Browsing by Author "Fagbamigbe, A. F."

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A Bayesian sensitivity analysis of the effect of different random effects distributions on growth curve models
(Statistics and Probability African Society, 2020) Ganjali, M.; Baghfalaki, T.; Fagbamigbe, A. F.
Growth curve data consist of repeated measurements of a contin uous growth process of human, animal, plant, microbial or bacterial genetic data over time in a population of individuals. A classical approach for analyzing such data is the use of non-linear mixed effects models under normality assumption for the responses. But, sometimes the underlying population that the sample is extracted from is an abnormal population or includes some homogeneous sub-samples. So, detection of original properties of the population is an important scientific question of interest. In this paper, a sensitivity analysis of using different parametric and non-parametric distributions for the random effects on the results of applying non-linear mixed models is proposed for emphasizing the possible heterogeneity in the population. A Bayesian MCMC procedure is developed for parameter estimation and inference is performed via a hierarchical Bayesian framework. The methodology is illustrated using a real data set on study of influence of menarche on changes in body fat accretion.
A comparative analysis of condom use among unmarried youths in rural community in Nigeria
(Scientific & Academic Publishing, 2011) Fagbamigbe, A. F.; Adebowale, A. S.; Olaniyan, F. A.
Globally, youths are more sexually active than any subgroup of the population. In Nigeria, the prevalence of condom use among youths is low. This study explored and compared condom use among in-school youths and out-of-school youths in south western Nigeria. This population based study used multistage random sampling technique to select eligible 600 youths aged 15-24 years which included 300 high school students and 300 out-of-school youths in Ekiti West Local Government area of Ekiti state, Nigeria. Descriptive statistics, t-test, chi square test and logistic regression were used for analysis. The mean age of in-school youths and out of school youths were 18.1±2.2 years and 19.0±2.7 years respectively. Overall, 35.5% of all sexually active respondents, 29.8% in-school and 40.8% out-of-school youths reported to have ever used condom during sexual intercourse (p<0.05) The study concluded that although, condom use is low across the study population, but higher among out-of-school youths. Youths aged 15-24 should be given free access to condom particularly the in-school youths.
A comparative analysis of fertility differentials in Ghana and Nigeria
(Women's Health and Action Research Centre, 2014) Olatoregun, O.; Fagbamigbe, A. F.; Akinyemi, O. J.; Yusuf, O. B.; Bamgboye, E. A.
Nigeria and Ghana are the most densely populated countries in the West African sub-region with fertility levels above world average. Our study compared the two countries’ fertility levels and their determinants as well as the differentials in the effect of these factors across the two countries. We carried out a retrospective analysis of data from the Nigeria and Ghana Demographic Health Surveys, 2008. The sample of 33,385 and 4,916 women aged 15-49 years obtained in Nigeria and Ghana respectively was stratified into low, medium and high fertility using reported children ever born. Data was summarized using appropriate descriptive statistics. Factors influencing fertility were identified using ordinal logistic regression at 5% significance level. While unemployment significantly lowers fertility in Nigeria, it wasn’t significant in Ghana. In both countries, education, age at first marriage, marital status, urban-rural residence, wealth index and use of oral contraception were the main factors influencing high fertility levels.
A comparative analysis of the infuence of contraceptive use and fertility desire on the duration of second birth interval in four sub-Saharan African countries
(BioMed Central, 2021) Afolabi, R. F.; Fagbamigbe, A. F.; Palamuleni, M. E.
Background: Fertility decline characterised by inter-birth intervals remains rather slow or stall in many countries of sub-Saharan African (SSA). Non-adherence to optimal inter-birth intervals often occasioned by low prevalence of contraceptive use and high fertility desires often lead to poor maternal and child health outcomes. Additionally, information on the influence of contraception and fertility desire on interval between first and second births (SBI) is rarely available. This study therefore aimed to examine the influence of fertility desire and contraception on SBI among women in four SSA countries. Methods: We analysed cross-sectional data on women aged 15–49 years who participated in the recent Demo graphic and Health Surveys in DR Congo, Ethiopia, Nigeria and South Africa. Semi-parametric Cox proportional hazards regression was employed for the analysis at 5% significance level. Results: The median time to second birth was 34 months in DR Congo; 35 months, Nigeria; 42 months, Ethiopia; and 71 months, South Africa. About 70% of the women desired additional child(ren) and two-thirds have never used contraceptive in both Nigeria and DR Congo. The hazard of second birth was significantly lower among women who desired additional child(ren) compared to desired for no more child in DR Congo (aHR=0.93; CI: 0.89–0.97), Ethiopia (aHR=0.64; CI: 0.61–0.67) and South Africa (aHR=0.51; CI: 0.47–0.55). Women who had never used contraceptive were 12%, 20% and 24% more likely to lengthen SBI than those who were current users in DR Congo, Nigeria and South Africa respectively. DR Congo and Nigerian women were about two times more likely to shorten SBI compared with their South African counterparts. Other significant determinants of SBI include ethnicity, rural residential, age and marital status at first birth, wealth and employment status. Conclusion: Findings showed differentials in the linkage between second birth interval and the desired fertility and contraception by country, demonstrating the importance of context. The contribution of these factors to second birth interval requires country context-specific attention if further decline in fertility and poor health outcomes associated with sub-optimal inter-birth interval is to be attained in SSA.
A model for measuring association between bivariate censored outcomes
(Medwell Journals, 2010) Fagbamigbe, A. F.; Adebowale, A. S.
The dependence between two random variables is completely described by their bivariate distribution. Bivariate sunrival analysis arises in the time to events analysis of measurements that are paired. Although, there are several comistent estimators of the bivariate distribution function, an efficient and consistent estimation has proven to be a difficult problem. It is of interest to determine if it exists, the possible association between pairs of variables, both of which are subject to censoring with recurrence times of kidney infection as a case study. Copula models which is one of the existing methods of measuring the possible association between bivariate cemored variables were reviewed. The overall average recurrence time and its standard deviation are 102 and 131, respectively though the recurrence time in the first kidney has average and standard deviation of 112 and 144.01, respectively whle the average and standard deviation of recurrence time in the second kidney recurrence time is 92 and 117.20, respectively. The study also showed that the modal recurrence time in the 2 kidneys is 42. The correlation between infection recurrence in the pairs of kidneys was found to be 0.268 with 95% confidential interval of (-01854985,07206918).
A randomized, open-label trial of combined nitazoxanide and atazanavir/ritonavir for mild to moderate COVID-19
(Frontiers Media, 2022-09) Fowotade, A.; Bamidele, F.; Egbetola, B.; Fagbamigbe, A. F.; Adeagbo, B. A.; Adefuye, B. O.; Olagunoye, A.; Ojo, T. O.; Adebiyi, A. O.; Olagunju, O. I.; Ladipo, O. T.; Akinloye, A.; Onayade, A.; Bolaji, O. O.; Rannard, S.; Happi, C.; Owen, A.; Olagunju, A.
Background: The nitazoxanide plus atazanavir/ritonavir for COVID-19 (NACOVID) trial investigated the efficacy and safety of repurposed nitazoxanide combined with atazanavir/ritonavir for COVID-19. Methods: This is a pilot, randomized, open-label multicenter trial conducted in Nigeria. Mild to moderate COVID-19 patients were randomly assigned to receive standard of care (SoC) or SoC plus a 14-day course of nitazoxanide (1,000 mg b.i.d.) and atazanavir/ritonavir (300/100 mg od) and followed through day 28. Study endpoints included time to clinical improvement, SARS-CoV-2 viral load change, and time to complete symptom resolution. Safety and pharmacokinetics were also evaluated (ClinicalTrials.gov ID: NCT04459286). Results: There was no difference in time to clinical improvement between the SoC (n = 26) and SoC plus intervention arms (n = 31; Cox proportional hazards regression analysis adjusted hazard ratio, aHR = 0.898, 95% CI: 0.492–1.638, p = 0.725). No difference was observed in the pattern of saliva SARS-CoV- 2 viral load changes from days 2–28 in the 35% of patients with detectable virus at baseline (20/57) (aHR = 0.948, 95% CI: 0.341–2.636, p = 0.919). There was no significant difference in time to complete symptom resolution (aHR = 0.535, 95% CI: 0.251–1.140, p = 0.105). Atazanavir/ritonavir increased tizoxanide plasma exposure by 68% and median trough plasma concentration was 1,546 ng/ml (95% CI: 797–2,557), above its putative EC90 in 54% of patients. Tizoxanide was undetectable in saliva. Conclusion: Nitazoxanide co-administered with atazanavir/ritonavir was safe but not better than standard of care in treating COVID-19. These findings should be interpreted in the context of incomplete enrollment (64%) and the limited number of patients with detectable SARS-CoV-2 in saliva at baseline in this trial.
A randomized, open-label trial of combined nitazoxanide and atazanavir/ritonavir for mild to moderate COVID-19
(Frontiers Media SA, 2022) Fowotade, A.; Bamidele, F.; Egbetola, B.; Fagbamigbe, A. F.; Adeagbo, B. A.; Adefuye, B. O.; Olagunoye, A.; Ojo, T. O.; Adebiyi, A. O.; Olagunju, O. I.; Ladipo, O. T.; Akinloye, A.; Onayade, A.; Bolaji, O. O.; Rannard, S.; Happi, C.; Owen, A.; Olagunju, A.
Background: The nitazoxanide plus atazanavir/ritonavir for COVID-19 (NACOVID) trial investigated the efficacy and safety of repurposed nitazoxanide combined with atazanavir/ritonavir for COVID-19. Methods: This is a pilot, randomized, open-label multicenter trial conducted in Nigeria. Mild to moderate COVID-19 patients were randomly assigned to receive standard of care (SoC) or SoC plus a 14-day course of nitazoxanide (1,000 mg b.i.d.) and atazanavir/ritonavir (300/100 mg od) and followed through day 28. Study endpoints included time to clinical improvement, SARS-CoV-2 viral load change, and time to complete symptom resolution. Safety and pharmacokinetics were also evaluated (ClinicalTrials.gov ID: NCT04459286). Results: There was no difference in time to clinical improvement between the SoC (n = 26) and SoC plus intervention arms (n = 31; Cox proportional hazards regression analysis adjusted hazard ratio, aHR = 0.898, 95% CI: 0.492–1.638, p = 0.725). No difference was observed in the pattern of saliva SARS-CoV2 viral load changes from days 2–28 in the 35% of patients with detectable virus at baseline (20/57) (aHR = 0.948, 95% CI: 0.341–2.636, p = 0.919). There was no significant difference in time to complete symptom resolution (aHR = 0.535, 95% CI: 0.251–1.140, p = 0.105). Atazanavir/ritonavir increased tizoxanide plasma exposure by 68% and median trough plasma concentration was 1,546 ng/ml (95% CI: 797–2,557), above its putative EC90 in 54% of patients. Tizoxanide was undetectable in saliva. Conclusion: Nitazoxanide co-administered with atazanavir/ritonavir was safe but not better than standard of care in treating COVID-19. These findings should be interpreted in the context of incomplete enrollment (64%) and the limited number of patients with detectable SARS-CoV-2 in saliva at baseline in this trial.
A survival analysis model for measuring association between bivariate censored outcomes: validation using mathematical simulation
(Scientific & Academic Publishing, 2017) Fagbamigbe, A. F.; Adebowale, A. S.; Bamgboye, E. A.
Bivariate censored data occur in follow-up studies of events that can result in two different outcomes. Many studies have explored methods for inference about the marginal recurrence times of these outcomes. However, very few have focused on the dependence structures between their occurrences or recurrence times especially when these outcomes are censored as evidence in the current study. This theoretical and empirical study used simulated data to monitor and validate the survival analysis model for measuring association between recurrence times of bivariate censored outcomes. Bivariate outcomes would naturally fall into one of four possibilities: only the first, only the second, none or both conditions occurring with different and distinct likelihoods. Using predetermined correlation coefficients, n=100000 bivariate standardized binormal data were simulated. The simulated data were then subjected to different censoring chances while contributions of the likelihoods of the four possibilities were examined and Maximum Likelihood Estimate (MLE) of the association parameter determined. For the data simulated at 50% censoring, MLE of the association parameter tended to zero as the predetermined correlation coefficients fell from +1.0 to -1.0. However, at 0% censoring, the MLE were approximates of the predetermined correlation coefficients. The developed model was robust as the model responded adequately to the dynamics of the predetermined correlation and censoring conditions. The model would be appropriate in studying associations between two censored survival times.
Academic student satisfaction and perceived performance in the e-learning environment during the COVID-19 pandemic: Evidence across ten countries
(Public Library of Science, 2021) Kerzič, D.; Alex, J. K.; Alvarado, R. P. B.; Bezerra, D. S.; Cheraghi, M.; Dobrowolska, B.; Fagbamigbe, A. F.; Faris, M. E.; Franca, T.
The outbreak of the COVID-19 pandemic has dramatically shaped higher education and seen the distinct rise of e-learning as a compulsory element of the modern educational land scape. Accordingly, this study highlights the factors which have influenced how students perceive their academic performance during this emergency changeover to e-learning. The empirical analysis is performed on a sample of 10,092 higher education students from 10 countries across 4 continents during the pandemic’s first wave through an online survey. A structural equation model revealed the quality of e-learning was mainly derived from service quality, the teacher’s active role in the process of online education, and the overall system quality, while the students’ digital competencies and online interactions with their colleagues and teachers were considered to be slightly less important factors. The impact of e-learning quality on the students’ performance was strongly mediated by their satisfaction with e-learning. In general, the model gave quite consistent results across countries, gender, study fields, and levels of study. The findings provide a basis for policy recommendations to support decision-makers incorporate e-learning issues in the current and any new similar circumstances.
An assessment of the nutritional status of ART receiving HIV-orphaned and vulnerable children in South-West Nigeria
(Elsevier Ltd, 2019) Fagbamigbe, A. F.; Adebowale, A. S.; Ajayi, I.
Introduction: Good nutritional status is pertinent to the optimal outcome of effective ART among children. Against this backdrop, the objective of the current study is to assess the nutritional indices of children receiving ART in South-West Nigeria. Methods: The study was cross-sectional in design. We randomly selected three urban and six rural ART sites from the ones offering ART services in Oyo state. All consented children receiving ART treatments in the aforementioned sites participated in the study. A total of 390 HIV-positive children and adolescents aged 6–18 years were interviewed using a semi-structured interviewer-administered questionnaire. Children were assessed and growth curves were constructed using the 2007 World Health Organisation (WHO) growth reference standard for children as well as adolescents. Data were presented using descriptive statistics. Results: About 52% of the children are male, 136 (34.9%) have lost at least one parent, 52 (13.3%) have lost either parent to HIV/AIDS. Among the males, 19%, 27%, and 27% were underweight, stunted and thin, respectively when compared with 17%, 23% and 23%, respectively, among females. The male and female weight-for-age average z-score were (-0.98 vs -1.04), height-for-age (-1.12 vs -1.07), and BMI-for-age (-1.19 vs -1.18). Irrespective of age, sex, parental survival, and residence, weight-for-age and BMI-for-age analysis revealed substantial underweight, with the worst outcomes being among those orphaned by HIV/AIDS. Conclusion: All nutritional indices considered in this study fell short of the WHO standard. HIV positive children in the ART sites included in this study are faced with a high burden of undernourishment despite been placed on daily ART regimens. In addition to efficient ART, interventions to ameliorate poor nutritional status is needed.
Analysis of regional variations in influence of household and environmental characteristics on prevalence of diarrhoea among under-five children in Nigeria
(Nigeria Medical Association, 2017) Fagbamigbe, A. F.; Morakinyo, O. M.; Abatta, E.
Background: Until now, factors influencing diarrhoea in children has been studied in Nigeria without full recourse to her wide geopolitical diversities. Aim: This study assessed the differentials in regional prevalence of diarrhoea and the role of household and environmental characteristics in the distribution and likelihood of diarrhoea among children under-five years within each geopolitical region in Nigeria. Subjects and Methods: A cross-sectional study among households with under-five children. We used the data from the 2012 Nigeria National HIV/AIDS and Reproductive Health Survey (NARHS Plus II). We weighed the data and used descriptive statistics, Pearson Chi-square (x2 ) and logistic regression to analyse data at 5% significance level. Results: Over a third, 38.0% (5062/13322) of households sourced drinking water from non-improved sources, highest in North East, 45.3% (1049/2315) and least in South West, 27.6% (521/1888) Over half, 52.7% (7021/13322) of toilets were non-improved, highest in North East, 68.6% (1588/2315) and least in South West, 35.7% (674/1888), most households practice open defecation. The overall prevalence of diarrhoea was 13.0% (1732/13322), 17.0% (294/1732) in North East and higher in other regions than 9.0% (156/1732) in the south west. The odds of diarrhoea was significantly higher among rural households in the South-South (OR=2.1, 95% CI: 1.4-3.1) but more prevalent in urban North East and South East. Also, the odds of having diarrhoea increased with wealth quintile to which household belongs was significant in all the regions except in the North East. Conclusions: The prevalence of diarrhoea varied widely across the regions. Also, the influence of household and environmental characteristics on the prevalence of diarrhoea differed across the geopolitical regions. This is an indication that policies on control of diarrhoea should be region-specific.
Application of the exponentiated log-logistic Weibull distribution to censored data
(Nigerian Society of Physical Sciences, 2019) Fagbamigbe, A. F.; Basele, G. K.; Makubate, B.; Oluyede, B. O.
In a recent paper, a new model called the Exponentiated Log-Logistic Weibull (ELLoGW) distribution with applications to reliability, survival analysis and income data was proposed. In this study, we applied the recently developed ELLoGW model to a wide range of censored data. We found that the ELLoGW distribution is a very competitive model for describing censored observations in life-time reliability problems such as survival analysis. This work shows that in certain cases, the ELLoGW distribution performs better than other parametric model such as the Log-Logistic Weibull, Exponentiated Log-Logistic Exponential, Log-Logistic Exponential distributions and the non-nested Gamma-Dagum (GD)
Assessing full immunisation coverage using lot quality assurance sampling in urban and rural districts of southwest Nigeria
(Royal Society of Tropical Medicine and Hygiene., 2013) Fatiregun, A. A.; Adebowale, A. S.; Ayoka, R. O.; Fagbamigbe, A. F.
Background: This study was conducted to identify administrative wards (lots) with unacceptable levels of full child immunisation coverage, and to identify factors associated with achievement of a complete child immunisation schedule in Ibadan North East (IBNE) and Ido local government areas (LGAs) of Oyo State, Nigeria. Methods: A cross-sectional survey involving 1178 mothers, 588 from IBNE LGAs and 590 from Ido LGAs, with children 12–23 months of age was conducted. Children were considered ‘fully-immunised if they received all the vaccines included in the immunisation schedule. Lot quality assurance sampling was used to determine lots with acceptable and non-acceptable coverage. Samples were weighted based on the population by lot to estimate overall coverage in the two LGAs and a logistic regression model was used to identify factors associated with the fully immunised child. Results: Mean age of the mothers was 28.5+5.6 and 28.1+6.0 years in IBNE and Ido LGAs, respectively. Eleven of 12 wards in IBNE and all the wards in Ido had unacceptable coverage. The proportion of fully immunised children was 40.2% in IBNE and 41.3% in Ido. Maternal age ≥30 years, retention of an immunisation card, completion of tertiary education, or secondary education, hospital birth and first-order birth were significant predictors of complete childhood immunisation. Conclusion: The level of full immunisation coverage was unacceptable in almost all the wards. Educational inter vention on the importance of completion of immunisation schedule should target young, uneducated mothers, mothers who delivered their babies at home and those with a high birth order.
Assessment of quality of antenatal care services in Nigeria: evidence from a population-based survey
(BioMed Central, 2015) Fagbamigbe, A. F.; Idemudia, E. S.
Background: The aim of the newly introduced “focused Antenatal Care (ANC)” is not only to achieve a minimum number of 4 visits, but also the timeliness of the commencement of the visits as well as the quality and relevance of services offered during the visits. This study is therefore designed to assess the quality of ANC services in Nigeria. Methods: We used information supplied by the 13410 respondents who claimed to have used the ANC facilities at least once within five year preceding the 2013 Nigeria Demographic and Household Survey (NDHS). Ten components of ANC including: offer of HIV test, Tetanus Toxoid injection, receiving iron supplementation, intermittent preventive treatment (IPT), intestinal preventive drug (IPD), timely ANC enrollment and number of visits were assessed. Receipts of all the ten components were classified as desirable (good) quality of ANC services while receipt of eight critical components among the ten were assumed to be the minimum acceptable quality. Data was weighted and analyzed using descriptive statistics and logistic regression models at 5 % significance level. Results: Measurement of blood pressure and receiving iron supplementation were the most commonly offered ANC component in Nigeria with 91.0 % each while IPD and IPT were given to only 20.7 % and 37.6 % respectively. Less than two thirds were taught on PMTCT while 41.7 % had HIV test and obtained results. Only 4.6 % (95 % CI: 4.2–5.1) of women received good quality of ANC while nearly 1.0 % did not receive any of the components. About 11.3 % (95 % CI: 10.6–11.9 %) of the attendees had minimum acceptable quality of ANC. Receipt of good quality ANC services was higher among users who initiated ANC early, had at least 4 ANC visits, attended to by skilled health workers, attended government and private hospitals and clinics. Higher odds of receiving good quality of ANC were found among users who lives in urban areas, having higher educational attainment, belonging to households in upper wealth quintiles and attended to by skilled ANC provider. Conclusions: The levels of desirable and minimum acceptable quality of ANC services were poor in Nigeria thereby jeopardizing efforts to achieve the MDGs. There is need for intensified commitment by national and state governments in Nigeria as well as other stakeholders to ensure that main components of ANC are received by the users.
Barriers to antenatal care use in Nigeria: evidences from non-users and implications for maternal health programming
(BioMed Central, 2015) Fagbamigbe, A. F.; Idemudia, E. S.
Background: In Nigeria, over one third of pregnant women do not attend Antenatal Care (ANC) service during pregnancy. This study evaluated barriers to the use of ANC services in Nigeria from the perspective of non-users. Methods: Records of the 2199 (34.9%) respondents who did not use ANC among the 6299 women of childbearing age who had at least one child within five years preceding the 2012 National HIV/AIDS and Reproductive Health Survey (NARHS Plus II), were used for this analysis. The barriers reported for not visiting any ANC provider were assessed vis-à-vis respondents’ social demographic characteristics, using multiple response data analysis techniques and Pearson chi-square test at 5% significance level. Results: Of the mothers who did not use ANC during five years preceding the survey, rural dwellers were the majority (82.5%) and 57.3% had no formal education. Most non-users (96.5%) were employed while 93.0% were currently married. North East with 51.5% was the geographical zone with highest number of non-users compared with 14.3% from the South East. Some respondents with higher education (2.0%) and also in the wealthiest quintiles (4.2%) did not use ANC. The reasons for non-use of ANC varied significantly with respondents’ wealth status, educational attainment, residence, geographical locations, age and marital status. Over half (56.4%) of the non-users reported having a problem with getting money to use ANC services while 44.1% claimed they did not attend ANC due to unavailability of transport facilities. The three leading problems: “getting money to go”, “Farness of ANC service providers” and “unavailability of transport” constituted 44.3% of all barriers. Elimination of these three problems could increase ANC coverage in Nigeria by over 15%. Conclusion: Non-use of ANC was commonest among the poor, rural, currently married, less educated respondents from Northern Nigeria especially the North East zone. Affordability, availability and accessibility of ANC providers are the hurdles to ANC utilization in Nigeria. Addressing financial and other barriers to ANC use, quality improvement of ANC services to increase women’s satisfaction and utilization and ensuring maximal contacts among women, society, and ANC providers are surest ways to increasing ANC coverage in Nigeria.
Bayesian geo-additive spatial modelling of HIV prevalence using data from population-based surveys
(Polish AIDS Research Society, 2019) Adebayo, S. B.; Gayawan, E.; Fagbamigbe, A. F.; Bello, F. W.
Introduction: Estimates of human immunodeficiency virus (HIV) prevalence in Nigeria have been based on the data from HIV surveillance and sentinel studies among pregnant women attending antenatal clinics at some selected sentinel sites. However, such data overestimate HIV prevalence. This paper explores possible geographical variations in HIV prevalence among the general population of males and females based on two waves of the National HIV/acquired immune deficiency syndrome (AIDS) and Reproductive Health Surveys. Material and methods: Data were extracted from the cross-sectional 2007 and 2012 National HIV/ AIDS and Reproductive Health Serological Surveys of men (15-64 years) and women (15-49 years) covering all states of Nigeria. Bayesian geo-additive modelling technique was employed for analysis. Appropriate prior distributions were assigned to the different types of variables in the models and inference was based on the Markov Chain Monte Carlo (MCMC) technique. Models of different specifications were considered. Results: The findings reveal significant spatial variations at a highly disaggregated level of states in Nigeria. The nonlinear effects of respondents’ age show a similar pattern of HIV prevalence for male, female and the combined respondents, implying that HIV prevalence is peak among middle-age individuals, from where it declines with age. Also, the results reveal a downward change in HIV prevalence in Nigeria between 2007 and 2012. Conclusions: When these findings are taken into consideration in designing intervention strategies, it is believed that each state can be targeted with the right intervention(s). This can also lead to efficient utilization of the scarce resources witnessed globally and more importantly with the economic recession in Nigeria.
Controlling malaria in pregnancy: how far from the Abuja targets?
(Dutch Malaria Foundation, 2016) Yusuf, O. B.; Akinyemi, J. O.; Fagbamigbe, A. F.; Ajayi, I. O.; Bamgboye, E. A.; Ngige, E.; Issa, K.; Abatta, E.; Ezire, O.; Amida, P.; Bashorun, A.
Background. The Roll Back Malaria (RBM) initiative recommended that all pregnant women receive Intermittent Preventive Treatment (IPTp) and that by 2010 at least 80% of people at risk of malaria (including pregnant women) use insecticide-treated bednets (ITN) in areas with stable transmission. We evaluated ITN/IPTp coverage, explored its associated factors, and estimated the number of pregnancies protected from malaria. Materials and methods. This analysis was based on data from the 2012 National HIV/AIDS and Reproductive Health Survey (NARHS Plus). To assess ITN coverage, we used the population of women that was pregnant (n=22,438) at the time of the survey. For IPTp coverage, we used women that had a live birth in the 5 years preceding the survey (n= 118,187) and extracted the population of pregnant women that, during their last pregnancy, received drugs for protection against malaria. We estimated the number of live births using the projected population of females in each state, population of women of child -bearing age and the total fertility rate. The estimated number of pregnancies covered/protected by ITN and IPTp was obtained from a product of the estimated live births and the reported coverage. Multivariate logistic regression was used to determine factors associated with ITN and IPTp use. Results. We estimated that there were 5,798,897 live births in Nigeria in 2012, of which 3,537,327 and 2,302,162 pregnancies were protected by ITN and IPTp, respectively. Four of 36 states achieved the 80% RBM target for ITN coverage. No state achieved the 100% target for IPTp. Education and socio-economic status were associated with IPTp use. Conclusion. ITN coverage was higher than in previous estimates even though it is still below the RBM targets. However, IPTp coverage remained low in 2012 and was not likely to increase to match the 2015 target coverage of 100%.
Coverage-level and predictors of maternity continuum of care in Nigeria: implications for maternal, newborn and child health programming
(BioMed Central, 2023) Oyedele, O. K.; Fagbamigbe, A. F.; Akinyemi, O. J.; Adebowale, A. S.
Background Completing maternity continuum of care from pregnancy to postpartum is a core strategy to reduce the burden of maternal and neonatal mortality dominant in sub-Saharan Africa, particularly Nigeria. Thus, we evaluated the level of completion, dropout and predictors of women uptake of optimal antenatal care (ANC) in pregnancy, continuation to use of skilled birth attendants (SBA) at childbirth and postnatal care (PNC) utilization at postpartum in Nigeria. Methods A cross-sectional analysis of nationally representative 21,447 pregnancies that resulted to births within five years preceding the 2018 Nigerian Demographic Health Survey. Maternity continuum of care model pathway based on WHO recommendation was the outcome measure while explanatory variables were classified as; socio-demographic, maternal and birth characteristics, pregnancy care quality, economic and autonomous factors. Descriptive statistics describes the factors, backward stepwise regression initially assessed association (p<0.10), multivariable binary logistic regression and complementary-log–log model quantifies association at a 95% confidence interval (α=0.05). Results Coverage decrease from 75.1% (turn-up at ANC) to 56.7% (optimal ANC) and to 37.4% (optimal ANC and SBA) while only 6.5% completed the essential continuum of care. Dropout in the model pathway however increase from 17.5% at ANC to 20.2% at SBA and 30.9% at PNC. Continuation and completion of maternity care are positively drive by women; with at least primary education (AOR=1.27, 95%CI=1.01–1.62), average wealth index (AOR=1.83, 95%CI=1.48 –2.25), southern geopolitical zone (AOR=1.61, 95%CI=1.29–2.01), making health decision alone (AOR=1.39, 95%CI=1.16–1.66), having nurse as ANC provider (AOR=3.53, 95%CI=2.01–6.17) and taking at least two dose of tetanus toxoid vaccine (AOR=1.25, 95%CI=1.06–1.62) while women in rural residence (AOR=0.78, 95%CI=0.68–0.90) and initiation of ANC as late as third trimester (AOR=0.44, 95%CI=0.34–0.58) negatively influenced continuation and completion. Conclusions 6.5% coverage in maternity continuum of care completion is very low and far below the WHO recommended level in Nigeria. Women dropout more at postnatal care than at skilled delivery and antenatal. Education, wealth, women health decision power and tetanus toxoid vaccination drives continuation and completion of maternity care. Strategies optimizing these factors in maternity packages will be supreme to strengthen maternal, newborn and child health.
Current and predicted fertility using poisson regression model: evidence from 2008 nigerian demographic health survey
(Women's Health and Action Research Centre, 2014) Fagbamigbe, A. F.; Adebowale, A. S.
Nigeria with persistent high growth rate is among top ten most populous countries. Monitoring key mechanisms of population dynamics particularly fertility in Nigeria is long overdue. Periodical availability of data on fertility and other demographic indices is scarce, hence this study. Our objective was to build a non-linear model to identify fertility determinants and predict fertility using women’s background characteristics. We used 2008 Nigeria Demography and Health Survey dataset consisting of 33,385 women with 31.4% from urban area. Fertility was measured using children ever born (CEB) and fitted into multi-factors additive Poisson regression models. Respondents mean age was 28.64±9.59years, average CEB of 3.13±3.07 but higher among rural women than urban women (3.42±3.16 vs 2.53±2.79). Women aged 20-24years were about twice as likely to have higher CEB as those aged 15-19years (IRR=2.06, 95% CI: 1.95-2.18). Model with minimum deviance was selected and was used to predict CEB by the woman.
Decomposing the educational inequalities in the factors associated with severe acute malnutrition among under-five children in low- and middle-income countries
(Biomed Central, 2020) Fagbamigbe, A. F.; Kandala, N. B.; Uthman, O. A.
Background: Low- and Middle-Income Countries (LMIC) have remained plagued with the burden of severe acute malnutrition (SAM). The decomposition of the educational inequalities in SAM across individual, household and neighbourhood characteristics in LMIC has not been explored. This study aims to decompose educational-related inequalities in the development of SAM among under-five children in LMIC and identify the risk factors that contribute to the inequalities. Methods: We pooled successive secondary data from the Demographic and Health Survey conducted between 2010 and 2018 in 51 LMIC. We analysed data of 532,680 under-five children nested within 55,823 neighbourhoods. Severe acute malnutrition was the outcome variable while the literacy status of mothers was the main exposure variable. The explanatory variables cut across the individual-, household- and neighbourhood-level factors of the mother-child pair. Oaxaca-Blinder decomposition method was used at p = 0.05. Results: The proportion of children whose mothers were not educated ranged from 0.1% in Armenia and Kyrgyz Republic to as much as 86.1% in Niger. The overall prevalence of SAM in the group of children whose mothers had no education was 5.8% compared with 4.2% among those whose mothers were educated, this varied within each country. Fourteen countries (Cameroon(p < 0.001), Chad(p < 0.001), Comoro(p = 0.047), Burkina Faso(p < 0.001), Ethiopia(p < 0.001), India(p < 0.001), Kenya(p < 0.001), Mozambique(p = 0.012), Namibia(p = 0.001), Nigeria(p < 0.001), Pakistan(p < 0.001), Senegal(p = 0.003), Togo(p = 0.013), and Timor Leste(p < 0.001) had statistically significant pro illiterate inequality while no country showed statistically significant pro-literate inequality. We found significant differences in SAM prevalence across child’s age (p < 0.001), child’s sex(p < 0.001), maternal age(p = 0.001), household wealth quintile(p = 0.001), mother’s access to media(p = 0.001), birth weight(p < 0.001) and neighbourhood socioeconomic status disadvantage(p < 0.001). On the average, neighbourhood socioeconomic status disadvantage, location of residence were the most important factors in most countries. Other contributors to the explanation of educational inequalities are birth weight, maternal age and toilet type. Conclusions: SAM is prevalent in most LMIC with wide educational inequalities explained by individual, household and community-level factors. Promotion of women education should be strengthened as better education among women will close the gaps and reduce the burden of SAM generally. We recommend further studies of other determinate causes of inequalities in severe acute malnutrition in LMIC.