THE PROBLEM Globally, non-communicable diseases (NCDs) are the leading cause of death and disabil... more THE PROBLEM Globally, non-communicable diseases (NCDs) are the leading cause of death and disability and are projected to account for seven out of every 10 deaths by 2020.[1] The majority (82%) of NCD deaths occur in lowand middleincome countries (LMICs) and are premature. Almost half of all deaths in Asia are attributable to NCDs, and Africa is projected to bear the greatest regional increase (27%) in NCD burden by 2025 [1,2]. The World Health Organization’s (WHO) 2030 Agenda for Sustainable Development recognizes NCDs as a major challenge to sustainable development and set a major goal of reducing by one-third, premature mortality from NCDs by 2030 [3]. The World Economic Forum currently ranks NCDs in the top five threats to global economic development worldwide. The financial implications of disease and disability due to the NCDs, combined with the costs of long-term management, are major causes of impoverishment and barriers to socio-economic development. The annual financial bu...
Background The success of antiretroviral therapy has led to an increase in life expectancy and an... more Background The success of antiretroviral therapy has led to an increase in life expectancy and an associated rise in the risk of cardiometabolic diseases (CMDs) among people living with HIV. Objective Our aim was to conduct a systematic review to synthesize the existing literature on the patterns of use and effects of mobile health (mHealth) interventions for improving treatment adherence and outcomes of care for CMD among people living with HIV. Methods A systematic search of multiple databases, including PubMed-MEDLINE, Embase, CINAHL, Scopus, Web of Science, African Journals online, ClinicalTrials.gov, and the World Health Organization Global Index Medicus of peer-reviewed articles, was conducted with no date or language restrictions. Unpublished reports on mHealth interventions for treatment adherence and outcomes of care for CMD among adults living with HIV were also included in this review. Studies were included if they had at least 1 component that used an mHealth interventio...
Objectives: This study developed and compared the performance of three widely used predictive mod... more Objectives: This study developed and compared the performance of three widely used predictive models—logistic regression (LR), artificial neural network (ANN), and decision tree (DT)—to predict diabetes mellitus using the socio-demographic, lifestyle, and physical attributes of a population of Nigerians.Methods: We developed three predictive models using 10 input variables. Data preprocessing steps included the removal of missing values and outliers, min-max normalization, and feature extraction using principal component analysis. Data training and validation were accomplished using 10-fold cross-validation. Accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUROC) were used as performance evaluation metrics. Analysis and model development were performed in R version 3.6.1.Results: The mean age of the participants was 50.52 ± 16.14 years. The classification accuracy, sensit...
This study was carried out to assess the blood donation practices and willingness to donate among... more This study was carried out to assess the blood donation practices and willingness to donate among residents of an urban slum. Cross sectional descriptive study design with a qualitative and quantitative component. Multistage sampling was used to select 400 respondents for the questionnaire interview while three FGD sessions were conducted guide among three groups of participants namely youths, men and women. The information collected was analyzed manually (FGD) and with Epi info version 3.5.3. Majority of the questionnaire respondents were female, married, traders, had at least secondary school education, with mean age of 37.6 years. Only 12.0% had donated in the past, the main reason given by non donors was that they had never been asked to donate; this was also a key finding in the FGD. Willingness to donate was positively associated with being a male, single and Christian, age was a significant predictor of previous donation while more of the previous donors were still willing to...
This study sought to determine the sociodemographic correlates of exclusive and concurrent use of... more This study sought to determine the sociodemographic correlates of exclusive and concurrent use of smokeless tobacco (SLT) and smoking (i.e., dual use) and to explore the association between SLT use and the amount of cigarettes smoked per day. Data were obtained from a nationally representative sample of Nigerian men aged 15-59 years (N = 15,453) who participated in the 2008 Nigerian Demographic and Health Survey (NDHS). The NDHS used an interviewer-administered questionnaire to collect data on participants' sociodemographic characteristics and tobacco use status. Taking account of the multistage sampling used in the NDHS, data analyses included descriptive statistics, chi-square analysis, and multivariable adjusted multinomial logistic regression analysis. Of the respondents, 12.2% (n = 1,842) were tobacco users, out of which 24.5% (n = 477) were exclusive SLT users, 69% (n = 1,236) were exclusive smokers, and 6.5% (n = 129) were dual users. Both SLT use and smoking were most prevalent among the Igbo ethnic group and among the least educated men. SLT use was most prevalent among those in the southeast (9.75%) and north-central (7.71%) regions, where smoking was also common. The number of cigarettes smoked per day was not significantly different among dual users when compared with exclusive smokers (7.3 vs. 5.6; p = .088). Dual users were also more likely to self-identify as traditionalists (RRR = 6.03; 95% CI = 2.96-12.28) compared with self-identifying as practicing Islam or Christianity. There are distinctive ethnic and regional differences in tobacco use patterns among Nigerian men, and SLT use was not associated with reduced smoking intensity among dual users.
The American journal of tropical medicine and hygiene, Jan 15, 2014
Nigeria has the world's 10th largest tuberculosis (TB) burden. Targeted community-based inter... more Nigeria has the world's 10th largest tuberculosis (TB) burden. Targeted community-based interventions can potentially help reduce TB incidence. We designed an intervention in a periurban community where 10 community volunteers were trained to provide community TB education and also detect and refer TB suspects to a nearby clinic. To determine the effect of the intervention on knowledge, attitude, and preventive practices of TB, we compared results from a pre-intervention survey with those of a post-intervention survey. Pre-intervention, respondents had a mean knowledge score of 10.6 ± 7.0 of a possible 34, a mean attitude score of 5.8 ± 3.3 of a possible 10, and a mean practice score of 5.3 ± 1.4 of a possible 7. The intervention significantly increased the mean knowledge score to 16 ± 5.4 (P < 0.001) and mean attitude score to 7.0 ± 1.8 (P < 0.001); however, there was no statistically significant difference in the mean practice score. Eight TB suspects were referred to th...
Background Lagos state is the industrial nerve centre of Nigeria and was the epicentre of the 201... more Background Lagos state is the industrial nerve centre of Nigeria and was the epicentre of the 2014 Ebola outbreak in Nigeria as it is now for the current Coronavirus Disease (COVID-19) outbreak. This paper describes how the lessons learned from the Ebola outbreak in 2014 informed the emergency preparedness of the State ahead of the COVID-19 outbreak and guided response. Discussion Following the Ebola outbreak in 2014, the Lagos State government provided governance by developing a policy on emergency preparedness and biosecurity and provided oversight and coordination of emergency preparedness strategies. Capacities for emergency response were strengthened by training key staff, developing a robust surveillance system, and setting up a Biosafety Level 3 laboratory and biobank. Resource provision, in terms of finances and trained personnel for emergencies was prioritized by the government. With the onset of COVID-19, Lagos state was able to respond promptly to the outbreak using the c...
Purpose: Hepatocellular Carcinoma (HCC) is the leading cause of cancer-related mortality in Niger... more Purpose: Hepatocellular Carcinoma (HCC) is the leading cause of cancer-related mortality in Nigeria. HIV and viral hepatitis B (HBV) and C (HCV) co-infection are common in Nigeria that significantly accelerates liver disease progression including HCC. Aging-related DNA methylation signatures obtained in liquid biopsy, such as circulating cell-free DNA (ccfDNA) extracted from serum/plasma are promising minimally-invasive biomarkers that may inform HIV-associated HCC. We examined the epigenetic age acceleration (EpiAgeAccel) in ccfDNA in HCC patients with HIV. Methods: The study included three groups of participants: a) HIV positive with HCC (n=7); b) HIV positive and cancer-free (n=45); and c) HIV negative with HCC (n=33). Epigenetic age was estimated by Horvath9s calculator using genome-wide ccfDNA methylation data profiled by Illumina EPIC array. EpiAgeAccel was computed as the residuals of a linear model of epigenetic age on chronological age, namely the unexplained portion of epi...
Background: The coronavirus disease 2019 outbreak in Nigeria was first reported on the 27th Febru... more Background: The coronavirus disease 2019 outbreak in Nigeria was first reported on the 27th February 2020 and 95 days after, it had spread to 35 states and the Federal Capital Territory (FCT) with 10,162 confirmed cases. We reviewed the trends of the epidemic from the 27th February to the 31st May 2020, when it reached the 10,000th mark vis-à-vis government policies to contain the spread of the disease. Methods: We used publicly available data from the Nigeria Center for Disease Control from 27th February 2020, when Nigeria recorded her first coronavirus disease 2019 case to the 31st May 2020. We used line graphs to describe the trends of the daily course of cumulative cases, discharges and deaths in states and nationally. The doubling time, transmission rates were inferred from these trends and the epidemiological curve generated was reviewed vis-a-vis the instituted government policies over the specified period. Results: The epidemic curve in Nigeria has been on an upward trajectory as the number of cases crossed the 10,000 marks, 3 months after the first case was recorded. The first spike in the number of new cases was observed on the 21st April 2020, with 117 cases. The number of daily deaths within the study period was highest on the 2nd May 2020 (17 new deaths). Geo-political zone variations were also observed. Of the 63,882 screening tests conducted during the study period, 15.9% tested positive; the doubling time and transmission rates were 23.5 days and 1.0%, respectively, as at 31st May 2020. Since the lockdown measures were lifted in Lagos and the FCT on the 4th May 2020, the number of cases has been on a steady increase each week. Conclusion and Recommendations: In Nigeria, the epidemic curve has been on an upward direction since the first reported case and it took 3 months to reach 10,000 cases. We recommend a sustained drive in the enforcement of physical and social distancing and increase in testing capacity to flatten the epidemic curve.
Background: Over the past three decades, there has been an increase in the use of motorcycles as ... more Background: Over the past three decades, there has been an increase in the use of motorcycles as a means of transportation in Nigeria. Motorcycle-related crashes have also been on the rise, with human error accounting for up to 90% of traffic accidents in Nigeria. This study aimed to identify risky behaviors for road traffic crashes among commercial motorcyclists in Ikenne local government of Ogun State, Nigeria. Methods: This descriptive cross-sectional study was carried out among 400 commercial motorcyclists selected using multistage sampling method. A semi-structured, interviewer-administered questionnaire was used to elicit data about respondents' awareness of certain risky behaviors as causes of motorcycle crashes and their attitude toward and practice of such risky behaviors. Data were analyzed using SPSS version 16 and presented as chart and tables. Results: The mean age of the respondents was 33.7 ± 9.5 years. Only few (4.0%) had tertiary education. All of them were males. Awareness of risky behaviors was good with an average of 85.9%. Attitude to causes of accidents was also good, with 90.4% of the respondents having good attitude. However, most (95.5%) of the respondents demonstrated accident-related risky behavior(s). Risk behavior was statistically associated with younger age (P < 0.001), lower levels of education (P < 0.01), and training before commencement of trade (P < 0.05). Conclusion: Despite good awareness and attitude, most respondents demonstrated one risky behavior or the other. Younger age and poor educational status were statistically associated with risky behaviors. There is need for strict enforcement of traffic codes to ensure compliance.
Background: Iodine deficiency affects over 2.2 billion individuals globally. It is the most commo... more Background: Iodine deficiency affects over 2.2 billion individuals globally. It is the most common cause of hypothyroidism in pregnancy and remains the leading cause of preventable infant intellectual deficits. This study set out to determine the relationship between gestational age and iodine status in Nigerian women. Methods: This was a prospective cross-sectional study with a total study population of 220 pregnant and 110 nonpregnant participants. Urinary Iodine Excretion (UIE) was performed using the Sandell–Kolthoff reaction. Pregnant women were grouped into three trimesters (0–13 weeks, 14–26 weeks, and ≥27 weeks.). Analysis of variance was used in comparison of means, Chi-square test used in analyzing proportions, while P ≤ 0.05 was considered statistically significant. Results: The median UIE was 135 μg/L in pregnant and 120 μg/L in the nonpregnant women. Among the pregnant women, 133 (60.5%) had insufficient iodine intake (UIE <150 μg/L) while 29 (27.3%) of the nonpregnant women had inadequate iodine intake (UIE <100 μg/L). The median UIE was 140, 139, and 120 μg/L in the first, second, and third trimesters, respectively (P = 0.13). The median UIE declined with advancing gestational age. The percentage of pregnant women with inadequate iodine intake was 53.6% in the first trimester and 59% and 72.6% in the second and third trimesters, respectively (P = 0.03). Conclusion: Three-fifths of the pregnant women had inadequate iodine intake. The median UIE decreased with advancing gestation. Iodine supplementation before and during pregnancy would help improve the iodine status in pregnancy.
Background: The Lagos State Regulation of Smoking Law was passed in February 2014 and stipulates ... more Background: The Lagos State Regulation of Smoking Law was passed in February 2014 and stipulates the total restriction of tobacco smoking in listed public places. Workers in hospitality venues are at a high risk of exposure to second-hand smoke (SHS). Therefore, their awareness of the health risks, attitudes toward SHS and their reported levels of exposure may play a crucial role in developing an effective monitoring, implementation, and enforcement mechanism. Methods: We conducted a cross-sectional, descriptive study among workers in restaurants, bars, and nightclubs registered with the Lagos State Ministry of Tourism in the second quarter of the year 2014. We used a multistage sampling technique to select one respondent each from the 300 centers randomly selected to participate in the survey. Data were collected using a modified version of the World Health Organization Global tobacco surveillance system tools. Univariate and bivariate analysis were carried out. Exposure to SHS in the workplace and in other public places was treated as the outcome variable in the bivariate analysis. Results: Majority (75.3%) of the respondents were aged between 21 and 40 years with a mean age of 27.7 + 8.6 years. Many (66%) were waiters/waitresses and spent more than 8 h a day. Most (60.6%) of the venues were indoor only establishments, and 26.8% had no form of smoking restrictions. Majority of the respondents were exposed to SHS at work, and this was higher in bars and nightclubs. A bivariate analysis of results showed that workers were exposed to SHS at work irrespective of workplace smoking restrictions or respondents smoking status. Conclusion: Our study demonstrates that second-hand smoke exposure is very high (65% in smokers; 65.6% in nonsmokers) among workers in restaurants, bars, and nightclubs in Lagos State. We are therefore of the opinion that strict enforcement of law would ensure the protection of these workers.
Background: Nigeria still experiences a high burden of unsafe motherhood. The knowledge of obstet... more Background: Nigeria still experiences a high burden of unsafe motherhood. The knowledge of obstetric danger signs and the effective application of the principles of birth preparedness and complication readiness (BPACR) have the potential to significantly reduce the high maternal and perinatal morbidity and mortality rates. However, rural-urban differences may exist in the knowledge and practice of BPACR among women, and these may limit its potential benefit. We set out to assess and compare the knowledge of obstetric danger signs and practice of BPACR among pregnant women attending Rural (Agbowa) and Urban (Gbagada) Hospitals in Lagos State. Materials and Methods: In this cross-sectional comparative study, pregnant women attending antenatal clinics in each health facility were recruited into the study using a systematic sampling method. A structured interviewer administered questionnaire adapted from the safe motherhood John Hopkins Program for International Education in Gynecology and Obstetrics prototype questionnaire was used for data collection. Data were analyzed using SPSS version 17.0. Results: Awareness of obstetric danger signs during pregnancy was good among rural and urban study participants accounting for 62.4% and 68.4%, respectively. The most commonly identified danger sign in pregnancy, labor, and after delivery was bleeding from the genital tract. The awareness of danger signs during labor and after delivery identified by the women was low in both settings, though relatively higher in the urban area. The level of BPACR was low in both groups of women but was higher among women attending the urban center (31.6%) compared with the rural center (13.2%) P-value < 0.001. Conclusion and Recommendations: Activities aimed at improving birth preparedness practices particularly among rural women should be considered.
Background: Excess risk for cardiovascular disease, especially hypertension, may exist among huma... more Background: Excess risk for cardiovascular disease, especially hypertension, may exist among human immunodeficiency virus infection (HIV)-positive persons. This study was carried out to assess the prevalence of the behavioral risk factors for hypertension, including their awareness of these factors and their attitudes toward them. Methods: This descriptive cross-sectional study was conducted among 400 HIV-infected adults who accessed care in nine secondary health facilities in Lagos State, Nigeria. Respondents were selected by multistage sampling and data elicited using a structured, interviewer-administered questionnaire. Blood pressure (BP) was measured thrice and a respondent was considered as having raised BP if the mean of the last two measurements is ≥140 mm Hg (systolic BP) or ≥90 mm Hg (diastolic BP) or if respondents are currently taking anti-hypertensive. Results: Prevalence of key behavioral risk factors for hypertension was high. For instance, 82.0% of the respondents were physically inactive. Stress and physical inactivity were the two most known risks of hypertension, identified by 87.3% and 70.5% of the respondents, respectively. Majority (66.0%) had positive attitudes toward hypertension risk factors and 26.7% of them had raised BP. Lower age, that is, 30 years and below (OR = 2.89, 95% CI = 1.26–6.64), BMI of less than 25 (OR = 1.87, 95 CI = 1.16–3.01), and being diagnosed of HIV for 5 years and less (OR = 1.62, 95% CI = 1.006–2.62) were significantly associated with normal BP measurements among respondents. Conclusion: The proportion of people living with HIV/AIDS who show known behaviors that place them at risk for hypertension is high. Measures to address these risk factors among them are warranted.
THE PROBLEM Globally, non-communicable diseases (NCDs) are the leading cause of death and disabil... more THE PROBLEM Globally, non-communicable diseases (NCDs) are the leading cause of death and disability and are projected to account for seven out of every 10 deaths by 2020.[1] The majority (82%) of NCD deaths occur in lowand middleincome countries (LMICs) and are premature. Almost half of all deaths in Asia are attributable to NCDs, and Africa is projected to bear the greatest regional increase (27%) in NCD burden by 2025 [1,2]. The World Health Organization’s (WHO) 2030 Agenda for Sustainable Development recognizes NCDs as a major challenge to sustainable development and set a major goal of reducing by one-third, premature mortality from NCDs by 2030 [3]. The World Economic Forum currently ranks NCDs in the top five threats to global economic development worldwide. The financial implications of disease and disability due to the NCDs, combined with the costs of long-term management, are major causes of impoverishment and barriers to socio-economic development. The annual financial bu...
Background The success of antiretroviral therapy has led to an increase in life expectancy and an... more Background The success of antiretroviral therapy has led to an increase in life expectancy and an associated rise in the risk of cardiometabolic diseases (CMDs) among people living with HIV. Objective Our aim was to conduct a systematic review to synthesize the existing literature on the patterns of use and effects of mobile health (mHealth) interventions for improving treatment adherence and outcomes of care for CMD among people living with HIV. Methods A systematic search of multiple databases, including PubMed-MEDLINE, Embase, CINAHL, Scopus, Web of Science, African Journals online, ClinicalTrials.gov, and the World Health Organization Global Index Medicus of peer-reviewed articles, was conducted with no date or language restrictions. Unpublished reports on mHealth interventions for treatment adherence and outcomes of care for CMD among adults living with HIV were also included in this review. Studies were included if they had at least 1 component that used an mHealth interventio...
Objectives: This study developed and compared the performance of three widely used predictive mod... more Objectives: This study developed and compared the performance of three widely used predictive models—logistic regression (LR), artificial neural network (ANN), and decision tree (DT)—to predict diabetes mellitus using the socio-demographic, lifestyle, and physical attributes of a population of Nigerians.Methods: We developed three predictive models using 10 input variables. Data preprocessing steps included the removal of missing values and outliers, min-max normalization, and feature extraction using principal component analysis. Data training and validation were accomplished using 10-fold cross-validation. Accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUROC) were used as performance evaluation metrics. Analysis and model development were performed in R version 3.6.1.Results: The mean age of the participants was 50.52 ± 16.14 years. The classification accuracy, sensit...
This study was carried out to assess the blood donation practices and willingness to donate among... more This study was carried out to assess the blood donation practices and willingness to donate among residents of an urban slum. Cross sectional descriptive study design with a qualitative and quantitative component. Multistage sampling was used to select 400 respondents for the questionnaire interview while three FGD sessions were conducted guide among three groups of participants namely youths, men and women. The information collected was analyzed manually (FGD) and with Epi info version 3.5.3. Majority of the questionnaire respondents were female, married, traders, had at least secondary school education, with mean age of 37.6 years. Only 12.0% had donated in the past, the main reason given by non donors was that they had never been asked to donate; this was also a key finding in the FGD. Willingness to donate was positively associated with being a male, single and Christian, age was a significant predictor of previous donation while more of the previous donors were still willing to...
This study sought to determine the sociodemographic correlates of exclusive and concurrent use of... more This study sought to determine the sociodemographic correlates of exclusive and concurrent use of smokeless tobacco (SLT) and smoking (i.e., dual use) and to explore the association between SLT use and the amount of cigarettes smoked per day. Data were obtained from a nationally representative sample of Nigerian men aged 15-59 years (N = 15,453) who participated in the 2008 Nigerian Demographic and Health Survey (NDHS). The NDHS used an interviewer-administered questionnaire to collect data on participants&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; sociodemographic characteristics and tobacco use status. Taking account of the multistage sampling used in the NDHS, data analyses included descriptive statistics, chi-square analysis, and multivariable adjusted multinomial logistic regression analysis. Of the respondents, 12.2% (n = 1,842) were tobacco users, out of which 24.5% (n = 477) were exclusive SLT users, 69% (n = 1,236) were exclusive smokers, and 6.5% (n = 129) were dual users. Both SLT use and smoking were most prevalent among the Igbo ethnic group and among the least educated men. SLT use was most prevalent among those in the southeast (9.75%) and north-central (7.71%) regions, where smoking was also common. The number of cigarettes smoked per day was not significantly different among dual users when compared with exclusive smokers (7.3 vs. 5.6; p = .088). Dual users were also more likely to self-identify as traditionalists (RRR = 6.03; 95% CI = 2.96-12.28) compared with self-identifying as practicing Islam or Christianity. There are distinctive ethnic and regional differences in tobacco use patterns among Nigerian men, and SLT use was not associated with reduced smoking intensity among dual users.
The American journal of tropical medicine and hygiene, Jan 15, 2014
Nigeria has the world's 10th largest tuberculosis (TB) burden. Targeted community-based inter... more Nigeria has the world's 10th largest tuberculosis (TB) burden. Targeted community-based interventions can potentially help reduce TB incidence. We designed an intervention in a periurban community where 10 community volunteers were trained to provide community TB education and also detect and refer TB suspects to a nearby clinic. To determine the effect of the intervention on knowledge, attitude, and preventive practices of TB, we compared results from a pre-intervention survey with those of a post-intervention survey. Pre-intervention, respondents had a mean knowledge score of 10.6 ± 7.0 of a possible 34, a mean attitude score of 5.8 ± 3.3 of a possible 10, and a mean practice score of 5.3 ± 1.4 of a possible 7. The intervention significantly increased the mean knowledge score to 16 ± 5.4 (P < 0.001) and mean attitude score to 7.0 ± 1.8 (P < 0.001); however, there was no statistically significant difference in the mean practice score. Eight TB suspects were referred to th...
Background Lagos state is the industrial nerve centre of Nigeria and was the epicentre of the 201... more Background Lagos state is the industrial nerve centre of Nigeria and was the epicentre of the 2014 Ebola outbreak in Nigeria as it is now for the current Coronavirus Disease (COVID-19) outbreak. This paper describes how the lessons learned from the Ebola outbreak in 2014 informed the emergency preparedness of the State ahead of the COVID-19 outbreak and guided response. Discussion Following the Ebola outbreak in 2014, the Lagos State government provided governance by developing a policy on emergency preparedness and biosecurity and provided oversight and coordination of emergency preparedness strategies. Capacities for emergency response were strengthened by training key staff, developing a robust surveillance system, and setting up a Biosafety Level 3 laboratory and biobank. Resource provision, in terms of finances and trained personnel for emergencies was prioritized by the government. With the onset of COVID-19, Lagos state was able to respond promptly to the outbreak using the c...
Purpose: Hepatocellular Carcinoma (HCC) is the leading cause of cancer-related mortality in Niger... more Purpose: Hepatocellular Carcinoma (HCC) is the leading cause of cancer-related mortality in Nigeria. HIV and viral hepatitis B (HBV) and C (HCV) co-infection are common in Nigeria that significantly accelerates liver disease progression including HCC. Aging-related DNA methylation signatures obtained in liquid biopsy, such as circulating cell-free DNA (ccfDNA) extracted from serum/plasma are promising minimally-invasive biomarkers that may inform HIV-associated HCC. We examined the epigenetic age acceleration (EpiAgeAccel) in ccfDNA in HCC patients with HIV. Methods: The study included three groups of participants: a) HIV positive with HCC (n=7); b) HIV positive and cancer-free (n=45); and c) HIV negative with HCC (n=33). Epigenetic age was estimated by Horvath9s calculator using genome-wide ccfDNA methylation data profiled by Illumina EPIC array. EpiAgeAccel was computed as the residuals of a linear model of epigenetic age on chronological age, namely the unexplained portion of epi...
Background: The coronavirus disease 2019 outbreak in Nigeria was first reported on the 27th Febru... more Background: The coronavirus disease 2019 outbreak in Nigeria was first reported on the 27th February 2020 and 95 days after, it had spread to 35 states and the Federal Capital Territory (FCT) with 10,162 confirmed cases. We reviewed the trends of the epidemic from the 27th February to the 31st May 2020, when it reached the 10,000th mark vis-à-vis government policies to contain the spread of the disease. Methods: We used publicly available data from the Nigeria Center for Disease Control from 27th February 2020, when Nigeria recorded her first coronavirus disease 2019 case to the 31st May 2020. We used line graphs to describe the trends of the daily course of cumulative cases, discharges and deaths in states and nationally. The doubling time, transmission rates were inferred from these trends and the epidemiological curve generated was reviewed vis-a-vis the instituted government policies over the specified period. Results: The epidemic curve in Nigeria has been on an upward trajectory as the number of cases crossed the 10,000 marks, 3 months after the first case was recorded. The first spike in the number of new cases was observed on the 21st April 2020, with 117 cases. The number of daily deaths within the study period was highest on the 2nd May 2020 (17 new deaths). Geo-political zone variations were also observed. Of the 63,882 screening tests conducted during the study period, 15.9% tested positive; the doubling time and transmission rates were 23.5 days and 1.0%, respectively, as at 31st May 2020. Since the lockdown measures were lifted in Lagos and the FCT on the 4th May 2020, the number of cases has been on a steady increase each week. Conclusion and Recommendations: In Nigeria, the epidemic curve has been on an upward direction since the first reported case and it took 3 months to reach 10,000 cases. We recommend a sustained drive in the enforcement of physical and social distancing and increase in testing capacity to flatten the epidemic curve.
Background: Over the past three decades, there has been an increase in the use of motorcycles as ... more Background: Over the past three decades, there has been an increase in the use of motorcycles as a means of transportation in Nigeria. Motorcycle-related crashes have also been on the rise, with human error accounting for up to 90% of traffic accidents in Nigeria. This study aimed to identify risky behaviors for road traffic crashes among commercial motorcyclists in Ikenne local government of Ogun State, Nigeria. Methods: This descriptive cross-sectional study was carried out among 400 commercial motorcyclists selected using multistage sampling method. A semi-structured, interviewer-administered questionnaire was used to elicit data about respondents' awareness of certain risky behaviors as causes of motorcycle crashes and their attitude toward and practice of such risky behaviors. Data were analyzed using SPSS version 16 and presented as chart and tables. Results: The mean age of the respondents was 33.7 ± 9.5 years. Only few (4.0%) had tertiary education. All of them were males. Awareness of risky behaviors was good with an average of 85.9%. Attitude to causes of accidents was also good, with 90.4% of the respondents having good attitude. However, most (95.5%) of the respondents demonstrated accident-related risky behavior(s). Risk behavior was statistically associated with younger age (P < 0.001), lower levels of education (P < 0.01), and training before commencement of trade (P < 0.05). Conclusion: Despite good awareness and attitude, most respondents demonstrated one risky behavior or the other. Younger age and poor educational status were statistically associated with risky behaviors. There is need for strict enforcement of traffic codes to ensure compliance.
Background: Iodine deficiency affects over 2.2 billion individuals globally. It is the most commo... more Background: Iodine deficiency affects over 2.2 billion individuals globally. It is the most common cause of hypothyroidism in pregnancy and remains the leading cause of preventable infant intellectual deficits. This study set out to determine the relationship between gestational age and iodine status in Nigerian women. Methods: This was a prospective cross-sectional study with a total study population of 220 pregnant and 110 nonpregnant participants. Urinary Iodine Excretion (UIE) was performed using the Sandell–Kolthoff reaction. Pregnant women were grouped into three trimesters (0–13 weeks, 14–26 weeks, and ≥27 weeks.). Analysis of variance was used in comparison of means, Chi-square test used in analyzing proportions, while P ≤ 0.05 was considered statistically significant. Results: The median UIE was 135 μg/L in pregnant and 120 μg/L in the nonpregnant women. Among the pregnant women, 133 (60.5%) had insufficient iodine intake (UIE <150 μg/L) while 29 (27.3%) of the nonpregnant women had inadequate iodine intake (UIE <100 μg/L). The median UIE was 140, 139, and 120 μg/L in the first, second, and third trimesters, respectively (P = 0.13). The median UIE declined with advancing gestational age. The percentage of pregnant women with inadequate iodine intake was 53.6% in the first trimester and 59% and 72.6% in the second and third trimesters, respectively (P = 0.03). Conclusion: Three-fifths of the pregnant women had inadequate iodine intake. The median UIE decreased with advancing gestation. Iodine supplementation before and during pregnancy would help improve the iodine status in pregnancy.
Background: The Lagos State Regulation of Smoking Law was passed in February 2014 and stipulates ... more Background: The Lagos State Regulation of Smoking Law was passed in February 2014 and stipulates the total restriction of tobacco smoking in listed public places. Workers in hospitality venues are at a high risk of exposure to second-hand smoke (SHS). Therefore, their awareness of the health risks, attitudes toward SHS and their reported levels of exposure may play a crucial role in developing an effective monitoring, implementation, and enforcement mechanism. Methods: We conducted a cross-sectional, descriptive study among workers in restaurants, bars, and nightclubs registered with the Lagos State Ministry of Tourism in the second quarter of the year 2014. We used a multistage sampling technique to select one respondent each from the 300 centers randomly selected to participate in the survey. Data were collected using a modified version of the World Health Organization Global tobacco surveillance system tools. Univariate and bivariate analysis were carried out. Exposure to SHS in the workplace and in other public places was treated as the outcome variable in the bivariate analysis. Results: Majority (75.3%) of the respondents were aged between 21 and 40 years with a mean age of 27.7 + 8.6 years. Many (66%) were waiters/waitresses and spent more than 8 h a day. Most (60.6%) of the venues were indoor only establishments, and 26.8% had no form of smoking restrictions. Majority of the respondents were exposed to SHS at work, and this was higher in bars and nightclubs. A bivariate analysis of results showed that workers were exposed to SHS at work irrespective of workplace smoking restrictions or respondents smoking status. Conclusion: Our study demonstrates that second-hand smoke exposure is very high (65% in smokers; 65.6% in nonsmokers) among workers in restaurants, bars, and nightclubs in Lagos State. We are therefore of the opinion that strict enforcement of law would ensure the protection of these workers.
Background: Nigeria still experiences a high burden of unsafe motherhood. The knowledge of obstet... more Background: Nigeria still experiences a high burden of unsafe motherhood. The knowledge of obstetric danger signs and the effective application of the principles of birth preparedness and complication readiness (BPACR) have the potential to significantly reduce the high maternal and perinatal morbidity and mortality rates. However, rural-urban differences may exist in the knowledge and practice of BPACR among women, and these may limit its potential benefit. We set out to assess and compare the knowledge of obstetric danger signs and practice of BPACR among pregnant women attending Rural (Agbowa) and Urban (Gbagada) Hospitals in Lagos State. Materials and Methods: In this cross-sectional comparative study, pregnant women attending antenatal clinics in each health facility were recruited into the study using a systematic sampling method. A structured interviewer administered questionnaire adapted from the safe motherhood John Hopkins Program for International Education in Gynecology and Obstetrics prototype questionnaire was used for data collection. Data were analyzed using SPSS version 17.0. Results: Awareness of obstetric danger signs during pregnancy was good among rural and urban study participants accounting for 62.4% and 68.4%, respectively. The most commonly identified danger sign in pregnancy, labor, and after delivery was bleeding from the genital tract. The awareness of danger signs during labor and after delivery identified by the women was low in both settings, though relatively higher in the urban area. The level of BPACR was low in both groups of women but was higher among women attending the urban center (31.6%) compared with the rural center (13.2%) P-value < 0.001. Conclusion and Recommendations: Activities aimed at improving birth preparedness practices particularly among rural women should be considered.
Background: Excess risk for cardiovascular disease, especially hypertension, may exist among huma... more Background: Excess risk for cardiovascular disease, especially hypertension, may exist among human immunodeficiency virus infection (HIV)-positive persons. This study was carried out to assess the prevalence of the behavioral risk factors for hypertension, including their awareness of these factors and their attitudes toward them. Methods: This descriptive cross-sectional study was conducted among 400 HIV-infected adults who accessed care in nine secondary health facilities in Lagos State, Nigeria. Respondents were selected by multistage sampling and data elicited using a structured, interviewer-administered questionnaire. Blood pressure (BP) was measured thrice and a respondent was considered as having raised BP if the mean of the last two measurements is ≥140 mm Hg (systolic BP) or ≥90 mm Hg (diastolic BP) or if respondents are currently taking anti-hypertensive. Results: Prevalence of key behavioral risk factors for hypertension was high. For instance, 82.0% of the respondents were physically inactive. Stress and physical inactivity were the two most known risks of hypertension, identified by 87.3% and 70.5% of the respondents, respectively. Majority (66.0%) had positive attitudes toward hypertension risk factors and 26.7% of them had raised BP. Lower age, that is, 30 years and below (OR = 2.89, 95% CI = 1.26–6.64), BMI of less than 25 (OR = 1.87, 95 CI = 1.16–3.01), and being diagnosed of HIV for 5 years and less (OR = 1.62, 95% CI = 1.006–2.62) were significantly associated with normal BP measurements among respondents. Conclusion: The proportion of people living with HIV/AIDS who show known behaviors that place them at risk for hypertension is high. Measures to address these risk factors among them are warranted.
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Papers by Oluwakemi Odukoya