Community Medicine
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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 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 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.Item Health literacy amongst tuberculosis patients in a general hospital in North Central Nigeria.(Association of Public Health Physicians of Nigeria (Lagos/Nigeria)., 2013) Oladunjoye, A. O.; Adebiyi, A.O.; Cadmus, E.O.; Ige, O.K.; Oladunjoye, O. O.Background: Healthy literacy has been shown to improve health care access and adherence to Tuberculosis (TB) treatment. Still it remains largely unstudied in many high risks, underserved and low literacy African populations. This study aims to bridge the existing knowledge gap by assessing health literacy among patients with TB in a rural town in Northern Nigeria. Methodology: A cross sectional study was conducted among patients who attended the TB clinic of a secondary health care facility in Babura, Jigawa State, Nigeria between Oct 2008 and March 2009. All patients who visited the TB clinic during this period were interviewed. Result: Many (71.6%) reported having been educated about TB by a health worker, mostly on predisposing factors 43.2%, general facts (31.1%) and disease process (21.6%) but less on patient's role in disease management (1.4%). Functional health literacy was high; mean score was 7.9±0.3 out of 10. Knowledge about the disease process, diagnostic requirements and treatment regimen were the highest. However 97.3% felt drugs were no longer necessary once symptoms abated. Patient involvement in treatment decisions was also suboptimal as only 52.7% reported making a joint decision about drug “pick up” options with their physicians. Conclusion: Very high functional literacy score seemed to have been achieved among these rural low literacy TB patients even without a structured health literacy program. However patient participation in treatment seems to be underemphasized and was thus suboptimal. An important gap in patient education regarding continued TB treatment was identified and should be targeted for intervention.