Dr George Eleje is a senior lecturer and researcher with the Nnamdi Azikiwe University Awka in Nigeria. He is a Cochrane author and reviewer and has numerous scientific publications. Address: Nnewi, Anambra State Nigeria
Background: Despite the cesarean section (CS) associated morbidities, only few studies have focus... more Background: Despite the cesarean section (CS) associated morbidities, only few studies have focused on long-term associations for children delivered by CS. Although some previous studies have suggested association between CS and neurodevelopmental disorders leading to poor academic achievement, none were randomized in design and findings could be at high risks of performance or detection bias. Also, most previous studies suffer from a long-term follow-up time and a lack of adjustment for major confounders. Objectives: To determine the impact of CS birth route on academic achievement among adolescents. Materials and methods: A randomized control trial was conducted in consenting 210 senior secondary 3 students offering economics in four coeducational schools. The mode of delivery was categorised as: vaginal delivery (VD), and cesarean section (CS). Following an initial base line pretest assessment, coeducational schools were randomized into 4 different arms viz Diagnostic Quantitative Economics Skill Test (DQEST) with feedback and remediation (CS=8; VD=52), DQEST with feedback (CS=4; VD=58), DQEST without feedback and remediation (CS=8; VD=35), and no DQEST, (CS=8; VD=37). Seven weeks post-intervention, posttest was done on all the participants to ascertain effect of CS on academic performance. The exclusion criteria were refusal of follow-up and students inability to know their route of birth. The students’ pretest and posttest scores were obtained using a Test of Achievement in Quantitative Economics (TAQE) comprising of 20 multiple-choice questions. Analysis was by SPSS version 23. A p-value ≤0.05 was taken as significant. Results: Of the 210 students randomized, 28 were delivered via CS while 182 were delivered via VD. The mean age was 18.6 ± 3.1 years (16-20 years). The result of pretest revealed no significance difference in the performance between adolescents that were delivered via CS and those delivered via VD in each of the group (P>0.05, for all). Post test results showed that among participants that were randomized into the control group that did not receive any of diagnostic test, feedback or remediation, adolescents delivered via CS performed significantly lower compared with those that had VD (p=0.0393). Conclusion: Without diagnostic test, feedback and/or remediation, adolescents delivered by CS had significantly lower academic achievement. Further research is needed to check the consistency of findings and to identify whether the relationship is causal.
Objective: To determine the predictors of payment methods for health care, perception and use of ... more Objective: To determine the predictors of payment methods for health care, perception and use of National health insurance scheme (NHIS) among pregnant women in a low income country. Methods: An adapted, pretested, semi-structured, interviewer administered questionnaire was used to collect data from 770 pregnant women attending antenatal care (ANC) services in the two selected tertiary health institutions in southeast Nigeria. All consenting pregnant women attending ANC in the facilities irrespective of age and reason for visit were included. Data analysis was by SPSS version 25. Logistic regression model was used to predict the factors influencing perception and use of NHIS. Statistical significance was accepted when P-value was <0.05. Results: Up to 70.9% of the respondents pay for health care out of their pockets for health services while only 20.0% use the NHIS. Fifty-two percent practice a monthly budget while 67.0% were aware of NHIS. The women had varied perceptions and concerns about NHIS which ranged from inability of the scheme to cover healthcare costs, and reduce hardships from high cost of health care to use of poor quality drugs. Eight (5.2%) of the 154 women that registered with the scheme had never used it. There were statistically significant association between level of education (x 2 = 107.7, p<0.001), respondents' occupation (x 2 =49.6, p<0.001), respondents' spouse occupation (x 2 =103.3, p<0.001), monthly income (x 2 =55.0, p<0.001) as well as age of the respondent (x 2 =8.2, p=0.004) and the awareness of NHIS in both facilities. Respondents aged less than 39 years were 0.46 times less likely to use NHIS compared to those 39 years and above (AOR=0.46, p< 0.022, 95%CI = 0.236-0.900). Use of NHIS was significantly associated with educational level (x 2 =19.0, p<0.001) and occupation of spouse (x 2 =24.0, p<0.001) in both facilities. There was a significant difference in the method of use of NHIS between the two hospitals (x 2 =14.83, p<0.001). Conclusion: Majority of pregnant women still pay for health care by out-of-pocket method and awareness about the NHIS was fair and a good number of the women were willing to enrol in the scheme if offered the opportunity. Significant predictors for NHIS use were maternal age, occupation of spouse and income.
Background: Genuine preterm labor precedes almost half of preterm births and preterm birth is the... more Background: Genuine preterm labor precedes almost half of preterm births and preterm birth is the leading cause of high prematurity and neonatal mortality indices in the world. In Nigeria, there is a paucity of recent data on the pattern of preterm labor and preterm births, including its prevalence and neonatal outcome. Objective: To determine the prevalence, patterns and immediate neonatal outcomes of preterm labor and preterm births in a single center population. Methods: This was a retrospective cross-sectional analytical study of all pregnant women who had preterm Obstet Gynecol Res 2020; 3 (1): 017-028. Women who delivered outside the study hospital were excluded. Data was manually collected from the patients' case files using a proforma and analyzed using a Statistical Package for Social Sciences (SPSS) version 20. P < 0.05 was considered statistically significant. Results: A total of 1573 deliveries were recorded of which 139 had preterm births, giving a prevalence of 8.8%. Thirty-five women had spontaneous, genuine preterm labor, giving a prevalence of 2.2%. The mean age of the women was 30.2 ± 2.3 years. Forty seven (33.8%) women were nulliparous, while 12 (8.6%) were grand multiparous. Majority, 103 (74.1%) were unbooked. Sixty five (46.8%) of the preterm births were iatrogenic while 35 (25.2%) were due to spontaneous preterm labor. Of the 139 women, 81 (58.3%) delivered via cesarean section and 125 (89.9%) had singleton births. Fifty four (38.8%) of the preterm babies had a birth weight of 1500-2499 grams, while the 14 (10.1%) had a birth-weight in <1000 grams. Seventy seven (55.4%) of the babies were males. One hundred and four (74.8%) babies were non-asphyxiated, 18.0% had a stillbirth, although 12 (8.6%) had immediate neonatal deaths while 102 (73.4%) were live births. Ninety one (65.5%) preterm babies did not require immediate resuscitation while 87 (62.6%) babies required admission into the Special Care Baby Unit. Sixty three (45.3%) preterm babies were moderate to late preterm (32 to <37 weeks), 58 (41.7%) were very preterm babies (28 to <32 weeks) and 18 (12.9%) were extremely preterm babies. There was statistical significance, association between the gestational age at birth and some neonatal outcomes such as birth weight (p-value=<0.001), Apgar scores (p-value=0.002), and the need for immediate neonatal resuscitation (p-value=0.010) Conclusion: The prevalence of preterm birth and spontaneous, genuine preterm labor was high in Nnewi, Nigeria and iatrogenic preterm births predominate. There were significance association between gestational age at preterm birth and route of delivery, birth weight, Apgar scores, and need for immediate neonatal resuscitation. Women and neonates at greater risk of preterm births need optimal care to improve survival.
The Journal of Maternal-Fetal & Neonatal Medicine, 2015
To determine diagnostic performance of placental alpha-microglobulin-1 (PAMG-1) test compared to ... more To determine diagnostic performance of placental alpha-microglobulin-1 (PAMG-1) test compared to conventional clinical assessment (CCA) in women with prolonged pre-labour rupture of membranes (PROM). A double-blind study of women with symptoms and signs of PROM in Nnamdi Azikiwe University Teaching Hospital, Nnewi and University of Nigeria Teaching Hospital, Enugu, in south-east Nigeria using CCA for PROM and PAMG-1 test was done. Women were included if their symptoms, signs or complaints suggestive of PROM was more than 24 h duration. PROM was diagnosed if two out of three methods from CCA (pooling, positive nitrazine test or ferning) were present. Confirmation of PROM was done after delivery using any two of these clinical criteria: delivery in 48 h to 7 days, evidence of chorioamnionitis, membranes obviously ruptured at delivery and adverse perinatal outcomes strongly correlated with prolonged PROM. Accuracy, specificity and sensitivity value for CCA were 72.5, 36.8 and 86.0% lower than for PAMG-1 test which were 95.7, 94.1 and 96.2%. In equivocal cases, PAMG-1 was significantly more accurate than CCA (92.3% versus 38.5%; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). This study in women with prolonged PROM, confirms that PAMG-1 test has high diagnostic accuracy irrespective of the duration of PROM before clinical evaluation.
To determine the seroreactivity of pregnant women to syphilis in order to justify the need for ro... more To determine the seroreactivity of pregnant women to syphilis in order to justify the need for routine antenatal syphilis screening. A multicenter retrospective analysis of routine antenatal venereal disease research laboratory (VDRL) test results between 1 September 2010 and 31 August 2012 at three specialist care hospitals in south-east Nigeria was done. A reactive VDRL result is subjected for confirmation using Treponema pallidum hemagglutination assay test. Analysis was by Epi Info 2008 version 3.5.1 and Stata/IC version 10. Adequate records were available regarding 2,156 patients and were thus reviewed. The mean age of the women was 27.4 years (±3.34), and mean gestational age was 26.4 weeks (±6.36). Only 15 cases (0.70%) were seropositive to VDRL. Confirmatory T. pallidum hemagglutination assay was positive in 4 of the 15 cases, giving an overall prevalence of 0.19% and a false-positive rate of 73.3%. There was no significant difference in the prevalence of syphilis in relation to maternal age and parity (P&gt;0.05). While the prevalence of syphilis is extremely low in the antenatal care population at the three specialist care hospitals in south-east Nigeria, false-positive rate is high and prevalence did not significantly vary with maternal age or parity. Because syphilis is still a serious but preventable and curable disease, screening with VDRL alone, without confirmatory tests may not be justified. Because of the increase in the demand for evidence-based medicine and litigation encountered in medical practice, we may advocate that confirmatory test for syphilis is introduced in routine antenatal testing to reduce the problem of false positives. The government should increase the health budget that will include free routine antenatal testing including the T. pallidum hemagglutination assay.
Nigerian medical journal : journal of the Nigeria Medical Association, 2014
The management of a large incisional hernia amidst gravid uterus in its sac is a very challenging... more The management of a large incisional hernia amidst gravid uterus in its sac is a very challenging obstetric entity. Because of the uncommonness of this entity, there has not been any evidence-based guideline regarding the optimal mode of treatment and so treatment is largely individualised. We present the case of a 32-year-old booked G7P6+0 Nigerian woman with two living children who was already booked for elective repeat lower segment Caesarean section (CS) and &amp;amp;amp;amp;#39;Caesarean&amp;amp;amp;amp;#39; herniorrhaphy at 38 weeks of gestation but only to present at 36-weeks gestation with a 4-hour history of labour pains. She had an emergency lower segment CS 2 years earlier due to obstructed labour but the CS was complicated by wound infection. Examination revealed gravid uterus that herniated through the incisional hernia. She subsequently had emergency lower segment CS with the repair of the hernia with polypropylene mesh. She had uneventful post-operative recovery. Herniated uterus of near-term pregnancy through an incisional hernia has not been reported in our hospital. As in our case, triumphant management required brave but multidisciplinary approach and currently there are emerging management options such as the use of mesh and laparoscopic technique.
Background: Despite the cesarean section (CS) associated morbidities, only few studies have focus... more Background: Despite the cesarean section (CS) associated morbidities, only few studies have focused on long-term associations for children delivered by CS. Although some previous studies have suggested association between CS and neurodevelopmental disorders leading to poor academic achievement, none were randomized in design and findings could be at high risks of performance or detection bias. Also, most previous studies suffer from a long-term follow-up time and a lack of adjustment for major confounders. Objectives: To determine the impact of CS birth route on academic achievement among adolescents. Materials and methods: A randomized control trial was conducted in consenting 210 senior secondary 3 students offering economics in four coeducational schools. The mode of delivery was categorised as: vaginal delivery (VD), and cesarean section (CS). Following an initial base line pretest assessment, coeducational schools were randomized into 4 different arms viz Diagnostic Quantitative Economics Skill Test (DQEST) with feedback and remediation (CS=8; VD=52), DQEST with feedback (CS=4; VD=58), DQEST without feedback and remediation (CS=8; VD=35), and no DQEST, (CS=8; VD=37). Seven weeks post-intervention, posttest was done on all the participants to ascertain effect of CS on academic performance. The exclusion criteria were refusal of follow-up and students inability to know their route of birth. The students’ pretest and posttest scores were obtained using a Test of Achievement in Quantitative Economics (TAQE) comprising of 20 multiple-choice questions. Analysis was by SPSS version 23. A p-value ≤0.05 was taken as significant. Results: Of the 210 students randomized, 28 were delivered via CS while 182 were delivered via VD. The mean age was 18.6 ± 3.1 years (16-20 years). The result of pretest revealed no significance difference in the performance between adolescents that were delivered via CS and those delivered via VD in each of the group (P>0.05, for all). Post test results showed that among participants that were randomized into the control group that did not receive any of diagnostic test, feedback or remediation, adolescents delivered via CS performed significantly lower compared with those that had VD (p=0.0393). Conclusion: Without diagnostic test, feedback and/or remediation, adolescents delivered by CS had significantly lower academic achievement. Further research is needed to check the consistency of findings and to identify whether the relationship is causal.
Objective: To determine the predictors of payment methods for health care, perception and use of ... more Objective: To determine the predictors of payment methods for health care, perception and use of National health insurance scheme (NHIS) among pregnant women in a low income country. Methods: An adapted, pretested, semi-structured, interviewer administered questionnaire was used to collect data from 770 pregnant women attending antenatal care (ANC) services in the two selected tertiary health institutions in southeast Nigeria. All consenting pregnant women attending ANC in the facilities irrespective of age and reason for visit were included. Data analysis was by SPSS version 25. Logistic regression model was used to predict the factors influencing perception and use of NHIS. Statistical significance was accepted when P-value was <0.05. Results: Up to 70.9% of the respondents pay for health care out of their pockets for health services while only 20.0% use the NHIS. Fifty-two percent practice a monthly budget while 67.0% were aware of NHIS. The women had varied perceptions and concerns about NHIS which ranged from inability of the scheme to cover healthcare costs, and reduce hardships from high cost of health care to use of poor quality drugs. Eight (5.2%) of the 154 women that registered with the scheme had never used it. There were statistically significant association between level of education (x 2 = 107.7, p<0.001), respondents' occupation (x 2 =49.6, p<0.001), respondents' spouse occupation (x 2 =103.3, p<0.001), monthly income (x 2 =55.0, p<0.001) as well as age of the respondent (x 2 =8.2, p=0.004) and the awareness of NHIS in both facilities. Respondents aged less than 39 years were 0.46 times less likely to use NHIS compared to those 39 years and above (AOR=0.46, p< 0.022, 95%CI = 0.236-0.900). Use of NHIS was significantly associated with educational level (x 2 =19.0, p<0.001) and occupation of spouse (x 2 =24.0, p<0.001) in both facilities. There was a significant difference in the method of use of NHIS between the two hospitals (x 2 =14.83, p<0.001). Conclusion: Majority of pregnant women still pay for health care by out-of-pocket method and awareness about the NHIS was fair and a good number of the women were willing to enrol in the scheme if offered the opportunity. Significant predictors for NHIS use were maternal age, occupation of spouse and income.
Background: Genuine preterm labor precedes almost half of preterm births and preterm birth is the... more Background: Genuine preterm labor precedes almost half of preterm births and preterm birth is the leading cause of high prematurity and neonatal mortality indices in the world. In Nigeria, there is a paucity of recent data on the pattern of preterm labor and preterm births, including its prevalence and neonatal outcome. Objective: To determine the prevalence, patterns and immediate neonatal outcomes of preterm labor and preterm births in a single center population. Methods: This was a retrospective cross-sectional analytical study of all pregnant women who had preterm Obstet Gynecol Res 2020; 3 (1): 017-028. Women who delivered outside the study hospital were excluded. Data was manually collected from the patients' case files using a proforma and analyzed using a Statistical Package for Social Sciences (SPSS) version 20. P < 0.05 was considered statistically significant. Results: A total of 1573 deliveries were recorded of which 139 had preterm births, giving a prevalence of 8.8%. Thirty-five women had spontaneous, genuine preterm labor, giving a prevalence of 2.2%. The mean age of the women was 30.2 ± 2.3 years. Forty seven (33.8%) women were nulliparous, while 12 (8.6%) were grand multiparous. Majority, 103 (74.1%) were unbooked. Sixty five (46.8%) of the preterm births were iatrogenic while 35 (25.2%) were due to spontaneous preterm labor. Of the 139 women, 81 (58.3%) delivered via cesarean section and 125 (89.9%) had singleton births. Fifty four (38.8%) of the preterm babies had a birth weight of 1500-2499 grams, while the 14 (10.1%) had a birth-weight in <1000 grams. Seventy seven (55.4%) of the babies were males. One hundred and four (74.8%) babies were non-asphyxiated, 18.0% had a stillbirth, although 12 (8.6%) had immediate neonatal deaths while 102 (73.4%) were live births. Ninety one (65.5%) preterm babies did not require immediate resuscitation while 87 (62.6%) babies required admission into the Special Care Baby Unit. Sixty three (45.3%) preterm babies were moderate to late preterm (32 to <37 weeks), 58 (41.7%) were very preterm babies (28 to <32 weeks) and 18 (12.9%) were extremely preterm babies. There was statistical significance, association between the gestational age at birth and some neonatal outcomes such as birth weight (p-value=<0.001), Apgar scores (p-value=0.002), and the need for immediate neonatal resuscitation (p-value=0.010) Conclusion: The prevalence of preterm birth and spontaneous, genuine preterm labor was high in Nnewi, Nigeria and iatrogenic preterm births predominate. There were significance association between gestational age at preterm birth and route of delivery, birth weight, Apgar scores, and need for immediate neonatal resuscitation. Women and neonates at greater risk of preterm births need optimal care to improve survival.
The Journal of Maternal-Fetal & Neonatal Medicine, 2015
To determine diagnostic performance of placental alpha-microglobulin-1 (PAMG-1) test compared to ... more To determine diagnostic performance of placental alpha-microglobulin-1 (PAMG-1) test compared to conventional clinical assessment (CCA) in women with prolonged pre-labour rupture of membranes (PROM). A double-blind study of women with symptoms and signs of PROM in Nnamdi Azikiwe University Teaching Hospital, Nnewi and University of Nigeria Teaching Hospital, Enugu, in south-east Nigeria using CCA for PROM and PAMG-1 test was done. Women were included if their symptoms, signs or complaints suggestive of PROM was more than 24 h duration. PROM was diagnosed if two out of three methods from CCA (pooling, positive nitrazine test or ferning) were present. Confirmation of PROM was done after delivery using any two of these clinical criteria: delivery in 48 h to 7 days, evidence of chorioamnionitis, membranes obviously ruptured at delivery and adverse perinatal outcomes strongly correlated with prolonged PROM. Accuracy, specificity and sensitivity value for CCA were 72.5, 36.8 and 86.0% lower than for PAMG-1 test which were 95.7, 94.1 and 96.2%. In equivocal cases, PAMG-1 was significantly more accurate than CCA (92.3% versus 38.5%; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). This study in women with prolonged PROM, confirms that PAMG-1 test has high diagnostic accuracy irrespective of the duration of PROM before clinical evaluation.
To determine the seroreactivity of pregnant women to syphilis in order to justify the need for ro... more To determine the seroreactivity of pregnant women to syphilis in order to justify the need for routine antenatal syphilis screening. A multicenter retrospective analysis of routine antenatal venereal disease research laboratory (VDRL) test results between 1 September 2010 and 31 August 2012 at three specialist care hospitals in south-east Nigeria was done. A reactive VDRL result is subjected for confirmation using Treponema pallidum hemagglutination assay test. Analysis was by Epi Info 2008 version 3.5.1 and Stata/IC version 10. Adequate records were available regarding 2,156 patients and were thus reviewed. The mean age of the women was 27.4 years (±3.34), and mean gestational age was 26.4 weeks (±6.36). Only 15 cases (0.70%) were seropositive to VDRL. Confirmatory T. pallidum hemagglutination assay was positive in 4 of the 15 cases, giving an overall prevalence of 0.19% and a false-positive rate of 73.3%. There was no significant difference in the prevalence of syphilis in relation to maternal age and parity (P&gt;0.05). While the prevalence of syphilis is extremely low in the antenatal care population at the three specialist care hospitals in south-east Nigeria, false-positive rate is high and prevalence did not significantly vary with maternal age or parity. Because syphilis is still a serious but preventable and curable disease, screening with VDRL alone, without confirmatory tests may not be justified. Because of the increase in the demand for evidence-based medicine and litigation encountered in medical practice, we may advocate that confirmatory test for syphilis is introduced in routine antenatal testing to reduce the problem of false positives. The government should increase the health budget that will include free routine antenatal testing including the T. pallidum hemagglutination assay.
Nigerian medical journal : journal of the Nigeria Medical Association, 2014
The management of a large incisional hernia amidst gravid uterus in its sac is a very challenging... more The management of a large incisional hernia amidst gravid uterus in its sac is a very challenging obstetric entity. Because of the uncommonness of this entity, there has not been any evidence-based guideline regarding the optimal mode of treatment and so treatment is largely individualised. We present the case of a 32-year-old booked G7P6+0 Nigerian woman with two living children who was already booked for elective repeat lower segment Caesarean section (CS) and &amp;amp;amp;amp;#39;Caesarean&amp;amp;amp;amp;#39; herniorrhaphy at 38 weeks of gestation but only to present at 36-weeks gestation with a 4-hour history of labour pains. She had an emergency lower segment CS 2 years earlier due to obstructed labour but the CS was complicated by wound infection. Examination revealed gravid uterus that herniated through the incisional hernia. She subsequently had emergency lower segment CS with the repair of the hernia with polypropylene mesh. She had uneventful post-operative recovery. Herniated uterus of near-term pregnancy through an incisional hernia has not been reported in our hospital. As in our case, triumphant management required brave but multidisciplinary approach and currently there are emerging management options such as the use of mesh and laparoscopic technique.
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Papers by George U ELEJE
Objectives: To determine the impact of CS birth route on academic achievement among adolescents.
Materials and methods: A randomized control trial was conducted in consenting 210 senior secondary 3 students offering economics in four coeducational schools. The mode of delivery was categorised as: vaginal delivery (VD), and cesarean section (CS). Following an initial base line pretest assessment, coeducational schools were randomized into 4 different arms viz Diagnostic Quantitative Economics Skill Test (DQEST) with feedback and remediation (CS=8; VD=52), DQEST with feedback (CS=4; VD=58), DQEST without feedback and remediation (CS=8; VD=35), and no DQEST, (CS=8; VD=37). Seven weeks post-intervention, posttest was done on all the participants to ascertain effect of CS on academic performance. The exclusion criteria were refusal of follow-up and students inability to know their route of birth. The students’ pretest and posttest scores were obtained using a Test of Achievement in Quantitative Economics (TAQE) comprising of 20 multiple-choice questions. Analysis was by SPSS version 23. A p-value ≤0.05 was taken as significant.
Results: Of the 210 students randomized, 28 were delivered via CS while 182 were delivered via VD. The
mean age was 18.6 ± 3.1 years (16-20 years). The result of pretest revealed no significance difference in the performance between adolescents that were delivered via CS and those delivered via VD in each of the group (P>0.05, for all). Post test results showed that among participants that were randomized into the control group that did not receive any of diagnostic test, feedback or remediation, adolescents delivered via CS performed significantly lower compared with those that had VD (p=0.0393).
Conclusion: Without diagnostic test, feedback and/or remediation, adolescents delivered by CS had significantly lower academic achievement. Further research is needed to check the consistency of findings and to identify whether the relationship is causal.
Objectives: To determine the impact of CS birth route on academic achievement among adolescents.
Materials and methods: A randomized control trial was conducted in consenting 210 senior secondary 3 students offering economics in four coeducational schools. The mode of delivery was categorised as: vaginal delivery (VD), and cesarean section (CS). Following an initial base line pretest assessment, coeducational schools were randomized into 4 different arms viz Diagnostic Quantitative Economics Skill Test (DQEST) with feedback and remediation (CS=8; VD=52), DQEST with feedback (CS=4; VD=58), DQEST without feedback and remediation (CS=8; VD=35), and no DQEST, (CS=8; VD=37). Seven weeks post-intervention, posttest was done on all the participants to ascertain effect of CS on academic performance. The exclusion criteria were refusal of follow-up and students inability to know their route of birth. The students’ pretest and posttest scores were obtained using a Test of Achievement in Quantitative Economics (TAQE) comprising of 20 multiple-choice questions. Analysis was by SPSS version 23. A p-value ≤0.05 was taken as significant.
Results: Of the 210 students randomized, 28 were delivered via CS while 182 were delivered via VD. The
mean age was 18.6 ± 3.1 years (16-20 years). The result of pretest revealed no significance difference in the performance between adolescents that were delivered via CS and those delivered via VD in each of the group (P>0.05, for all). Post test results showed that among participants that were randomized into the control group that did not receive any of diagnostic test, feedback or remediation, adolescents delivered via CS performed significantly lower compared with those that had VD (p=0.0393).
Conclusion: Without diagnostic test, feedback and/or remediation, adolescents delivered by CS had significantly lower academic achievement. Further research is needed to check the consistency of findings and to identify whether the relationship is causal.