Community Medicine
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Item Knowledge of Child adoption services in civil servants in Ibadan, Nigeria.(Jana Publication and Research LLP, 2019) Nwachukwu, C. C.; Cadmus, E. O.; Owoaje, E.T.Adoption provides an alternative for childless couples to have their own children, but the knowledge of this option and its services affects people’s choice. This study assessed the awareness and depth of knowledge of adoption among 403 civil servants working in the Oyo State Secretariat, Ibadan, Nigeria. This was a descriptive cross-sectional study conducted between February and May, 2008. Self-administered questionnaire was used to collect data on socio-demographic characteristics, knowledge of child adoption, laws and services. Each correct knowledge question had a score of 1 and each wrong knowledge question had a score of 0. Total scores were computed for each respondent. Knowledge scores which ranged from 0-5 and from 6-13 were considered low and high, respectively. Descriptive and Chisquare statistics were used for data analysis.Mean age of respondents was 40.2 ± 9.7 years. Sixty five percent had tertiary education, 77.4% were married, and 53.3% were senior civil servants. Majority (91.8%) had heard about child adoption; of these 65.1% could correctly state its meaning. Sixty three percent were aware of adoption services; of these, 33.0% knew where adoption services were provided and 47.3% were aware of adoption laws. Also (41.1%) knew someone that had adopted a child. Overall, 16.9% had high knowledge scores. Respondents who had tertiary education were more knowledgeable about adoption than others (p< 0.05). Majority of respondents were aware of child adoption services but knowledge of the details was low. Efforts should be made to enlighten the public about adoption.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 Older persons’ perceptions about advanced directives and end of life issues in a geriatric care setting in southwestern Nigeria(Pan African Medical Journal (PAMJ), 2019) Cadmus, E. O.; Adebusoye, L. A.; Olowookere, O. O.; Olusegun, A. T.; Oyinlola, O.; Adeleke, R. O.; Alonge, T.O.Introduction: advanced directives enable the planning of care and support services independent of the older person’s ability to make the decision. There is a paucity of information regarding the views and preferences regarding advanced directives and other end of life issues among older persons in low and middle-income countries such as Nigeria. The study aimed to explore the knowledge, attitude and belief of older persons regarding decision making surrounding end of life and advance directives. Methods: data were collected through focus group discussions at a monthly social gathering of outpatients in a geriatric center in Oyo State, Nigeria. Discussions were audiotaped, transcribed and analyzed manually using a thematic approach. Results: respondents’ knowledge about the end of life care and advanced directives as prescribed in high income settings were sparse and did not include choices about treatment options or any medical directives. The predominant perceptions among the participants bordered mainly on the arrangements for place of death, burial and property sharing. Participants listed in order of preference the major decision makers in the advanced directive process mainly, the oldest male child, religious leaders and legal practitioners. Conclusion: our findings imply the need for improving knowledge and awareness about the benefits of advanced directives among older persons with a focus on opportunities for their active participationItem A descriptive study of the morbidity pattern of older persons presenting at a geriatric centre in southwestern Nigeria.(Wolters Kluwer - Medknow Publications, 2017) Cadmus, E. O.; Adebusoye, L. A.; Olowookere, O. O.; Oluwatosin, O. G.; Owoaje, E. T.; Alonge, T. O.Context: Rapid population ageing is a demographic reality in most countries of the world. Old age is associated with changes which may culminate in health problems, necessitating provision of appropriate preventive, curative, and rehabilitative services. However, reports from many low- and middle-income countries have shown lack of preparedness to cater for the healthcare needs of older persons. Aim: This study described the morbidity profile and its determinants among persons aged 60 years and above who presented at an established geriatric centre in southwestern Nigeria. Materials and Methods: Data were obtained from electronic health records of 4886 patients aged ≥60 years who visited the facility between 1st January 2013 and 31st December 2014. Data were analyzed using Stata version 13 (Texas, USA). Frequency distributions were used for descriptive analysis, and chi-square test was used to test associations. Results: More than a half, 2919 (59.7%), of the respondents were females and almost three quarters 3501 (71.7%) were aged between 60 and 74 years. Mean number of morbidities was 1.81 ± 0.9, and less than half, 1097 (42.0%), presented with only one morbidity, most commonly, hypertension. There were significant age-related differences for musculoskeletal (P = 0.001), endocrine (P = 0.01), and psychological problems (P = 0.01). In addition, gender differences were observed as a significantly higher proportion of females presented with general symptoms (P = 0.02) and musculoskeletal problems (P = 0.0001) than men. Conclusion: The most common presenting morbidities at this geriatric health centre were mostly no communicable diseases. Information obtained will be useful in the design of similar facilities in other parts of the country and region at large.Item Knowledge of malaria prevention among pregnant women and female caregivers of under-five children in rural southwest Nigeria.(PeerJ, Inc., 2015) Adebayo, A. M.; Akinyemi, O. O.; Cadmus, E. O.Introduction. The morbidity and mortality from malaria are still unacceptably high in the developing countries, especially among the vulnerable groups like pregnant women and under-five children, despite all control efforts. The knowledge about the preventive measures of malaria is an important preceding factor for the acceptance and use of malaria preventive measures like Insecticide Treated Nets (ITN) by community members. Therefore, this study assessed the knowledge of malaria prevention among caregivers of under-five children and pregnant women in a rural community in Southwest Nigeria. Methodology. This is part of a larger malaria prevention study in rural Southwest Nigeria. A descriptive cross-sectional survey was conducted among pregnant women and caregivers of under-five children in Igbo-Ora, a rural town in Southwest Nigeria using a semi-structured, interviewer-administered questionnaire. Information was obtained on knowledge of malaria prevention, and overall composite scores were computed for knowledge of malaria prevention and ITN use. Data were analyzed using SPSS version 16. Associations between variables were tested using a Chi-square with the level of statistical significance set at 5%. Results. Of the 631 respondents, 84.9% were caregivers of under-five children and 67.7% were married. Mean age was 27.7 }6.3 years with 53.4% aged between 20 and 29 years. Majority (91.1%) had at least primary school education and 60.2% were traders. Overall, 57.7% had poor knowledge of malaria prevention. A good proportion (83.5%) were aware of the use of ITN for malaria prevention while 30.6% had poor knowledge of its use. Respondents who were younger (<30 years), had at least primary education and earn <10,000/per month had significantly poor knowledge of ITN use in malaria prevention. Majority (60.0%) respondents had poor attitude regarding use of ITNs. Conclusion. This study showed that the knowledge of malaria prevention is still low among under-five caregivers and pregnant women in rural Southwest Nigeria despite current control measures. There is a need for concerted health education intervention to improve the knowledge of rural dwellers regarding malaria prevention, including the use of ITN. This will go a long way to improving the reported low level of ownership and utilization of ITN in the rural areas.Item Ownership and utilisation of insecticide-treated mosquito nets among caregivers of under-five children and pregnant women in a rural community in Southwest Nigeria(Pacini Editore Srl., 2014) Adebayo, A. M.; Akinyemi, O. O.; Cadmus, E. O.Introduction. Malaria still constitutes a serious public health problem in Nigeria despite control efforts. The use of Insecticide Treated Net (ITN) has been proven to be an effective preventive modality in the control of malaria but its utilisation has been shown to be low. This study assessed the ownership and utilization of ITN in Igbo-Ora, a rural community in Ibarapa Central Local Government Area (LGA) of Oyo State, Southwest Nigeria. Methods. A descriptive cross-sectional survey among female caregivers of under-five children and pregnant women was conducted using semi-structured interviewer-administered questionnaire. Data were analyzed using SPSS version 16. Results. Among 631 respondents that participated, 84.9% were caregivers of under-five children. Mean age was 27.7 ± 6.3 years with 53.4% between 20-29 age group. Majority, 91.1% had at least primary education, 60.2% were traders and 69.7% were married. Most respondents, 71.8% had at least one type of mosquito nets. Among those that had, 85.4% had window/door net, 25.2% untreated mosquito net while only 15.5% had ITN. Overall, 11.1% of the respondents had ITN among which 78.6% had ever slept under an ITN. Among those that had ever slept under an ITN, slightly less than half, 49.1% slept under an ITN the previous night. Less educated respondents were five times more likely to use ITN (95% CI = 1.24-21.28). Conclusions. This study revealed very low ownership and utilization of ITNs. There is need to improve on the knowledge of community members of the relevance of ownership and utilisation of ITN in malaria prevention.Item In their own words: mental health and quality of life of West African refugees in Nigeria.(Springer, 2014) Akinyemi, O. O.; Owoaje, E. T.; Cadmus, E. O.Refugees are exposed to extreme stressors and are therefore at risk of mental health and social problems. Other issues refugees have to cope with include the loss of their country, culture, language, profession, family, friends, and future plans. Much of the studies that have been done on refugee mental health have not attempted to explain what these experiences mean to these individuals. Thus, this study provides explorative data on the mental health and quality of life of West African refugees living in Nigeria in order to understand their views and perspectives. This study carried out in 2010 employed qualitative methods; a total of four focus group discussions (FGDs) were conducted among adult male and female refugees purposively selected at the Oru Refugee Camp, Ogun State, Nigeria. Respondents described quality of life as a major determinant of mental health status. Most of the participants believed that women were more predisposed to mental ill health due to their sensitive emotional make-up. Factors identified by respondents as affecting mental health and quality of life among refugees included poverty, unemployment, physical health, housing and environment, discrimination, stigmatization, and insecurity. Refugees rated their mental health and quality of life as poor due to the aforementioned factors. Recommendations were made to the international community, national and local governments to invest more on education, provision of vocational and entrepreneurial skills as well as adequate housing in order to improve the mental health and quality of life of refugees.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.Item Knowledge about complications and practice of abortion among female undergraduates in the University of Ibadan, Nigeria.(The Association of Resident Doctors (ARD), University College Hospital (UCH), Ibadan, Nigeria., 2011) Cadmus, E. O.; Owoaje, E. T.Background: Unwanted pregnancies and unsafe abortion pose major health risks to women in the reproductive age group. Female undergraduates are particularly exposed to these risks. This study was carried out to assess the knowledge about complications and practice of abortion among female undergraduates of the University of Ibadan. Methods: A cross-sectional study was conducted using structured, self-administered questionnaires, to collect data on respondents’ socio-demographic characteristics, sexual behaviour, knowledge about various complications of abortion and practice of abortion. Data was analyzed using SPSS version 14. Results: A total of 425 students were interviewed, mean age of the undergraduates was 21.5± 2.8 years. Overall, 122 (29%) of the respondents had ever had sexual intercourse. Twenty five percent of those who were sexually active had ever been pregnant and 90% had terminated the pregnancy. The most common reason given for termination was that pregnancy was unplanned for. Most of the respondents 354 (83.3%) had a good knowledge about complications of abortion and mean knowledge score was 4.01±1.58 (range 0-5). Conclusion: This group of students were aware of the risks associated with unsafe abortion; however, the abortion rate was still high. Sexual reproductive health interventions are needed on campus in order to equip female undergraduates with comprehensive knowledge and skills to reduce the likelihood of unplanned pregnancies.