesarean section (CS) among women with gestational diabetes mellitus (GDM). Methodology We utilized the National Inpatient Sample (NIS) database from January 2000 to September 2015 to conduct a retrospective analysis of all GDM-associated hospitalizations. We then explored the interaction between race/ethnicity and insurance types and determined how these interactions affect the incidences of CS among GDM patients, controlling for traditional risk factors for CS and patients' sociodemographics. Subsequently, we determined the risk of primary postpartum hemorrhage (PPH) in the CS group and a propensity score-matched control group who had vaginal deliveries. Results There were 932,431 deliveries diagnosed with GDM in the NIS database from January 2000 to September 2015. The mean age of the study population was 30.6 ± 5.9 years, 44.5% were white, 14.0% were black, and 26.7% were Hispanic. The CS rate was 40.5%. After controlling for covariates, women who utilized private insurance had the highest CS rate across the different races/ethnicities; white (odds ratio (OR) = 1.21 (1.17-1.25)) blacks (OR = 1.33 (1.26-1.41)), and Hispanic (OR = 1.12 (1.06-1.18)). CS patients were less likely to develop PPH compared to their matched controls with vaginal deliveries (OR = 0.67 (0.63-0.71)). Conclusions Private insurance is associated with higher incidences of CS among women with GDM, irrespective of race/ethnicity.

Comparison of respiratory and skin disorders between residents living close to and far from Solous landfill site in Lagos State, Nigeria.

BACKGROUND: Solid waste dump sites have proven to have potentially high risk to human health as it serves as a source of air, soil and underground water pollution. AIM: This study aimed to assess and compare the knowledge, respiratory disorders and skin disorders between residents living close to and far from landfill sites in Lagos State, Nigeria. SETTING: Igando (a community within 5 km close to) and Badagry (a community beyond 5 km from) Solous Landfill sites in Lagos state, Nigeria. METHODS: A comparative cross-sectional study amongst 103 respondents recruited from each of the two study sites by multistage sampling method was carried out. Data were collected using pretested, structured, interviewer-administered questionnaire, and analysed using Microsoft Excel 2007, EPI Info 7 and WinPepi statistical software packages. Student t-test, Fisher's exact and Chi-square tests were carried out. The p ≤ 0.05 was considered statistically significant. RESULTS: The mean age of Igando and Badagry respondents was 34.18 ± 10.21 years and 32.62 ± 9.84 years, respectively. The two communities differed significantly (p 0.0001) with respect to distance of workplace from landfill site and duration of stay in the residential location. The mean knowledge score of respondents on respiratory and skin disorders associated with solid waste dump site close to landfill sites (82.53 ± 20.60) was statistically significantly higher than those of respondents far from landfill sites (71.84 ± 20.57) (p = 0.0003). Respiratory and skin disorders experiences of respondents close to landfill sites were statistically significantly (p 0.0001) higher than those of residents far from landfill sites with respect to wheezing, frequent sneezing, unpleasant odour, fever and skin rashes. CONCLUSION: Respiratory and skin disorders experienced by respondents close to landfill sites are higher than those of residents far from landfill sites. Landfill sites should not be located close to human settlements.

Knowledge and utilisation of National Health Insurance Scheme among adult patients attending a tertiary health facility in Lagos State, South-Western Nigeria.

BACKGROUND: Despite the creation of the National Health Insurance Scheme (NHIS) by the Nigerian government, most Nigerians are not covered by the scheme. AIM: The aim of this study was to assess the knowledge and utilisation of NHIS among adult patients who attended a tertiary health facility in Lagos state, South-Western Nigeria. SETTING: Outpatient clinic, Lagos State University Teaching Hospital, Ikeja, Lagos. METHODS: A descriptive cross-sectional study of 487 respondents recruited using a multi- stage sampling method. Data were collected using pretested semi-structured self-administered questionnaires, and analysis was done using Microsoft Excel 2007 and EPI Info 7 statistical software. Level of significance was set at p 0.05. Ethical approval was obtained from the Health Research Ethics Committee Lagos State university teaching Hospital. RESULTS: A total of 487 of the 500 self-administered questionnaires were retrieved and analysed, giving a response rate of 97.4%. The study showed that 80.7% of the respondents had poor knowledge of NHIS, only12.3% of the respondents had registered with the NHIS, and 43.8% of respondents who had not registered with NHIS claimed they do not know where to register. There was a statistically significant association between age and utilisation (p = 0.0007), marital status and utilisation of NHIS (p = 0.016), employment status and utilisation of NHIS (p = 0.001).Most (96%) of those who have utilised NHIS were satisfied with NHIS services. CONCLUSION: Majority of the respondents had poor knowledge of NHIS and also majority of those who had registered were satisfied with the scheme. There should be increased awareness campaigns so that all Nigerians can benefit from the scheme.

Knowledge and utilisation of National Health Insurance Scheme among adult patients attending a tertiary health facility in Lagos State, South-Western Nigeria

Background: Despite the creation of the National Health Insurance Scheme (NHIS) by the Nigerian government, most Nigerians are not covered by the scheme. Aim: The aim of this study was to assess the knowledge and utilisation of NHIS among adult patients who attended a tertiary health facility in Lagos state, South-Western Nigeria. Setting: Outpatient clinic, Lagos State University Teaching Hospital, Ikeja, Lagos. Methods: A descriptive cross-sectional study of 487 respondents recruited using a multi- stage sampling method. Data were collected using pretested semi-structured self-administered questionnaires, and analysis was done using Microsoft Excel 2007 and EPI Info 7 statistical software. Level of significance was set at p < 0.05. Ethical approval was obtained from the Health Research Ethics Committee Lagos State university teaching Hospital. Results: A total of 487 of the 500 self-administered questionnaires were retrieved and analysed, giving a response rate of 97.4%. The study showed that 80.7% of the respondents had poor knowledge of NHIS, only 12.3% of the respondents had registered with the NHIS, and 43.8% of respondents who had not registered with NHIS claimed they do not know where to register. There was a statistically significant association between age and utilisation (p= 0.0007), marital status and utilisation of NHIS (p= 0.016), employment status and utilisation of NHIS (p=0.001). Most (96%) of those who have utilised NHIS were satisfied with NHIS services. Conclusion: Majority of the respondents had poor knowledge of NHIS and also majority of those who had registered were satisfied with the scheme. There should be increased awareness campaigns so that all Nigerians can benefit from the scheme