Recently acquired olfactory dysfunction (OD) has emerged as one of the hallmark manifestations of the novel coronavirus disease (COVID-19), but the evolution of its spontaneous recovery has remained inconclusive, with reports of persistence of OD beyond 6 months of onset. We undertook this systematic review and meta-analysis with a view of generating a pooled recovery rate of COVID-19-associated ODs and attempt to examine the predictors of olfactory recovery. A systematic search of Scopus, Google Scholar, and PubMed databases, comprising all longitudinal studies reporting the trajectory of COVID-19-related OD, was carried out. The pooled recovery rate was estimated with random-effects model, and the potential heterogeneity of the subgroup sources was analyzed using a meta-regression test. After the Preferred Reporting Items for Systematic Reviews and Meta-Analysis selection process, 28 studies from 16 countries were included, with a total of 5,175 OD patients, among 11,948 COVID-19 cases. The estimated global pooled recovery rate of OD was 82.7% (95% confidence interval, 77.46–88.04%), with a pooled median duration of OD of 11.6 days. Only 2 out of 28 studies had recovery data beyond a period of 2 months. But no significant difference was found in the recovery rate regarding the length of follow-up (P = 0.840). Studies that conducted objective olfactory assessments showed a significantly higher recovery rate than those with subjective assessments (P = 0.001). Although 10 studies (36%) reported >90% recovery, 9 studies (32%) documented persistence of OD in >25% of their patients. Five out of six studies showed that hyposnia tended to show complete recovery than anosmia. Age, co-morbidities, and intranasal treatments had no effects. Test of homogeneity between subgroups using Cochran’s Q test was not significant (Q = 0.69, P = 0.40). Our meta-analysis revealed high rates of early- and medium-term recovery of COVID-19-related OD. However, it also showed disturbing rates of persistence of OD. Anosmia tended to be predictive of residual OD than hyposmia. Age, comorbidities, intranasal corticosteroid, and decongestants had no effects on OD recovery.
{"title":"Evolution of COVID-19-related olfactory disorders: A systematic review and meta-analysis","authors":"F. Orji, J. Akpeh, Nekwu E. Okolugbo, E. Chime","doi":"10.4103/ijmh.ijmh_42_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_42_22","url":null,"abstract":"Recently acquired olfactory dysfunction (OD) has emerged as one of the hallmark manifestations of the novel coronavirus disease (COVID-19), but the evolution of its spontaneous recovery has remained inconclusive, with reports of persistence of OD beyond 6 months of onset. We undertook this systematic review and meta-analysis with a view of generating a pooled recovery rate of COVID-19-associated ODs and attempt to examine the predictors of olfactory recovery. A systematic search of Scopus, Google Scholar, and PubMed databases, comprising all longitudinal studies reporting the trajectory of COVID-19-related OD, was carried out. The pooled recovery rate was estimated with random-effects model, and the potential heterogeneity of the subgroup sources was analyzed using a meta-regression test. After the Preferred Reporting Items for Systematic Reviews and Meta-Analysis selection process, 28 studies from 16 countries were included, with a total of 5,175 OD patients, among 11,948 COVID-19 cases. The estimated global pooled recovery rate of OD was 82.7% (95% confidence interval, 77.46–88.04%), with a pooled median duration of OD of 11.6 days. Only 2 out of 28 studies had recovery data beyond a period of 2 months. But no significant difference was found in the recovery rate regarding the length of follow-up (P = 0.840). Studies that conducted objective olfactory assessments showed a significantly higher recovery rate than those with subjective assessments (P = 0.001). Although 10 studies (36%) reported >90% recovery, 9 studies (32%) documented persistence of OD in >25% of their patients. Five out of six studies showed that hyposnia tended to show complete recovery than anosmia. Age, co-morbidities, and intranasal treatments had no effects. Test of homogeneity between subgroups using Cochran’s Q test was not significant (Q = 0.69, P = 0.40). Our meta-analysis revealed high rates of early- and medium-term recovery of COVID-19-related OD. However, it also showed disturbing rates of persistence of OD. Anosmia tended to be predictive of residual OD than hyposmia. Age, comorbidities, intranasal corticosteroid, and decongestants had no effects on OD recovery.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":"28 1","pages":"326 - 336"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78618149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Okechukwu Ozoalor, A. Ikefuna, A. Aronu, N. Ojinnaka
Background: Adolescent obesity is a serious public health issue. Inconsistent findings on its association with mental health problems are reported. Objective: This study aimed to determine the prevalence, pattern, and sociodemographic correlates of psychosocial disorders among obese adolescents in Enugu metropolis, Nigeria. Materials and Methods: A cross-sectional study was conducted over a 5-month period in 16 secondary schools in Enugu, Nigeria. A multi-staged systematic sampling technique was used to select participating schools. A total of 4364 adolescents aged 10–19 years from these schools were screened for obesity by measuring their height and weight, and calculating their body mass indices (BMIs), which were plotted on the Centers for Disease Control and Prevention BMI percentile chart. Seventy-four obese students were identified, and from their respective class registers, systematic sampling scheme was applied in selection of equal number of apparently healthy normal BMI (5th–84th percentile) controls matched for age and sex. The youth version of the Pediatric Symptom Checklist was used to screen for psychosocial disorder in the study participants. Results: The prevalence of psychosocial disorder was 17.6% and 12.2% among the obese and control adolescents, respectively (P = 0.02). Attention and externalizing problems were the highest among the obese adolescents, whereas psychosocial disorders were more in females than males (28.1% vs 9.5%; χ2 = 4.34, P = 0.04). Conclusion: Obese adolescents have a higher prevalence of psychosocial disorder compared to controls, with attention and externalizing problems being most common, and this was influenced by gender. Periodic assessment of the mental health of obese adolescents is advocated.
{"title":"Prevalence, Pattern and Sociodemographic Correlates of Psychosocial Disorders in Obese Adolescents in Enugu, Nigeria","authors":"Okechukwu Ozoalor, A. Ikefuna, A. Aronu, N. Ojinnaka","doi":"10.4103/ijmh.ijmh_40_21","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_40_21","url":null,"abstract":"Background: Adolescent obesity is a serious public health issue. Inconsistent findings on its association with mental health problems are reported. Objective: This study aimed to determine the prevalence, pattern, and sociodemographic correlates of psychosocial disorders among obese adolescents in Enugu metropolis, Nigeria. Materials and Methods: A cross-sectional study was conducted over a 5-month period in 16 secondary schools in Enugu, Nigeria. A multi-staged systematic sampling technique was used to select participating schools. A total of 4364 adolescents aged 10–19 years from these schools were screened for obesity by measuring their height and weight, and calculating their body mass indices (BMIs), which were plotted on the Centers for Disease Control and Prevention BMI percentile chart. Seventy-four obese students were identified, and from their respective class registers, systematic sampling scheme was applied in selection of equal number of apparently healthy normal BMI (5th–84th percentile) controls matched for age and sex. The youth version of the Pediatric Symptom Checklist was used to screen for psychosocial disorder in the study participants. Results: The prevalence of psychosocial disorder was 17.6% and 12.2% among the obese and control adolescents, respectively (P = 0.02). Attention and externalizing problems were the highest among the obese adolescents, whereas psychosocial disorders were more in females than males (28.1% vs 9.5%; χ2 = 4.34, P = 0.04). Conclusion: Obese adolescents have a higher prevalence of psychosocial disorder compared to controls, with attention and externalizing problems being most common, and this was influenced by gender. Periodic assessment of the mental health of obese adolescents is advocated.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":"53 1","pages":"292 - 299"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81889020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chidiebere J. Otti, E. Izuka, C. Obiora-Izuka, Okechukwu Ifebi, L. Ikeako, U. Nwagha
Background: One per cent of women diagnosed with cervical cancer are pregnant or postpartum at the time of diagnosis. Therefore, awareness during pregnancy is of utmost significance. Objective: To determine predictors of knowledge of cervical cancer screening among pregnant women who attended antenatal clinics in Enugu, Nigeria. Materials and Methods: It was a descriptive cross-sectional study of 419 pregnant women who attended antenatal care at the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu (139) and the Mother of Christ Specialist Hospital, Enugu (280). A multistage random sampling method was used to select the study centres and the participants. The questionnaires were administered by the interviewers and the data collected included sociodemographic characteristics, knowledge, and practice of cervical cancer screening. Data were analyzed using SPSS version 23. Results: The mean age of the participants was 28.86 ± 5.69, Christians (92.7%), and married (82.5%). Most of the respondents (82.3%) heard about cervical cancer screening methods through their gynecologists and of the 198 respondents who have heard about cervical cancer screening, 151 (76.3%) knew about Pap smear. One hundred thirty-eight (69.7%) of the participants believe that screening for premalignant lesions of the cervix can be performed during pregnancy. Only 37.9% of the participants had ever done Pap’s smear in the past 3 years. Respondents with higher social status (Civil/Public servants) were 10 times more likely to know about cervical cancer screening than those with lower social status (Trader/farmer/artisan) (P = 0.027, OR = 9.957, 95% CI = 1.301 – 76.191). Conclusion: Higher social status is more predictive of knowledge of cervical cancer screening amongst pregnant women attending antenatal clinics. Gynaecologist disseminate the information on cervical cancer screening more and Pap’s smear remain the main screening modality known to pregnant women. Efforts should be made by other health workers and the media to disseminate appropriate information on screening modalities for the prevention of cervical cancer
背景:诊断为宫颈癌的妇女中有1%在诊断时怀孕或产后。因此，怀孕期间的意识是至关重要的。目的:确定在尼日利亚埃努古参加产前诊所的孕妇中宫颈癌筛查知识的预测因素。材料和方法:这是一项描述性横断面研究，对在埃努古伊图库-奥扎拉尼日利亚大学教学医院(139人)和埃努古基督之母专科医院(280人)接受产前护理的419名孕妇进行了研究。采用多阶段随机抽样的方法选择研究中心和研究对象。问卷由采访者填写，收集的数据包括社会人口学特征、宫颈癌筛查的知识和实践。数据分析采用SPSS version 23。结果:参与者平均年龄28.86±5.69岁，基督徒占92.7%，已婚占82.5%。大部分受访者(82.3%)曾透过妇科医生了解子宫颈癌筛查方法，而在198名曾听说子宫颈癌筛查的受访者中，151名(76.3%)曾了解子宫颈抹片检查。138(69.7%)的参与者认为宫颈癌前病变的筛查可以在怀孕期间进行。只有37.9%的参与者在过去3年内曾做过子宫颈抹片检查。社会地位较高的被调查者(公务员/公务员)对宫颈癌筛查的了解程度是社会地位较低的被调查者(商人/农民/工匠)的10倍(P = 0.027, OR = 9.957, 95% CI = 1.301 ~ 76.191)。结论:较高的社会地位对到产前诊所就诊的孕妇对宫颈癌筛查的了解程度有较高的预测作用。妇科医生更多地宣传子宫颈癌检查的资料，而子宫颈抹片检查仍然是孕妇所知的主要检查方式。其他保健工作者和媒体应努力传播关于预防宫颈癌的筛查方式的适当信息
{"title":"Predictors of knowledge of cervical cancer screening among pregnant women attending antenatal clinic in Enugu, Nigeria","authors":"Chidiebere J. Otti, E. Izuka, C. Obiora-Izuka, Okechukwu Ifebi, L. Ikeako, U. Nwagha","doi":"10.4103/ijmh.ijmh_12_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_12_22","url":null,"abstract":"Background: One per cent of women diagnosed with cervical cancer are pregnant or postpartum at the time of diagnosis. Therefore, awareness during pregnancy is of utmost significance. Objective: To determine predictors of knowledge of cervical cancer screening among pregnant women who attended antenatal clinics in Enugu, Nigeria. Materials and Methods: It was a descriptive cross-sectional study of 419 pregnant women who attended antenatal care at the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu (139) and the Mother of Christ Specialist Hospital, Enugu (280). A multistage random sampling method was used to select the study centres and the participants. The questionnaires were administered by the interviewers and the data collected included sociodemographic characteristics, knowledge, and practice of cervical cancer screening. Data were analyzed using SPSS version 23. Results: The mean age of the participants was 28.86 ± 5.69, Christians (92.7%), and married (82.5%). Most of the respondents (82.3%) heard about cervical cancer screening methods through their gynecologists and of the 198 respondents who have heard about cervical cancer screening, 151 (76.3%) knew about Pap smear. One hundred thirty-eight (69.7%) of the participants believe that screening for premalignant lesions of the cervix can be performed during pregnancy. Only 37.9% of the participants had ever done Pap’s smear in the past 3 years. Respondents with higher social status (Civil/Public servants) were 10 times more likely to know about cervical cancer screening than those with lower social status (Trader/farmer/artisan) (P = 0.027, OR = 9.957, 95% CI = 1.301 – 76.191). Conclusion: Higher social status is more predictive of knowledge of cervical cancer screening amongst pregnant women attending antenatal clinics. Gynaecologist disseminate the information on cervical cancer screening more and Pap’s smear remain the main screening modality known to pregnant women. Efforts should be made by other health workers and the media to disseminate appropriate information on screening modalities for the prevention of cervical cancer","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":"72 1","pages":"270 - 276"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81400127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Meka, C. Okwor, Ekene Arum, Michael I. Ogamba, B. Omotowo, O. Kanu
Background: Prostate-specific antigen (PSA) testing has been recommended for prostate cancer screening by the World Health Organization. The combined use of total and free PSA and digital rectal examination is said to improve the sensitivity and specificity of total PSA and also to reduce the need for 20% of unnecessary biopsies. Tertiary hospital laboratories ought to be appropriately equipped to offer these tests for improved patient outcomes. Objective: The objective was to determine the proportion of Nigerian tertiary care laboratories that offer quantitative total and free PSA testing. Materials and Methods: A cross-sectional survey was carried out in functional government-owned tertiary hospitals in all the geopolitical zones of Nigeria. Respondents were drawn from the Laboratory section of each hospital. Data were collected using semi-structured self-administered questionnaires and analyzed using SPSS version 22. Results: The study included a total of 34 tertiary care laboratories. The mean (SD) age of respondents was 43.71 (5.2) years. Of the surveyed hospitals, 27 (79.41%) had facilities for PSA testing, whereas 7 (20.59%) had no functional PSA testing facility. Of those with a functional testing facility, 27 (100%) had facilities for total PSA whereas 12 (44.44%) had facilities for free PSA. Three facilities [3 (42.85%)] out of the seven facilities with no functional testing facilities cited equipment breakdown as the reason. Conclusion: Availability of PSA testing facilities was not adequate in tertiary care laboratories in Nigeria, with free PSA facilities being less than total PSA facilities. More support is needed in making these important testing facilities more readily available in Nigerian tertiary healthcare laboratories.
{"title":"Evaluation of prostate-specific antigen testing: An empirical survey of laboratories in Nigerian tertiary care centers","authors":"I. Meka, C. Okwor, Ekene Arum, Michael I. Ogamba, B. Omotowo, O. Kanu","doi":"10.4103/ijmh.ijmh_8_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_8_22","url":null,"abstract":"Background: Prostate-specific antigen (PSA) testing has been recommended for prostate cancer screening by the World Health Organization. The combined use of total and free PSA and digital rectal examination is said to improve the sensitivity and specificity of total PSA and also to reduce the need for 20% of unnecessary biopsies. Tertiary hospital laboratories ought to be appropriately equipped to offer these tests for improved patient outcomes. Objective: The objective was to determine the proportion of Nigerian tertiary care laboratories that offer quantitative total and free PSA testing. Materials and Methods: A cross-sectional survey was carried out in functional government-owned tertiary hospitals in all the geopolitical zones of Nigeria. Respondents were drawn from the Laboratory section of each hospital. Data were collected using semi-structured self-administered questionnaires and analyzed using SPSS version 22. Results: The study included a total of 34 tertiary care laboratories. The mean (SD) age of respondents was 43.71 (5.2) years. Of the surveyed hospitals, 27 (79.41%) had facilities for PSA testing, whereas 7 (20.59%) had no functional PSA testing facility. Of those with a functional testing facility, 27 (100%) had facilities for total PSA whereas 12 (44.44%) had facilities for free PSA. Three facilities [3 (42.85%)] out of the seven facilities with no functional testing facilities cited equipment breakdown as the reason. Conclusion: Availability of PSA testing facilities was not adequate in tertiary care laboratories in Nigeria, with free PSA facilities being less than total PSA facilities. More support is needed in making these important testing facilities more readily available in Nigerian tertiary healthcare laboratories.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":"195 1","pages":"233 - 237"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75872934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Josepha Achi, A. Amucheazi, Virginus Ajuzieogu, T. Onyeka
Background: The median and the paramedian approaches are used to access the epidural space. Median approach is commonly used but can be technically difficult in certain patients. The paramedian approach is the alternative. Success rate during the blind procedure is determined by the skin to epidural distance (SED). SED in turn is affected by patients’ anthropometric characteristics. Prediction of the SED serves to determine the depth of needle advancement in order to improve the success rate. Objectives: The study compared the SED using median vs. paramedian approaches, the time required to access the epidural space, place the catheter, and investigate anthropometric factors which may have influenced this distance among the participants. Materials and Methods: The study was a blinded randomized controlled study. Following ethical approval and informed consent, 60 women scheduled for elective gynecological procedures were allocated to one of the two groups: Group M (median) (30) and Group PM (paramedian) (30). Results: The SED was longer using the PM approach. The mean time it took to gain access was shorter in the PM group. The mean SED increased as the body mass index increased in both groups (P < 0.0001). There was a significant association of anthropometric measurements with the SED using both approaches. Conclusion: The study showed that the SED was longer in the PM group. Also as the patient’s anthropometric measurements increased, so did the SED.
{"title":"A comparative study of skin to epidural distance at lumbar region using median and paramedian techniques","authors":"Josepha Achi, A. Amucheazi, Virginus Ajuzieogu, T. Onyeka","doi":"10.4103/ijmh.ijmh_23_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_23_22","url":null,"abstract":"Background: The median and the paramedian approaches are used to access the epidural space. Median approach is commonly used but can be technically difficult in certain patients. The paramedian approach is the alternative. Success rate during the blind procedure is determined by the skin to epidural distance (SED). SED in turn is affected by patients’ anthropometric characteristics. Prediction of the SED serves to determine the depth of needle advancement in order to improve the success rate. Objectives: The study compared the SED using median vs. paramedian approaches, the time required to access the epidural space, place the catheter, and investigate anthropometric factors which may have influenced this distance among the participants. Materials and Methods: The study was a blinded randomized controlled study. Following ethical approval and informed consent, 60 women scheduled for elective gynecological procedures were allocated to one of the two groups: Group M (median) (30) and Group PM (paramedian) (30). Results: The SED was longer using the PM approach. The mean time it took to gain access was shorter in the PM group. The mean SED increased as the body mass index increased in both groups (P < 0.0001). There was a significant association of anthropometric measurements with the SED using both approaches. Conclusion: The study showed that the SED was longer in the PM group. Also as the patient’s anthropometric measurements increased, so did the SED.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":"28 1","pages":"285 - 291"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77106533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Since the turn of the millennium, efforts across the world have been aimed at promoting good living and reducing poverty. This has resulted in countries taking necessary steps to ensure increased access to affordable health care by promoting Universal Health Coverage. Nigeria is not an exemption especially as private health spending has its own substantial impoverishing effects on households. Objective: The objective of this study was to study willingness to pay (WTP) for Community-based Health Insurance Scheme in a Nigerian State. Materials and Methods: The study sample was purposively selected to cover the three senatorial zones of Enugu State, Nigeria. A questionnaire was used to collect data from the respondents that were randomly selected. Focus group discussions were held to collect qualitative data. Key variables which included WTP for in- and outpatient care for the different stated amount of of money in naira and dollar: ₦400 ($1.0), ₦500 ($1.25), ₦1000 ($2.5) or more) were compared across socio-economic status (SES) groups using “asset holding and level of WTP” with the groups classified into SES quartiles. Results: Most respondents were neither WTP a minimum of ₦400 ($1.0) nor a maximum of ₦1000 ($2.5) for inpatient or outpatient care. The overall maximum amount to pay by the groups was ₦500 ($1.25), whereas the minimum amount across the communities was ₦50 ($0.125). Conclusion: There was a ceiling of maximum/minimum willing amounts to pay across the different socio-economic strata and these ceilings were observed to be low.
{"title":"Willingness to Pay (WTP) for Community-based Health Insurance Scheme (CBHIS) in a Nigerian State","authors":"C. Idoko, Chuka Obienu","doi":"10.4103/ijmh.ijmh_42_21","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_42_21","url":null,"abstract":"Background: Since the turn of the millennium, efforts across the world have been aimed at promoting good living and reducing poverty. This has resulted in countries taking necessary steps to ensure increased access to affordable health care by promoting Universal Health Coverage. Nigeria is not an exemption especially as private health spending has its own substantial impoverishing effects on households. Objective: The objective of this study was to study willingness to pay (WTP) for Community-based Health Insurance Scheme in a Nigerian State. Materials and Methods: The study sample was purposively selected to cover the three senatorial zones of Enugu State, Nigeria. A questionnaire was used to collect data from the respondents that were randomly selected. Focus group discussions were held to collect qualitative data. Key variables which included WTP for in- and outpatient care for the different stated amount of of money in naira and dollar: ₦400 ($1.0), ₦500 ($1.25), ₦1000 ($2.5) or more) were compared across socio-economic status (SES) groups using “asset holding and level of WTP” with the groups classified into SES quartiles. Results: Most respondents were neither WTP a minimum of ₦400 ($1.0) nor a maximum of ₦1000 ($2.5) for inpatient or outpatient care. The overall maximum amount to pay by the groups was ₦500 ($1.25), whereas the minimum amount across the communities was ₦50 ($0.125). Conclusion: There was a ceiling of maximum/minimum willing amounts to pay across the different socio-economic strata and these ceilings were observed to be low.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":"20 1","pages":"313 - 317"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83547207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Ibekwe, C. Ogugua, U. Chikani, R. Ibekwe, E. Onwe, M. Orji
Introduction: Tropical calcific pancreatitis is known to be associated with malnutrition and insulin-requiring diabetes mellitus. Recent studies suggest that genetic and environmental factors play a role in its etiopathogenesis. Objective: The objectives of this was were to study the prevalence, profile, and outcome of children managed for type 1 diabetes mellitus with pancreatic calcification. Materials and Methods: This was a cross-sectional study of children managed for type 1 diabetes mellitus in the pediatric endocrine unit of Federal Teaching Hospital Abakaliki, Nigeria. All patients who consented underwent ultrasonography of the pancreas. We undertook a case note review to identify factors that may be associated with pancreatic calcification. Results: Thirty-seven children were diagnosed with diabetes mellitus. The mean age was 12.3 years (5–17 years), 21 males and 16 females. Twenty of 37 (54.1%) patients were screened for pancreatic calcifications using abdominal ultrasound. Seventeen of 37 were not studied as nine of them (24.3%) died, six lost to follow-up, and two declined to participate. The mean duration of diabetes mellitus was 2.7 years (3 months–8 years). All patients were managed with a premixed twice-daily insulin regimen. Pancreatic calcification was seen in seven out of the 20 (35%) and was commoner among males and older children. The average glycosylated hemoglobin (Hba1c) was 13 and 11, and average height/weight standard deviation score was –1.9/–1.9 and –1.03/–1.02 in those with calcification and those without, respectively. Conclusion: Tropical calcific pancreatitis is common among children diagnosed with diabetes mellitus in Abakaliki, Nigeria and is associated with morbidity. Routine pancreatic ultrasound of patients with type 1 diabetes mellitus may be necessary.
{"title":"Pancreatic Calcification among Children with Childhood Diabetes in Abakaliki, Nigeria: Could This Be Fibrocalculous Pancreatic Diabetes?","authors":"M. Ibekwe, C. Ogugua, U. Chikani, R. Ibekwe, E. Onwe, M. Orji","doi":"10.4103/ijmh.ijmh_36_21","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_36_21","url":null,"abstract":"Introduction: Tropical calcific pancreatitis is known to be associated with malnutrition and insulin-requiring diabetes mellitus. Recent studies suggest that genetic and environmental factors play a role in its etiopathogenesis. Objective: The objectives of this was were to study the prevalence, profile, and outcome of children managed for type 1 diabetes mellitus with pancreatic calcification. Materials and Methods: This was a cross-sectional study of children managed for type 1 diabetes mellitus in the pediatric endocrine unit of Federal Teaching Hospital Abakaliki, Nigeria. All patients who consented underwent ultrasonography of the pancreas. We undertook a case note review to identify factors that may be associated with pancreatic calcification. Results: Thirty-seven children were diagnosed with diabetes mellitus. The mean age was 12.3 years (5–17 years), 21 males and 16 females. Twenty of 37 (54.1%) patients were screened for pancreatic calcifications using abdominal ultrasound. Seventeen of 37 were not studied as nine of them (24.3%) died, six lost to follow-up, and two declined to participate. The mean duration of diabetes mellitus was 2.7 years (3 months–8 years). All patients were managed with a premixed twice-daily insulin regimen. Pancreatic calcification was seen in seven out of the 20 (35%) and was commoner among males and older children. The average glycosylated hemoglobin (Hba1c) was 13 and 11, and average height/weight standard deviation score was –1.9/–1.9 and –1.03/–1.02 in those with calcification and those without, respectively. Conclusion: Tropical calcific pancreatitis is common among children diagnosed with diabetes mellitus in Abakaliki, Nigeria and is associated with morbidity. Routine pancreatic ultrasound of patients with type 1 diabetes mellitus may be necessary.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":"28 1","pages":"238 - 243"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88269125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ifeyinwa L Ezenwosu, N. Ugwunna, M. Ajuba, Osita Ezenwosu, Emmanuel Otache, Ijeoma Ejike
Background: In a resource-limited setting where nutrient availability is a challenge, it may be necessary to determine factors that affect dietary diversity in people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) as addressing them could lead to better access to diversified diets in this group. Objective: The objective of this study was to determine the factors that influence dietary diversity among HIV clients attending the HIV clinic in a low-resource tertiary health facility. Materials and Methods: An institutional-based cross-sectional study was conducted among HIV clients receiving anti-retroviral therapy in Enugu state, Nigeria. A systematic random sampling technique was employed in selecting the study participants. Bivariate analysis was done using the chi-square test which was further subjected to multivariate logistic regression analyses to determine predictors of dietary diversity. Results: In this study, respondents who earned a family monthly income of 72.5 US dollars and below were 2.6 times less likely to have high dietary diversity (AOR = 0.378, CI = 0.180–0.792) compared to those who earned above 145 dollars. Also, HIV clients on cotrimoxazole prophylaxis were 2.3 times more likely to have high dietary diversity (AOR = 2.304, CI = 1.155–4.598) compared to those who were not on the prophylaxis. Conclusions: High family monthly income and being on cotrimoxazole prophylaxis were predictors of high dietary diversity in People living with HIV/AIDS. Therefore, there is a need to improve the income of PLWHA as well as ensure the ready availability of cotrimoxazole to reduce the rate of opportunistic infections thus leading to better consumption of diversified diets.
背景:在资源有限的环境中，营养物质的供应是一个挑战，可能有必要确定影响人类免疫缺陷病毒/获得性免疫缺陷综合症(HIV/艾滋病)患者饮食多样性的因素，因为解决这些因素可能会导致这一群体更好地获得多样化的饮食。目的:本研究的目的是确定影响在低资源三级卫生机构艾滋病门诊就诊的艾滋病患者饮食多样性的因素。材料和方法:在尼日利亚埃努古州接受抗逆转录病毒治疗的艾滋病毒患者中进行了一项基于机构的横断面研究。采用系统随机抽样技术选择研究对象。采用卡方检验进行双变量分析，并进一步进行多变量logistic回归分析，以确定饮食多样性的预测因素。结果:在本研究中，家庭月收入为72.5美元及以下的受访者与家庭月收入为145美元以上的受访者相比，饮食多样性高的可能性低2.6倍(AOR = 0.378, CI = 0.180-0.792)。此外，接受复方新诺明预防的HIV患者饮食多样性高的可能性是未接受预防的患者的2.3倍(AOR = 2.304, CI = 1.155-4.598)。结论:家庭月收入高和复方新诺明预防是HIV/AIDS患者饮食多样性高的预测因素。因此，有必要提高艾滋病感染者的收入，并确保复方新诺明的可得性，以减少机会性感染率，从而使人们更好地消费多样化的饮食。
{"title":"Predictors of Dietary Diversity among HIV Clients in a Low-resource Tertiary Health Facility in Southeast Nigeria: A Cross-sectional Analytical Study","authors":"Ifeyinwa L Ezenwosu, N. Ugwunna, M. Ajuba, Osita Ezenwosu, Emmanuel Otache, Ijeoma Ejike","doi":"10.4103/ijmh.ijmh_39_21","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_39_21","url":null,"abstract":"Background: In a resource-limited setting where nutrient availability is a challenge, it may be necessary to determine factors that affect dietary diversity in people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) as addressing them could lead to better access to diversified diets in this group. Objective: The objective of this study was to determine the factors that influence dietary diversity among HIV clients attending the HIV clinic in a low-resource tertiary health facility. Materials and Methods: An institutional-based cross-sectional study was conducted among HIV clients receiving anti-retroviral therapy in Enugu state, Nigeria. A systematic random sampling technique was employed in selecting the study participants. Bivariate analysis was done using the chi-square test which was further subjected to multivariate logistic regression analyses to determine predictors of dietary diversity. Results: In this study, respondents who earned a family monthly income of 72.5 US dollars and below were 2.6 times less likely to have high dietary diversity (AOR = 0.378, CI = 0.180–0.792) compared to those who earned above 145 dollars. Also, HIV clients on cotrimoxazole prophylaxis were 2.3 times more likely to have high dietary diversity (AOR = 2.304, CI = 1.155–4.598) compared to those who were not on the prophylaxis. Conclusions: High family monthly income and being on cotrimoxazole prophylaxis were predictors of high dietary diversity in People living with HIV/AIDS. Therefore, there is a need to improve the income of PLWHA as well as ensure the ready availability of cotrimoxazole to reduce the rate of opportunistic infections thus leading to better consumption of diversified diets.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":"8 1","pages":"220 - 225"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88342224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The impact of uncontrolled hypertension results in undesirable cardiovascular events. Hence, there is a need to emphasize on adequate control of blood pressure. Objectives: The objectives of this study were to determine the prevalence and determinants of controlled blood pressure and the complications of hypertension in a tertiary hospital in Nigeria. Materials and Methods: This was a retrospective study of 257 patients of Cardiology Unit of University of Nigeria Teaching Hospital diagnosed with hypertension from 2014 to 2018. A proforma-designed questionnaire was used to retrieve responses from the patients’ medical records. Data were entered and analyzed using Statistical Package for Social Sciences version 20. The level of significance was set at 0.05. Results: The prevalence of controlled blood pressure was 35.8% with mean blood pressure of 112.39/72.72 mmHg. Adherence to drug therapy was found to be associated with controlled blood pressure (χ2 = 8.370, P = 0.005). Two-thirds of patients diagnosed with hypertension developed complications of which hypertensive heart disease, stroke, and chronic kidney diseases were the commonest. Age (χ2 = 9.629, P = 0.008) and the initial presenting diagnosis (χ2 = 7.662, P = 0.004) were factors associated with the development of complications. Conclusion: Adequate blood pressure control is still a challenge among hypertensive patients in the study population. A comprehensive program is advocated for the control of blood pressure that will accommodate drug adherence in addition to education, and socio-behavioral change modifications.
背景:不受控制的高血压会导致不良的心血管事件。因此，有必要强调适当控制血压。目的:本研究的目的是确定尼日利亚一家三级医院控制血压和高血压并发症的患病率和决定因素。材料与方法:回顾性研究2014 - 2018年尼日利亚大学教学医院心内科诊断为高血压的257例患者。采用形式设计的问卷从患者的医疗记录中检索答案。数据输入和分析使用统计软件包的社会科学版本20。显著性水平设为0.05。结果:血压控制率为35.8%，平均血压为112.39/72.72 mmHg。药物治疗依从性与血压控制相关(χ2 = 8.370, P = 0.005)。三分之二被诊断为高血压的患者出现并发症，其中高血压心脏病、中风和慢性肾病是最常见的。年龄(χ2 = 9.629, P = 0.008)和初诊(χ2 = 7.662, P = 0.004)是并发症发生的相关因素。结论:适当的血压控制仍然是研究人群中高血压患者面临的挑战。一项全面的血压控制方案，除了教育和社会行为改变之外，还将适应药物依从性。
{"title":"Prevalence of Controlled Blood Pressure among Hypertensive Patients and Determinants of Hypertensive Complications in a Nigerian Population","authors":"C. Kassy, C. Okeke, A. Ndu, A. Umeobieri","doi":"10.4103/ijmh.ijmh_3_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_3_22","url":null,"abstract":"Background: The impact of uncontrolled hypertension results in undesirable cardiovascular events. Hence, there is a need to emphasize on adequate control of blood pressure. Objectives: The objectives of this study were to determine the prevalence and determinants of controlled blood pressure and the complications of hypertension in a tertiary hospital in Nigeria. Materials and Methods: This was a retrospective study of 257 patients of Cardiology Unit of University of Nigeria Teaching Hospital diagnosed with hypertension from 2014 to 2018. A proforma-designed questionnaire was used to retrieve responses from the patients’ medical records. Data were entered and analyzed using Statistical Package for Social Sciences version 20. The level of significance was set at 0.05. Results: The prevalence of controlled blood pressure was 35.8% with mean blood pressure of 112.39/72.72 mmHg. Adherence to drug therapy was found to be associated with controlled blood pressure (χ2 = 8.370, P = 0.005). Two-thirds of patients diagnosed with hypertension developed complications of which hypertensive heart disease, stroke, and chronic kidney diseases were the commonest. Age (χ2 = 9.629, P = 0.008) and the initial presenting diagnosis (χ2 = 7.662, P = 0.004) were factors associated with the development of complications. Conclusion: Adequate blood pressure control is still a challenge among hypertensive patients in the study population. A comprehensive program is advocated for the control of blood pressure that will accommodate drug adherence in addition to education, and socio-behavioral change modifications.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":"14 1","pages":"226 - 232"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85058019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The advances in medical practice have increased the average life expectancy of people living with sickle cell disease (SCD) to 54 years. The high prevalence rates of SCD in Nigeria therefore highlights the need for research that will support overall disease management. Objective: To determine the health risk behavior (HRB) of adolescents with sickle cell disease in Nigeria. Materials and methods: In a cross-sectional descriptive survey using purposive sampling method, 122 adolescents with SCD attending sickle cell clubs in Ogun State, Nigeria were selected for the study. A 58-item questionnaire adapted from the Youth Risk Behavior Survey (YRBS) instrument developed by Centre for Disease Control and Prevention (CDC) was used to collect data from the adolescents. Results: The mean age of the respondents was 15.7 ± 2.3 years, there were more females (58.2%) than males (41.2%). Majority were from a monogamous family setting and average to large family size (≥3siblings) (63% and 76% respectively) and only 6% of the parents had no formal education. The mean ages at first sexual intercourse, cigarette smoking and alcohol use were 16 ± 5.7, 15.7 ± 0.7, and 14.9 ± 1.9 years respectively. One-fifth (21.3%) have had sex and half (50%) of them have had sex by the age of 17. Over one-tenth (13.9%) had smoked cigarette while 14.8% had taken alcohol. Adolescents from monogamous family background were more likely to be involved in substance abuse (χ2: 4.99; P=0.008) and exposed to sexual activities (χ2: 10.9; P=0.004) than those from polygamous or single parent family. Conclusion: It was concluded that adolescents with SCD are involved in HRB and may be dependent on family characteristics. It is recommended that regular health care of chronically ill adolescents should include screening and counselling for HRBs.
{"title":"Health risk behavior of adolescents with sickle cell disease in Nigeria","authors":"P. Ajike, K. Adediran, T. Kotila, M. Dairo","doi":"10.4103/ijmh.ijmh_9_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_9_22","url":null,"abstract":"Background: The advances in medical practice have increased the average life expectancy of people living with sickle cell disease (SCD) to 54 years. The high prevalence rates of SCD in Nigeria therefore highlights the need for research that will support overall disease management. Objective: To determine the health risk behavior (HRB) of adolescents with sickle cell disease in Nigeria. Materials and methods: In a cross-sectional descriptive survey using purposive sampling method, 122 adolescents with SCD attending sickle cell clubs in Ogun State, Nigeria were selected for the study. A 58-item questionnaire adapted from the Youth Risk Behavior Survey (YRBS) instrument developed by Centre for Disease Control and Prevention (CDC) was used to collect data from the adolescents. Results: The mean age of the respondents was 15.7 ± 2.3 years, there were more females (58.2%) than males (41.2%). Majority were from a monogamous family setting and average to large family size (≥3siblings) (63% and 76% respectively) and only 6% of the parents had no formal education. The mean ages at first sexual intercourse, cigarette smoking and alcohol use were 16 ± 5.7, 15.7 ± 0.7, and 14.9 ± 1.9 years respectively. One-fifth (21.3%) have had sex and half (50%) of them have had sex by the age of 17. Over one-tenth (13.9%) had smoked cigarette while 14.8% had taken alcohol. Adolescents from monogamous family background were more likely to be involved in substance abuse (χ2: 4.99; P=0.008) and exposed to sexual activities (χ2: 10.9; P=0.004) than those from polygamous or single parent family. Conclusion: It was concluded that adolescents with SCD are involved in HRB and may be dependent on family characteristics. It is recommended that regular health care of chronically ill adolescents should include screening and counselling for HRBs.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":"4057 4 1","pages":"261 - 269"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86743086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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