West African journal of medicine最新文献

Background: The global prevalence of food insecurity presents particular challenges for university students, with medical students experiencing compounded risks due to financial limitations and academic pressures. These constraints frequently manifest in poor dietary diversity, creating a bidirectional relationship where food insecurity limits access to nutritious foods, while monotonous diets exacerbate health and academic consequences. Understanding this connection is crucial for developing targeted interventions in high-pressure academic environments.

Aim: This study assessed the prevalence of dietary diversity, food insecurity, and associated socio-demographic factors among medical students at the University of Ibadan, Nigeria.

Methods: A descriptive cross-sectional study was conducted in 2019 among 208 medical students in their 300-500 academic levels. Participants were selected using a purposive sampling technique. Data were collected using the 10-item US Adult Food Security Scale Module for food security assessment and dietary diversity tools (Minimum Dietary Diversity for Women [MDD-W] and Individual Dietary Diversity Score [IDDS]). Statistical analysis was performed using SPSS version 20, including descriptive statistics, chi-square test was used to determine associations between categorical variables, while multivariate logistic regression was employed to identify food insecurity predictors among students. Statistical significance was set at p < 0.05.

Results: The mean age of participants was 21.7 ± 2.7 years, with 53.8% being male. Over one-third (34.5%) reported a monthly allowance of ₦10,100-₦20,000, while 42.3% had daily food expenditures of ₦800-₦1000. Low dietary diversity was prevalent, particularly among female students (90.0%) compared to males (38.6%). Cereals (98.8%) and legumes (32.5%) were the most consumed food groups, whereas fruits (27.5%) and vegetables (11.3%) were under-consumed. The overall prevalence of food insecurity was 64.9%, with significant predictors including female gender (OR=2.51, 95% CI: 1.16-5.43) and a monthly allowance below ₦10,000 (OR=25.4, 95% CI: 2.08-309.2).

Conclusion: This study highlights a high prevalence of food insecurity and low dietary diversity among medical students at the University of Ibadan, with financial constraints and gender disparities being key determinants. These findings underscore the urgent need for institutional interventions, such as subsidized meal programs and nutrition education initiatives, to mitigate this public health concern and support students' well-being and academic success.

Background: Management of diabetes mellitus can be quite challenging especially if glucose control is poor necessitating the use of multiple health facilities. Failure of good control is usually multifactorial, leading to an evolving trend in the use of complementary and alternative medicine (CAM) by patients to improve outcome. In view of increasing use of CAM as adjunct or as an alternative treatment, more assessment on CAM use is needed.

Objectives: To assess the effect of CAM use on fasting blood glucose on type 2 DM patients attending the General Outpatient Clinic.

Methods: Two hundred and forty-four adult type 2 diabetics selected using systematic sampling were recruited into the study. A semi- structured interviewer-administered questionnaire was used to obtain information on sociodemographic characteristics and CAM use. Data obtained was analyzed with the Statistical Package for Social Sciences (SPSS Version 23). Statistical analyses were significant at p< 0.05 and a 95% confidence interval.

Results: The mean age ± standard deviation was 56.97 ±10.69 years. Overall CAM use was 40.1%. The highest proportion of CAM use was among those aged between 30 - 40 years (52.9%). Most of the CAM users (71.4%) had uncontrolled fasting blood glucose. Moringa was the most used CAM 61(34.4%). Those who did not use CAM (OR=1.95, CI= 1.12 - 3.37, p<0.05) were 1.95 times more likely to have controlled FBG, and was statistically significant.

Conclusion: Many of the diabetic patients used CAM and most of those who practiced concurrent use of CAM and orthodox medicine had poor glycaemic control. Developing a patient-centred approach to CAM use through health education, community engagement, workshops for CAM providers and strengthening health system will reduce reliance on CAM.

Background: Cardiovascular disease (CVD) risk preventive interventions should be informed by and targeted at addressing health literacy needs of individuals and communities. This study assessed the CVD risk knowledge, perception, behaviours, and utilization of routine risk screening services among a Nigerian adult population.

Methods: A cross-sectional analytic study design was employed to assess the CVD risk knowledge, perception, behaviours, and utilization of risk screening services among a random multistage sample of 900 adults. Data were collected using an interviewer-administered semi-structured questionnaire adapted from the WHO STEPS questionnaire. Descriptive and inferential analyses of data collected were carried out using the IBM SPSS version 28 software.

Results: The mean age of the study participants was 45.0 (SD = 18.7) years, with 66.8% reporting three concurrent risk behaviours, and 34.2% reporting utilization of at least one CVD risk screening service in the preceding year. Overall good CVD risk knowledge, and perception among the study participants was 77.2% and 19.6% respectively. Education, urban settlement, family history of CVD, good overall CVD risk knowledge and perception were predictors of the utilization of CVD risk screening services.

Conclusion: A significant proportion of the study participants reported multiple CVD risk behaviours, had poor risk perception and utilization of risk screening services despite having a good overall CVD risk knowledge. There is need for concerted efforts by the relevant stakeholder in the State Ministry of Health to target the adult population in the study setting with health promotion information on CVD risk prevention and the benefits of early risk detection.

Background: The rapidly growing elderly population in sub-Saharan Africa, particularly Nigeria, poses challenges due to diminished income-generating ability and limited social safety nets. As income-generating ability decreases with age, elderly people become increasingly vulnerable economically.

Objectives: This study sought to assess income sources and purchasing power among elderly residents in Ukpo, Dunukofia Local Government Area (LGA), Anambra State.

Materials and methods: After obtaining approval from the ethics and research committees in Nnamdi Azikiwe University Teaching Hospital, a cross-sectional study involving 185 elderly residents in Ukpo, Dunukofia LGA in Anambra state who met the eligibility criteria, was conducted. They were selected using a multistage sampling technique from 1st March to 1st August 2024. Data was collected via pre-tested, semi-structured, interviewer-administered questionnaires and analysed using Statistical Package for Social Science (SPSS) software, version 25.0 (IBM Inc., Armonk, New York, United States). The level of significance for this study was set at p ≤ 0.05.

Results: A total of 185 elderly residents with a mean age and standard deviation of 71.12 ± 8.21 years participated in the study. Most respondents were female (75.7%), widowed (50.3%), and Christian (96.8%), with nearly half living on less than ₦10,000 per month. Relative remittances were the primary income source, and many struggled to afford necessities. No significant relationship between income and health status was found.

Conclusion: The findings highlight the economic vulnerability of the elderly and suggest the need for targeted interventions. Future research should focus on longitudinal studies to better understand income dynamics.

Introduction: Female genital mutilation (FGM) is prevalent in many parts of Africa, Asia and the Middle East. Healthcare providers are key players in its medicalization; hence, effort must be put in place to discourage this harmful practice right from inception of medical training.

Method: A descriptive cross-sectional study conducted amongst clinical medical students at the University College Hospital, Ibadan, between February and March 2022. Purposive sampling was utilized to recruit 380 participants. A self-administered questionnaire was used to collect data which was analyzed using IBM SPSS version 26. Descriptive statistics were generated, and Chi-square was used to test the association between categorical variables. Logistic regression analysis was performed, and p-value was set at 0.05.

Result: Three hundred and eighty questionnaires were administered, however, only 355 (93.4%) were completed and suitable for analysis. The mean age of the respondents was 22.9 (± 2.0) years. There were more males (58.9%) than females (41.1%) with majority being of Yoruba (73.2%) extraction. Sixty-eight (19.2%), 170 (47.9%), and 152 (42.8%) respondents had good knowledge about classification, complication, and medicalization of FGM respectively. A significant association (p<0.05) was noted between religion, gender and years of training with knowledge about FGM. The majority of the respondents' attitude towards FGM was that of objection (91.3%) and outright abolishment (90.4%).

Conclusion: Prevention of FGM should be a collaborative effort by healthcare practitioners through the incorporation of programmes to equip trainees on the strategies to eliminate FGM. Medicalization of FGM should be discouraged through targeted mass education and enforcement of penalties.

Background and objectives: The pattern of emergency presentations in children with congenital heart disease (CHD) is changing. The aim of our study was to identify the pattern and its associated factors.

Methods: It is a retrospective study of medical records of 252 children with CHD admitted as emergency cases from June 2018 - May 2023. Inclusion criteria were children with presentations from the CHD and those with no direct presentations were excluded. Data collected included age, gender, pre-existing diagnosis, main complaint and patient condition at discharge. The children were divided into two groups; cyanotic and acyanotic groups. Data was analyzed using SPSS version 25. Fishers exact -test was used for continuous variables and the χ2 test for nominal variables, p < 0.05 was taken to be statistically significant.

Results: The participants were 252; 131 (51.8%) were males The age range was 1 month -18 years, with a mean of 9.3 ± 9.1 years. There were more children in acyanotic group, 167 (66.3%). The main presentations in acyanotic group were symptoms of heart failure 71 (43.1%) and lower respiratory tract infection 51 (31.1%) while in cyanotic group the presentations were failure to thrive 29 (34.1 %) and cyanosis 23 (27%). The main causes of heart failure were uncorrected lesions and pulmonary hypertension. There was no significant difference in mortality between both groups. All required cardiac surgery, however only 13 (5%) had the intervention.

Conclusion: Children with CHD presented with varied manifestations which are type and age-specific. Improved knowledge of the common presentations in emergencies will help management.

Background: Metabolic dysfunction-Associated Steatotic Liver disease (MASLD) is characterized by hepatic steatosis in the absence of excessive alcohol consumption. Limited data exist on the evaluations of fibrosis in MASLD in Africa.

Objectives: The study aimed to investigate MASLD prevalence, its presentation pattern, risk factors, and the frequency, degree and risk factors of fibrosis.

Methods: This prospective cohort study included 150 patients referred to University of Benin Teaching Hospital for MASLD. A structured questionnaire was used for data collection. Laboratory investigations followed standard procedures. After an overnight fast, 50 recruited patients underwent fibroscan examination using the Fibroscan 530 compact model from Echosens, measuring steatosis and fibrosis.

Results: Out of 2390 patients, 153 had MASLD, establishing a prevalence of 6.4%. The mean age was 50.3 ± 11.5 years with a F: M ratio of 2.3:1. The mean controlled attenuation parameter (CAP) score was 269.6±60.3; and the median transient elastography (TE) score was 4.95. A strong positive correlation existed between CAP score and waist circumference (p = 0.037), Body Mass Index (BMI) (p = 0.049) and comorbidities (p = 0.049). More than 90% of MASLD patients had no symptoms, with 6% reporting right hypochondrial pain. Fibrosis showed significant associations with BMI (p =0.022), and Waist-to-Hip Ratio (p =0.032). Twelve percent of MASLD individuals exhibited severe fibrosis (≥ F2); 4% had cirrhosis, and 8% had F2 fibrosis.

Conclusions: The study highlighted a 6.4% MASLD prevalence, with central obesity, BMI, and comorbidity identified as independent risk factors. Fibroscan revealed 12% of MASLD patients had significant fibrosis with obesity and higher WHR as risk factors.

Background and objective: Falls are one of the most common causes of trauma among pregnant women. Footwears are part of the major environmental risk factors of falls, yet there is no evidence to ascertain how different footwear types affect balance and risk of falls in pregnant women. Our study assessed the effects of footwear types on balance and risk of falls among apparently healthy pregnant women.

Methods: 43 pregnant women in their second and third trimesters simulated static balance, measured by the maximum width base of support and risk of falls as determined by the three-meter backward test, using six different types of footwear. Data were analyzed using descriptive statistics and one-way analysis of variance at an alpha level of 0.05.

Results: There was a significant variation in balance with types of footwear (p < 0.001), with the female variant flip flop slippers exerting the most unfavourable effects on balance (maximum width base of support of 32.3±4.4cm). The work shoes and ankle strap sandals provided the greatest degree of balance, with mean maximum width base of support of 30.8±4.3 and 31.4±3.9, respectively. Surprisingly, there was no significant variation in the risk of falls with types of footwear (p< 0.052).

Conclusion: Work shoes and ankle strap sandals have a greater tendency to improve static balance in pregnant women while flip flop slippers may contribute to poor balance performance, as compared to other footwear types. The findings may be helpful to researchers and clinicians in understanding balance responses to different footwear designs.

Introduction and objectives: Erectile dysfunction (ED) is common among men over 40years and prevalence increases with age. ED occurs at an earlier age in the diabetic population and strongly associated with serum testosterone, age, hypertension and obesity. The aim of this study was to determine the predictors of ED among type 2 diabetic Nigerian men.

Materials and methods: A cross-sectional hospital-based study done among patients with ED and diabetes. ED was assessed using International Index of Erectile Function (IIEF) 5 questionnaire. Age, BMI serum testosterone, glycosylated haemoglobin and fasting lipid profile were measured in each group.

Results: A total of 102 participants were recruited; 51 participants in each study group. Majority, were >55 years in the diabetic and non-diabetic groups respectively (p = 0.456). The BMI and the waist circumference of the two groups showed statistically significant difference (0.006 and 0.007 respectively). The weight, hip circumference and waist/hip ratio of the two groups showed no statistical significance. The median value of serum testosterone for the non-diabetic group (622.2ng/ml) was significantly higher than the diabetic group (288ng/ml) (p=0.001). Multivariate logistic regression analysis showed increased risk of ED in diabetic patients aged > 60years ( OR 4.9), serum testosterone <270ng/ml (OR 3.8), hypertension (OR 2.93), fasting blood glucose (FBS) >125mg/dl (OR 2.6), low density lipoprotein (LDL) > 160mg/dl (OR 6.3) and triglyceride >150mg/dl (OR 2.9).

Conclusion: The study showed that age, serum testosterone, hypertension, elevated FBS and dyslipidaemia are independent predictors of ED among type 2 diabetic men.