FACULTY OF CLINICAL SCIENCES
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Item Psychiatric morbidity among pregnant and non-pregnant women in Ibadan, Nigeria.(Taylor & Francis, 2023) Bello, O.B.; Bella-Awusah, T.T.; Adebayo, A.M.; John Akinola, J.O; Ndikom, C.M.; Ilori, T.; Cadmus, E.O.; Omokhodion, F.A comparative cross-sectional study was conducted among 991 pregnant and 674 non-pregnant women of reproductive age attending healthcare facilities in Ibadan, Nigeria using the General Health Questionnaire-12 (GHQ), and WHO self-reporting questionnaire (SRQ). Logistic regression analysis was conducted to identify predictors of psychiatric morbidity at p<0.05. A significantly higher proportion of pregnant women experienced psychological distress on the GHQ (51.8%) and psychiatric morbidity on SRQ (33.3%) compared with 28.6% and 18.2% of non-pregnant women, respectively. Predictors of psychiatric morbidity among pregnant women were the type of facility, poor satisfaction and communication with partners, the experience of violence in the home, previous abortions, and previous history of depression. Psychiatric morbidity among non-pregnant women was predicted by younger age, previous history of depression, poor satisfaction and communication with partners. There is a need for early identification of psychiatric morbidity among women of reproductive age, to ensure early interventions and prevent long-term disability.Item Predictors of Shisha use among Medical and Dental Students in Ibadan, Nigeria(College of Health Sciences, Obafemi Awolowo University, 2022) Fagbule, O.F.; Cadmus, E.O.Background: Shisha is a form of smoked tobacco product. Medical trainees arepotential stakeholders in providing accurate information about shisha and discouraging its use. However, few studies have targeted medical trainees to provide much‑needed information for policymaking and planning of programs. Aim: To determine the prevalence and predictors of shisha use among medical and dental students in Ibadan, Nigeria. Subjects and Methods: A cross‑sectional study was conducted among medical and dental students (n = 252) of the University of Ibadan, selected using the stratified random sampling technique. The Global Health Profession Students Survey (GHPSS) questionnaire was used to obtain information about socio‑demographics, shisha and other tobacco use, and knowledge and attitude towards shisha use. The data were analyzed using Statistical Package for the Social Sciences (SPSS) version 25. Continuous data were presented using mean and standard deviation, whereas categorical variables were reported as proportions. The association between the outcome variable (shisha use) and independent variables (sociodemographic characteristics, having friends who use shisha) was measured using Pearson’s Chi‑square test, and factors significant (P < 0.05) were entered into the multivariable logistic regression model. Result: The mean age (± SD) was 21.7 (± 3.1) years. Over half [136 (54%)] were males, and most [199 (79%)] were medical students. About 28 (11%) were not aware of shisha, whereas 22 (8.7%) reported they had ever used shisha. The mean knowledge score was 5.6 ± 4.7, and 76 (33.9%) supported shisha use. Positive predictors of shisha use included the male gender [OR: 6.4 (95% CI: 1.76–23.10)] and having a friend who uses shisha [OR: 28.2 (95% CI: 5.49–144.23)]. Conclusion: The prevalence of shisha use among medical and dental students in Ibadan is unacceptably high, although low compared to other countries in similar resource settings. Surprisingly, the students had poor knowledge about shisha, and over a third supported its use, especially males who were more prone to use it. There is a need to design targeted health promotion and education for the students, especially males.Item Qualitative exploration of health system response to COVID-19 pandemic applying the WHO health systems framework: Case study of a Nigerian state(Elsevier, 2021) Akinyemi, O.O.; Popoola, O.A.; Fowotade, A.; Adekanmbi O.; Cadmus, E.O.; Adebayo. A. M.Pandemics can result in significantly high rates of morbidity and mortality with higher impact in Lower- and Middle-Income Countries like Nigeria. Health systems have an im- portant role in a multi-sector response to pandemics, as there are already concerns that COVID-19 will significantly divert limited health care resources. This study appraised the readiness and resilience of the Nigerian health system to the COVID-19 pandemic, using Oyo State, southwest Nigeria, as a case study. This study was a cross-sectional qualita- tive study involving key informant and in-depth interviews. Purposive sampling was used in recruiting participants who were members of the Task Force on COVID-19 in the state and Emergency Operations Centre (EOC) members (physicians, nurses, laboratory scientists, "contact tracers", logistic managers) and other partners. The state's health system response to COVID 19 was assessed using the WHO health systems framework. Audio recordings of the interviews done in English were transcribed and thematic analysis of these tran- scripts was carried out using NVIVO software. Results show that the state government re- sponded promptly by putting in place measures to address the COVID-19 pandemic. How- ever, the response was not adequate owing to the fact that the health system has already been weakened by various challenges like poor funding of the health system, shortage of human resources and inadequate infrastructure. These contributed to the health system's sub-optimal response to the pandemic. In order to arm the health system for adequate and appropriate response during major health disasters like pandemics, fundamental pillars of the health system-finance, human resources, information and technology, medical equip- ment and leadership - need to be addressed in order to have a resilient health system.Item Appraisal of the Geriatric Centre University College Hospital Ibadan.(West African College of Physicians and the West African College of Surgeons, 2021) Adebusoye, L. A.; Olowookere, O.; Ajayi, S.; Cadmus, E.O.; Labaeka, EGeriatric medicine is an emerging subspecialty in Nigeria. The interest in the care of older Nigerians followed the Madrid International Plan of Action on Ageing in April 2002. This led to an increase in research, publications and advocacy culminating in the establishment of the pioneer geriatric centre in Nigeria in 2012. Since then, there has been an increase in capacity building, manpower development and institutionalization of geriatric care in Nigeria. This is an account of the evolution of the Chief Tony Anenih Geriatric Centre, University College Hospital, Ibadan (UCH). METHODS: We undertook the review of the history, structure and key service elements in the Geriatric Centre, UCH from January 1, 2013, to December 31, 2020. RESULTS: The number of patients rose from 2,559 in the first year to 19,300 by the end of 2020. The initial four multidisciplinary units increased to 12 over the review period. Likewise, the in-patient admission increased between the first year (122 patients) and 2020 (141 patients). The overall mortality rate was 11.4% over the review period. Internship opportunities were provided to students including resident doctors, undergraduates (medical) and postgraduate students (Masters and PhD). Besides, 139 medical doctors have undergone the annual basic certificate training in geriatric medicine organised by the Centre. Also, 7 fellowship dissertations and 11 peer-reviewed papers have been published. CONCLUSION: The centre has demonstrated the possibility of caring for older patients in a low-resource setting. The employment of the multidisciplinary approach yielded a low mortality rate, higher attendance and manpower development.Item Correlates of quit intentions among current Nigerian smokers: Evidence from the 2012 Global Adult Tobacco Surveys (GATS).(European Publishing (on behalf of the European Network for Smoking and Tobacco Prevention - ENSP), 2020) Iken, O.; Cadmus, E.O.; Ahmed, BINTRODUCTION Approximately 3.1 million people use tobacco in Nigeria contributing to the burden of tobacco-related morbidity and mortality. However, many tobacco users who have tried to quit have been unable to do so at the first try, but may succeed or give up after multiple attempts. The transtheoretical model helps by classifying those with quit intentions into preparation, contemplation and precontemplation stages. These assist in the development of targeted interventions towards smokers in each stage for more effective results. There is limited evidence about cessation and quitting behaviour in the Nigerian context. This study aimed to explore the factors related to the intention to quit among current tobacco smokers in Nigeria using the transtheoretical model. METHODS The study was a secondary data analysis of the Nigeria 2012 Global Adult Tobacco Survey (GATS). The survey included non-institutionalized men and women aged ≥15 years. Data were analysed using SPSS version 21. The primary outcome variable was smoking quit intention. The correlates of quit intentions were determined for a p<0.05. RESULTS A total of 429 current smokers were mostly in precontemplation (64.7%) while 14.9% were in the preparation stage. Exposure to anti-tobacco media messages was associated with increased quit attempts, however, knowledge about the harmful effects of tobacco was associated with fewer quit intentions. Very few had access to cessation therapy and none had accessed a quitline. Male respondents were 9 times more likely to have a quit intention compared to females (OR=9.615; 95% CI: 1.449–1.478). Respondents with primary education were nearly three times more likely to have quit intentions than those with tertiary education (OR=2.991; 95% CI: 2.930–3.053). CONCLUSIONS While attention is on smoking prevention, most smokers in Nigeria are not considering quitting. There is a need for targeted interventions to reach smokers at various stages.Item Insights into the gut microbiota of Nigerian elderly with type 2 diabetes and non-diabetic elderly persons.(U.S. Department of Health and Human Services., 2020) Afolayan, A.; Adebusoye, L.; Cadmus, E.O.; Ayeni, FType 2 diabetes (T2D) is a prevalent non-communicable disease among the world's growing elderly population. The contribution of the gut microbiota to T2D in several Westernized countries has been established. However, there is little information on the role of the gut microbiota in T2D from the African continent where lifestyle and life expectancy are different. Aims: This study sought to investigate gut microbiota variation in relation to elderly people living with T2D. in Nigeria. Methods: Whole microbial community DNA were derived from the stool samples of healthy urban-dwelling elderly individuals and urban-dwelling elderly individuals with T2D. The V4 region of the 16S rRNA gene was Illumina- sequenced and analyzed using QIIME2. Results: Beta taxonomic diversity was significantly different between healthy elderly individuals and elderly in- dividuals with T2D. However, no difference in the alpha taxonomic diversity and predicted functional alpha diversity of the gut microbiota was observed. The genus Ruminococcus (T2D versus Healthy: 2.89% vs 2.21%), families Coriobacteriaceae (Collinsella, T2D versus Healthy: 2.62 % vs 1.25%) and Bifidobacteriaceae were enriched in elderly individuals with T2D, while members of Clostridiaceae (Clostridium, Healthy versus T2D: 5.6% vs 3.2%) and Peptostreptococcaceae (Healthy versus T2D: 3.45% vs 1.99%) were enriched in healthy volunteers. Pathways involved in amino acid biosynthesis were enriched in elderly individuals with T2D, while pathways involved in respiration and the biosynthesis of vital building blocks were enriched in healthy volunteers. Conclusions: The study demonstrated for the first time in an African elderly population that the abundance of Bifidobacteriaceae, Collinsella, and Ruminococcus within the gut varies in relation to T2D. Findings from this study suggest that the restoration of features associated with healthiness via the way of gut microbiota modification could be one step needed to improve elderly patient care.Item Caring for older adults during the COVID pandemic and beyond: Experience from a specialized tertiary facility for the care of older persons in a low-resource setting.(Pan African Medical Journal (PAMJ), 2020) Adebusoye, L. A.; Cadmus, E.O.; Labaeka, E. O.; Ajayi, S. A.; Olowookere, O. O.; Otegbayo, J. A.The ongoing Coronavirus disease (COVID-19) pandemic has markedly changed health care provisions and arrangements for patient care. Older adults are most susceptible to worse outcomes. The public health impact of the disease in terms of morbidity and mortality has necessitated the evolution of management protocols for effective care of older persons. This review describes our experience during this period attending to the healthcare needs of both the acutely ill and clinically stable patients at the first purpose-built facility for the care of older persons in Nigeria, the Chief Tony Anenih Geriatric Centre (CTAGC), University College Hospital, Ibadan. A major strategy recommended by the World Health Organization was a lockdown with restricted movements and laid down rules for engagement. As such, the CTAGC also embarked on steps to ensure patient safety as well as effective care. Prior to the lockdown, targeted activities included fumigation of the centre as well as health education and promotional activities. Measures were put in place to care for up to 95% of our patients at home. Thus, a “Care in Place” approach was adopted to enable them to take ownership of their care. Ambulatory older patients were seen on an out-patient basis following scheduled appointments after a telephone consultation through the hospital’s designated lines. Clients were managed for their routine health conditions which were mostly non-communicable diseases (NCDs). Also,Item Frailty and mortality among older patients in a tertiary hospital in Nigeria.(Ghana Medical Association (Accra, Ghana), 2019) Adebusoye, L. A.; Cadmus, E.O.; Owolabi, M.O.; Ogunniyi, A.Background: This study determined the frailty status and its association with mortality among older patients. Design: A prospective cohort design. Setting: Study was conducted at the medical wards of University College Hospital, Ibadan, Nigeria. Participants and study tools: Four hundred and fifty older patients (>60 years) were followed up from the day of admission to death or discharge. Information obtained includes socio demographic characteristics and clinical frailty was assessed using the Canadian Study of Health and Aging (CSHA) scale. Bivariate and multivariate analyses were carried out using SPSS version 21 at a p <0.05. Results: Overall, frailty was identified in 285 (63.3%) respondents. Mortality was significantly higher among frail respondents (25.3%) than non-frail respondents (15.4%) p=0.028. Logistic regression analysis showed factors associated with frailty were: male sex (OR=1.946 [1.005–3.774], p=0.048), non-engagement in occupational activities (OR=2.642 [1.394–5.008], p=0.003), multiple morbidities (OR=4.411 [1.944–10.006], p<0.0001), functional disability (OR=2.114 [1.029–4.343), p=0.042], malnutrition (OR=9.258 [1.029–83.301], p=0.047) and being underweight (OR=7.462 [1.499–37.037], p=0.014). Conclusion: The prevalence of frailty among medical in-hospital older patients is very high and calls for its prompt identification and management to improve their survival.Item Child Passenger Safety, Child Car Restraint, Child Car Seat, Mobile Health Intervention(Society for Public Health Professionals of Nigeria (SPHPN)., 2017) Olumide, A.O.; Adebayo, E.S.; Cadmus, E.O.; Folajimi, Y.; Amodu, O.K.; Balogun, F.M.Background: Child car-passenger safety practices remain low in Nigeria. Findings from the formative phase of a project to deliver an m-health intervention on child-passenger safety to mothers/caregivers attending selected child-immunization clinics in Ibadan are presented in this paper. The aim of this study was to describe stakeholders’ awareness of child passenger safety measures; to determine the cost of child car seats and acceptability of interventions to improve child-passenger safety practices. Methods: Twenty-four key-informant interviews with traffic enforcement officers (four), physicians (five), and mothers of children (fifteen) ;and a market survey was conducted. Results: Physicians and traffic law enforcement officers were more knowledgeable about child passenger safety measures compared to mothers. Cost of infant seats ranged from N6, 000.00 - N36, 000.00 (USD27.9 - USD 167.67) and toddler seats, N6, 000.00 - N81, 000.00 (USD27.95 - USD377.27). Acceptance of a mobile-phone intervention and its accompanying law enforcement was very high. Conclusions: Our findings suggest that an intervention to improve child-passenger safety practices using mobile technology is acceptable to stakeholders in the study area. The intervention should address caregivers’ misconceptions about current child passenger safety measures as this could further enhance compliance with these safety measures.Item Prevalence of previously undetected tuberculosis and underlying risk factors for transmission in a prison setting in Ibadan, southwestern Nigeria(University College Hospital (UCH), Ibadan., 2014) Adesokan, H. K.; Cadmus, E.O.; Adeyemi, W. B.; Lawal, O.; Ogunlade, C.O.; Osman, E.; Olaleye, O.D.; Cadmus, S.I.B.People with congregational tendencies such as the prison inmates constitute an important target group in the global efforts towards the control of tuberculosis (TB). The prison setting in most developing countries particularly Nigeria, currently does not have routine diagnostic procedures for TB despite the existing risks that could facilitate disease transmission. We conducted a cross sectional study among the inmates in a major prison in south-western Nigeria for TB by screening their sputum samples using a simple random sampling method coupled with questionnaire interview, on the assumption of sub-clinical pulmonary TB infection. The overall TB prevalence found was 1.2% (2/164). Significant risk factors that could facilitate disease transmission in the prison included lack of BCG immunization (p = 0.017); history of contact with TB patients (p = 0.020); prolonged cough (p = 0.016) and drug abuse (p = 0.019). Our findings of 1.2% undetected pulmonary TB infection among the inmates though low; still reiterate previous observation that the prison setting constitutes a veritable environment for TB transmission and a threat to public health. Efforts are therefore needed to institute routine screening and reduce the risk factors associated with TB transmission among prison inmates in Nigeria.