Browsing by Author "Akinyemi, O."

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Anemia in pregnancy at two levels of health care in Ibadan, south west Nigeria
(Annals of African Medicine Society, 2011-12) Adesina, O.; Akinyemi, O.; Oladokun, A.
Background: In Africa, anemia in pregnancy contributes to non-attainment of the MDG goals 4 and 5. This study examined the prevalence and some risk factors for anemia at two levels of health care in the Ibadan metropolis. Methods: This was a retrospective study of the booking records of pregnant women at the University College Hospital (UCH, a profit-making tertiary institution) and Adeoyo Maternity Hospital (AMH, a secondary level institution offering free services) in Ibadan, September 1, 2008 to December 31, 2008. Eligible women had singleton pregnancies and no known chronic illnesses. Anemia was defined as packed cell volume (PCV) <30%, and degrees of anemia as mild (PCV 27–29%), moderate (PCV 19–26%), and severe (PCV below 19%). Statistical analysis was done by the Chi-square test, Fisher exact test, and t-test. A P value of <0.05 was considered significant. Results: Data from 2702 women (384 and 2318 from UCH and AMH, respectively) were available for analysis. About 30% of the women were anemic. The patients in UCH had higher mean PCV (33.03± 4.32 vs. 31. 04 ± 4.09, P = 0.00). A higher proportion of anemia was seen in patients presenting in Adeoyo (32.4% vs. 16.7%, P = 0.00). Factors associated with anemia included young age (P = 0.00), low parity (P = 0.00), and hospital type (P = 0.00). Parity and hospital type remained significant on logistic regression. Conclusion: Lower prevalence of anemia at the tertiary hospital maybe attributed to the higher socioeconomic status of the clientele. Short-term early antenatal management of anemia and long-term economic/educational empowerment is advocated.
Ethical issues in the COVID-19 pandemic control preparedness in a developing economy
(AFENET, 2020) Jegede, A.; Ajayi, I.; Akintola, S.; Falade, C.; Dipeolu, I. O.; Cadmus, S.; Ajala, A.; Olaifa, A.; Olatoye, O.; Akinyemi, O.
Adequate preparation for highly pathogenic infectious disease pandemic can reduce the incidence, prevalence and burden of diseases like COVID-19 pandemic. An antidote to the spread of the disease is adequate preparation for its control since there is no proven curative measure yet. Effective management of identified cases, social distancing, contact tracing and provision of basic infrastructure to facilitate compliance with preventive measures, testing are proven management strategies. Although these measures seem to be the best options presently, it is important to pay attention to ethical issues arising from the implementation process to ensure best practice. While disease epidemic is not alien to human societies, lessons from previous outbreaks are vital for addressing future outbreaks. For effective control of this pandemic, there should be a clear definition of social distancing in terms of distance and space in line with the WHO definition, adequate provision of basic amenities, screening and testing with specific criteria for selecting those to be screened. Also, there should be a free testing procedure, access to treatment opportunities for those who test positive, ethical free contact tracing practice, respect for the autonomy of those to be tested, and global best practice of open science, open data and data sharing practices. In conclusion, a framework/guideline for epidemic/pandemic ethics guidance should be developed while an ethical sensitive communication manual should be prepared for public engagement on epidemic and pandemic.
Human Immuno-deficiency Virus and Hepatitis B virus coinfection in pregnancy at the University College Hospital, Ibadan
(2010) Adesina, O.; Oladokun, A.; Akinyemi, O.; Adedokun, B.; Awolude, O.; Odaibo, G. O.; Olaleye, D.; Adewole, J.
Human Immuno-deficiency virus (HIV) and Hepatitis B Virus (HBV) share common modes of transmission which include blood borne and the vertical routes. Although, the natural course of HIV does not appear altered by HBV, the rate of liver-related deaths is several times higher among HIV/HBV co-infected persons. Clinicians providing care for HIV positive individuals, including pregnant women, need to be aware of this problem. This is a 2-year cross-sectional study that commenced in January 2006, among HIV positive pregnant women seen at the University College Hospital, Ibadan. During the study period, 721 HIV positive pregnant women were screened for hepatitis B virus infection. Sixty-four women (8.9%) were positive for HBsAg, 14(1.9%) were HCV positive and 642 (89.2%) were negative for both HBV and HCV. One patient was positive forboth HBV and HCV. There were no remarkable differences between HIV infected and HIV-HBV coinfected patients in terms of the hematological, albumin and bilirubin measurements. Alanine transaminase was however higher in the HIV-HBV co-infected patients than HIV patients and this was statistically significant (17.5 iu/ ml vs. 15.0 iu/ml, p value--0.009). In addition, the CD4 cell count was lower and the viral load marginally higher in the hepatitis B virus positive patients. The differences were however not statistically significant (p value--0.114 and 0.644 respectively). HIV-HBV co-infection in HIV positive pregnant women is not of negligible proportions as demonstrated in this study. Thus, HIV positive pregnant women should be screened for HBV and assisted to access care targeted at preventing morbidity and vertical transmission.
Human immuno-deficiency virus and hepatitis B virus coinfection in pregnancy at the University College Hospital, Ibadan
(2010) Adesina, O.; Oladokun, A.; Akinyemi, O.; Adedokun, B.; Awolude, O.; Odaibo, G.; Olaleye, D.; Adewole, I. F.
Human Immuno-deficiency virus (HIV) and Hepatitis B Virus (HBV) share common modes of transmission which include blood borne and the vertical routes. Although, the natural course of HTV does not appear altered by HBV, the rate of liver-related deaths is several times higher among HIV/HBV co-infected persons. Clinicians providing care for HIV positive individuals, including pregnant women, need to be aware of this problem. This is a 2-year cross-sectional study that commenced in January 2006, among HIV positive pregnant women seen at the University College Hospital, Ibadan. During the study period, 721 HIV positive pregnant women were screened for hepatitis B virus infection. Sixty-four women (8.9%) were positive for HBsAg, 14(1.9%) were HCV positive and 642 (89.2%) were negative for both HBV and HCV. One patient was positive for both HBV and HCV. There were no remarkable differences between HIV infected and IIIV-HBV coinfected patients in terms of the hematological, albumin and bilirubin measurements. Alanine transaminase was however higher in the HIV-HB V co-infected patients than HIV patients and this was statistically significant (17.5 iu/ ml vs. 15.0 iu/ml, p value- 0.009). In addition, the CD4 cell count was lower and the viral load marginally higher in the hepatitis B virus positive patients. The differences were however not statistically significant (p value- 0.114 and 0.644 respectively). HIV- HBV co-infection in HTV positive pregnant women is not of negligible proportions as demonstrated in this study. Thus, HIV positive pregnant women should be screened for HBV and assisted to access care targeted at preventing morbidity and vertical transmission.
Perceived social support among HIV positive and HIV-negative people in Ibadan, Nigeria.
(Scientific Research, 2014) Folasire, O. F.; Akinyemi, O.; Owoaje, E.
Background: People living with HIV and AIDS (PLWHA) are assumed to have poor social support. This study compared the satisfaction with perceived social support of people living with HIV and AIDS with HIV negative patients. Method: 150 HIV positive patients were age and sex matched with 150 HIV negative patients in a cross sectional comparative study. Information on socio-demography and social support was assessed with questionnaire including multidimensional scale of perceived social support (MSPSS). Chi square test, student t-test, and linear regression analysis were done at p = 0.05 level of significance. Result: Mean age of the HIV positive versus HIV negative patients is 38.1 ± 9.0 years versus 37.7 ± 9.2 years. Both groups had the lowest social support scores from family, (FA): 3.81 ± 1.08 vs 3.95 ± 0.89, p = 0.240. Perceived support from friends (FR) was higher in the HIV negative group 7.41 ± 1.99 vs 5.55 ± 2.34, p = 0.000 as well as perceived total support (TS), 3.94 ± 0.68 vs 3.59 ± 0.77, p = 0.000. Linear regression for all the respondents revealed HIV status contributed the most and predicted TS and FR scores respectively (β = −0.181 95% C.I = −5.843 to −0.766, p = 0.010 and β = −0.317, 95% C.I, −4.260 to −1.792, p = 0.000). For PLWHA group, employment contributed most to perceived TS (β = −0.181 95% C.I −11.812 to −0.0361, p = 0.049). However, in HIV negative group, TS and FR had the greatest contribution from marital status, (β = −0.416 95% C.I −6.157 to −1.829, p = 0.000) and (β = −0.381 95% C.I −2.851 to −0.756, p = 0.001). Also, the current living status (β = −0.268, 95% C.I −3.238 to −0.360, p = 0.015, and β = −0.241 95% C.I −1.48 to −0.09, p = 0.027). Conclusion: All respondents had the poorest perception of support from family (FA). Lack of employment is the most important factor identified in this group of PLWHA, responsible for the poor TS. For the HIV negative group, not being married and living outside family setting were the strongest factors for poor social support.
Point Prevalence Survey of Antimicrobial Prescribing in a Nigerian Hospital: Findings and Implications on Antimicrobial Resistance
(West African College of Physicians and West African College of Surgeons, 2020) Fowotade, A.; Fasuyi, T.; Aigbovo, O.; Versporten, A.; Adekanmbi, O.; Akinyemi, O.; Goossens, H.; Kehinde, A.; Oduyebo, O.
BACKGROUND: Antimicrobial resistance is a global health challenge. There is inadequate information on antimicrobial prescribing practices in many sub-Saharan African countries including Nigeria. A standardized method for surveillance of antimicrobial use in hospitals was employed to assess the antimicrobial prescribing practices in UCH, Ibadan, Nigeria. METHODS: A point prevalence survey (PPS) was conducted in December 15, 2017 at the UCH Ibadan. The survey included all in-patients receiving an antimicrobial on the day of PPS. Data collected included details on the antimicrobial agents, reasons and indications for treatment as well as a set of quality indicators. A web-based application was used for data-entry, validation and reporting as designed by the University of Antwerp (www.global-pps.be). RESULTS: This survey included 451 patients from 38 different wards of which 59.6% received at least one antimicrobial. The neonatal medical wards contributed the highest number of patients who received antibiotics. A total of 172 therapeutic antibiotic prescriptions were issued, mainly for Community- Acquired Infections (n=119; 69.2%). Most prescriptions for Healthcare Associated Infections (n=53) were intervention related (47.2%). Frequently used antibiotics include third generation cephalosporins (23.9%; mainly ceftriaxone); followed by combination of penicillin's (17.4%; mainly amoxicillin with enzyme inhibitor) and fluoroquinolones (16.6%). Majority, 312(69.9%) of the patients had parenteral antibiotics and only 95 (21.3%) of all antibiotic prescriptions had a documented stop or review date. Although the reason for antibiotic prescription was indicated for 413 (92.4%) prescriptions, targeted therapy was the basis for only 17 (3.8%) of these prescriptions. For surgical prophylaxis, 98.7% of all prescriptions were given for more than one day. Compliance to guidelines was non-existent. CONCLUSION: Our findings showed high broad spectrum prescribing, high number of intervention related health care infections, high use of prolonged surgical prophylaxis, inexistence of local guidelines; and low utilization of laboratory facilities. Hospital related intervention should include development of antibiotic guideline and increased enlightenment on rational prescribing practices.
Risk of anaemia in HIV positive pregnant women in Ibadan, Southwest Nigeria
(2011) Adesina, O.; Oladokun, A.; Akinyemi, O.; Akingbola, T.; Awolude, O.; Adewole, I.
Anaemia in pregnancy is an important cause of maternal and neonatal mortality. It is a recognized co-morbidity of HIV infection. This study aimed to determine the risk of anaemia in HIV positive pregnant women. Methodology- This is a cross sectional study of healthy pregnant women attending Adeoyo Hospital, a secondary health centre in South-western Nigeria over a 1- month period (January 2007). During the study period, 2,737 eligible women presented for antenatal care. About 98% (2,682) of these women consented to HIV testing. Over all, their mean (± S.D) packed cell volume was 30.96% (±4.13). The prevalence of HIV infection was 2.9% (95% Cl 2.3% - 3.6%) and the overall prevalence of anaemia was 33.1%. Frequency of anaemia was significantly higher in HIV +ve women (57.3% vs. 42.7%, p= 0.00. OR=2.81., CI=1.72-4.58). HIV +ve women presented more frequently with moderate or severe anaemia. In the logistic regression analysis only HIV infection (OR=2.4, 95%CI=1.37- 4.21) and primigravidity (OR=1.25,95% 0=1.04-15.2) remained independently associated with anemia. Anaemia is common in HIV positive pregnant women in this environment. Care providers must endeavor to determine the HIV status of every pregnant woman especially if she presents with anaemia with a view to providing appropriate interventions.