Prevalence of asymptomatic malaria infection by microscopy and its determinants among residents of Ido-Ekiti, Southwestern Nigeria

Background: Asymptomatic malaria infections have received less attention than symptomatic malaria infections in major studies. Few epidemiological studies on asymptomatic malaria infections have often focused on pregnant women and children under-five years of age as the most vulnerable groups. However, there is limitation on data regarding asymptomatic infections among the old adult populations, particularly in the study area. Therefore, this study determined the prevalence of asymptomatic malaria infection by microscopy and its determinants among residents of Ido- Ekiti, Southwestern Nigeria. Methods: A hospital-based cross-sectional study was conducted between July and September 2021 among 232 consenting apparently healthy individuals aged 40 years and above who were recruited during a free health screening program using a standardised interviewer-administered questionnaire. The questionnaire sought information on respondents' socio-demographics, presence and types of co-morbidity, and the prevention methods being adopted against malaria infection. Venous blood samples were collected and processed for asymptomatic infections using Giemsa-stained blood smear microscopy. Data were analysed using SPSS version 21. Multivariate logistic regression was used to identify factors associated with asymptomatic infections. Results: Of the total 232 respondents, 19.0% (48/232) were confirmed to be infected with Plasmodium falciparum (95% confidence interval (CI): 14.1% - 24.6%). Lack of formal education (Adjusted odds ratio (AOR): 5.298, 95% (CI): 2.184-13.997), being diabetic (AOR: 4.681, 95% CI: 1.669-16.105), and not sleeping under Long Lasting Insecticide Net (LLINs) (AOR: 4.594, 95% CI: 1.194-14.091), were the determinants of asymptomatic Plasmodium falciparum infection. Conclusion: The prevalence of asymptomatic Plasmodium falciparum was 19%. Lack of formal education, being diabetic, and not sleeping under LLINs were the determinants of asymptomatic infections

Acute severe asthma and its predictors of mortality in rural Southwestern Nigeria: a-five year retrospective observational study

Abstract Objectives: There is an observed paucity of data regarding the predictors of asthma mortality in Nigeria. This study aimed to ascertain the clinical presentations and predictors of acute severe asthma mortality in rural Southwestern Nigeria. Methods: A retrospective observational study using a data form and a standardized questionnaire was used to review the 124 patients admitted at Emergency Department between January 2015 and December 2019. The data were analyzed using SPSS Version 22.0. The results were presented in descriptive and tabular formats. Binary logistic regression analysis was used to determine the predictors of asthma mortality and a p-value <.05 was considered statistically significant. Results: A total of 124 patients were studied. The acute severe asthma mortality was 4.8% and its predictors were older age (Crude odds Ratio (COR), 14.857; 95% CI: 2.489–88.696, p < .001), Tobacco smoking (COR, 6.741; 95% CI: 1.170– 38.826, p = .016), more than three co-morbidities (COR, 2.750; 95% CI: 1.147–26.454, p = 0.012), diabetes mellitus (COR, 13.750; 95% CI: 2.380–79.433, p < .001), Human Immunodeficiency virus (COR, 117.000; 95% CI: 9.257–1479.756, p < .001), ≥2 days before presentation (COR, 7.440; 95% CI: 1.288–42.980, p = .039), and Short-acting-B2-agonists overuse (COR, 7.041; 95% CI: 1.005–62.165, p = .044). Conclusion: The mortality rate was 4.8% and its predictors were older age patients, tobacco smoking, multiple comorbidities, diabetes mellitus, HIV, SP02 <90%, delay presentation, and Short-acting-B2-agonists over use, The study showed that there is high prevalence of asthma mortality in rural Southwestern Nigeria. The findings may be used to plan for asthma preventions and control programs in rural settings, and may also provide an impetus for prospective research on these outcomes

Pattern of admissions and outcome in the children emergency department of a tertiary health institution in Southwestern Nigeria: A four-year review

Introduction: Pediatrics and adolescents are susceptible to illnesses that often necessitate emergency attention. Morbidity and mortality from illnesses in these ages have attracted much interest globally, particularly in Africa. Knowledge of pattern and outcomes of admissions may guide policy and interventions especially in resource constrained settings. The study aimed to determine the pattern of admissions, outcomes and seasonal variations of conditions that presented at the children emergency of a tertiary health institution over a four-year period. Methods: A retrospective descriptive study of children emergency admissions from January 2016 to December 2019. Information obtained included age, diagnosis, month and year of admission, and outcome. Descriptive statistics were used to describe the demographic characteristics and Chi-squared test to assess their associations with the diagnoses made. Results: There were 3,223 admissions. There were more males (1866; 57.9%) and more toddlers (1181; 36.6%). The highest number of admissions were observed in the year 2018 (951; 29.6%) and during the wet season (1962; 60.9%). There was an overall mortality rate of 7%; complicated malaria, gastroenteritis and meningitis were the leading causes of death. Malaria (χ2 = 135.522, p value < 0.001), and gastroenteritis (χ2 = 130.883, p value < 0.001) were predominant among the toddlers while sepsis (χ2 = 71.530, p value < 0.001) and pneumonia (χ2 = 133.739, p value < 0.001) were more among the infants. Typhoid enteritis (χ2 = 26.629, p value < 0.001) and HIV (χ2 = 16.419, p value = 0.012) were commoner among the early adolescents. Conclusion: The major causes of death in the study area are preventable with more of these amongst the children under the age of 5 years. There are seasonal and age-related patterns to admissions and the need for policy formulations and emergency preparations to be tailored towards these observed patterns through the year

Comparative Study of the Prevalence of Syphilis among Pregnant Women and Prospective Blood Donors in Ekiti State, South Western Nigeria

Background: Syphilis is a highly contagious, systemic bacterial illness that poses a serious public health threat on a worldwide scale. In addition to being spread sexually, the illness can also be contracted through blood donation. To accurately evaluate the epidemiological pattern and community impact of the disease, this research sought to ascertain the seroprevalence of syphilis among pregnant women and potential blood donors. In Ekiti State, southwest Nigeria, a comparative study was conducted to determine the frequency of syphilis among expectant mothers and potential blood donors. Materials and Methods: For this comparison research, which was conducted over a 12-month span, 370 potential blood donors and 300 antenatal enrolees were both selected. After getting each participant's full permission, a questionnaire comprising socio-demographic data was given, and 5 ml of whole blood was drawn by venepuncture into an EDTA bottle. Within seconds, plasma was extracted into a clear receptacle using spinning at 2500g for 5 minutes. ELISA-based fast test tools from Diaspot and Lab Acon were used to find Treponema pallidum. Each sample's reactivity to the two test instruments was read as a positive result, while each sample's lack of reactivity was interpreted as a negative result. Results: Syphilis seroprevalence among expectant mothers was 2.0% and 0% among female blood donors. Male blood donors had a syphilis seroprevalence of 2.1%, which was comparable to the seroprevalence of 2.0% observed in expectant women. Conclusion: The screening of potential blood donors and pregnant women for syphilis must be required, available, and cheap as this will improve early detection of the disease for proper therapy. There is a significant correlation between syphilis infection and pregnancy and blood donors

Prevalence, Risk Factors and Treatment Outcomes of Acute Asthma Exacerbations in Rural South-Western Nigeria: A Three-year Retrospective Observational Study

There is increasing evidence that asthma-related morbidity and mortality may be greater in older population due to greater risk of coexisting co-morbidities. The study ascertained the prevalence, risk factors, and treatment outcomes of asthma exacerbation admissions at a tertiary hospital in rural southwestern Nigeria. A retrospective observational survey using data form and predetermined questionnaire was used to review the patients admitted for asthma exacerbation between January 2019 and December 2021. The data were analyzed using SPSS Version 22.0. The results were presented in descriptive and tabular formats. A p-value of <0.05 was used to determine the significant of association. A total of 102 asthma patients were studied. The prevalence of asthma exacerbation was 5.1%, and its risk factors were family history (p = 0.032 ), tobacco smoking (p = 0.040), keeping pets (p = 0.028), co-morbidity (p=0.001), numbers of co-morbidities (p<0.001), hypertension (p<0.001), obesity (p<0.001), obstructive sleep apnea (p=0.004), COPD (P<0.001), Diabetes mellitus (p<0.001), and gastro-esophageal reflux disease (p=0.037).The treatment outcomes showed that 85.3% of the patients were discharged, 11.8% DAMA, and 2.9% died on admission. The study strengthens the argument that asthma exacerbation morbidity and mortality are higher in older age population. The results may provide an impetus for asthma preventive intervention, control strategies, and future research in the study area

Perception and willingness to the uptake of covid-19 vaccine among household-heads in a rural community of south-western Nigeria

Background: The COVID-19 pandemic and its vaccine have been met with varying perceptions that may have both negative and positive effects on the willingness to uptake the COVID-19 vaccine. The study is set to determine the perception and willingness of the household heads to the uptake of COVID-19 vaccine in a rural community in Southwestern, Nigeria. Materials and Methods: A cross-sectional study was carried out among 409 household heads selected through a multistage sampling technique. The instrument of data collection was a semi-structured interviewer-administered questionnaire using the Health Belief model constructs. Data were analyzed with IBM SPSS version 21.0 and Pearson's Chi-square test was used to determine the association between perception and willingness to uptake vaccine. P<0.05 was taken as significant at 95% confidence interval. Results: The majority of the unvaccinated respondents in the study were not willing to take the COVID-19 vaccine (60.1%). There was a poor perception of the susceptibility/severity of unvaccinated respondents to COVID-19 infection and a poor perception of the benefit/barrier to the uptake of the COVID-19 vaccine. Perception of susceptibility and severity of COVID-19 infection were statistically related to the willingness to uptake the COVID-19 vaccine. Conclusion: There should be an increase in awareness campaigns to change the perception of people positively to COVID-19 infection and uptake of the COVID-19 vaccine

Malaria among the elderly in five communities of Osun East district, Southwest Nigeria: Prevalence and association with noncommunicable diseases

Objective: The level of immunity against pathogens decreases with old age. As a result, the elderly may be regarded to be at increased risk of malaria morbidity and fatality. There is paucity of studies on malaria among the elderly population in Osun East district, Southwest Nigeria. This study aimed to determine the prevalence of malaria and its association with medical comorbidities among the elderly. Methods: A descriptive cross-sectional study was carried out, which involved 972 adult residents of five communities in Osun State, who were selected using a multistage random sampling technique. Data was collected with aid of a structured questionnaire. The medical history of respondents and anthropometric measures were obtained. The presence of malaria parasitaemia in the respondents was determined by rapid diagnostic test (RDT). Appropriate descriptive and inferential analyses were done. Results: Out of the 972 respondents, 504 (51.9%) were 60 years and above. The overall prevalence of malaria RDT positivity was 4%. The positivity rate was higher among the elderly (4.6%) compared to those less than 60 years (3.4%), albeit not statistically significant (p=0.36). Among these elderlies, 52.6% and 16.1% used insecticide-treated nets and insecticide sprays, respectively. There was no association between the prevalence of malaria positivity and comorbid conditions, such as hypertension (p=0.37), overweight/obesity (p=0.77), or diabetes (p=0.15). Malaria positivity rate was also not significantly associated with the use of insecticide-treated nets (p=0.64) or insecticide sprays (p=0.45). Conclusion: The malaria positivity rate was higher among the elderly in the study area, although not statistically significant. The prevalence was not associated with comorbid medical conditions

A 5‑year analysis of admissions, seasonal variation, and patient outcomes in rural Nigeria: A retrospective observational study

Introduction: In low- and middle-income countries like Nigeria, there is an observed paucity of data on the admission pattern and patient outcomes in health facilities. Few related studies were conducted in the urban centers, but none from the rural areas where the majority of the populace resides. This study is to ascertain the demographic profile, seasonal variations, yearly distribution, admission pattern, and treatment outcomes at the accident and emergency department (AED). Materials and Methods: A retrospective survey was used to review the data of patients admitted to the AED of the institution between January 2015 and December 2019. The data obtained were analyzed using SPSS Version 20.0. The results were presented in descriptive and tabular formats. Results: Five thousand nine hundred and forty-four patients were studied with a mean age of 49.8 ± 19 years. There were 53.9% males and 46.1% females. Many (60.1%) were admitted from April to October. There were 58.9% medical and 41.1% surgical cases. Among the medical cases were 18.6% noncommunicable and 18.5% communicable diseases. Out of 5944 patients, 9435 disease patterns were diagnosed with infectious diseases 15.5%, and orthopedic 14.4% being the most frequently diagnosed medical and surgical cases, respectively. The treatment outcome revealed that the mortality rate was 3.7%. Conclusions: The number of admissions increased over 5 years. Although most patients were treated and discharged successfully, the number discharged against medical advice was high. Therefore, appropriate hospital and community interventions should be implemented to improve admission outcomes. The following core competencies are addressed in this article: Patient care and procedural skills, Medical knowledge, and Systems-based practice

Effect of an Antidepressant on Medication Adherence among Type 2 Diabetic Patients with Depression Accessing Care in GOPC of FETHI

Comorbid depression among diabetes mellitus (DM) patients is on the increase. This has been linked with poor glycaemic control, greater risk of complications, high burden of medical cost and health care utilisation, and worsening prevalence of other comorbidities resulting in decreased life expectancy. This study determined the antidepressant effect of amitriptyline on depression and glycaemic control among the depressed type 2 DM patients attending Federal Teaching Hospital, Ido-Ekiti (FETHI), Nigeria. It was an interventional study involving 51 depressed type 2 DM patients randomly screened using Patient Health Questionnaire-9 (PHQ-9). They had health education and oral amitriptyline 50mg at night for two months. Postintervention assessment was done using the same tool. Respondents’ age ranged between 44 and 78 years with a mean age of 58±8.4 years. Post-intervention assessment showed improved depressive symptoms; 50% of the respondents had significantly improved glycaemic control with a statistically significant effect on depression (the median score of PHQ-9 reduced from 6.0 to 3.0). WAJM 2023; 40(4): 375–381

Unmet needs for family planning and its determinants among women of reproductive age in Ilesha Southwest Nigeria: A cross-sectional study

Background: A high rate of unintended pregnancy is said to be driving population growth, particularly in Sub-Saharan Africa, where approximately half of all pregnancies are unintended, coming too soon or even unwanted. Most of these unintended pregnancies could have been prevented with effective family planning services. There, however, remains an unmet gap between the women’s reproductive intention and their contraceptive behaviour.Objectives: This study determined the prevalence of unmet needs for family planning and examined its determinants among women of reproductive age group at a tertiary health facility in Southwest Nigeria.Design: This was a hospital-based cross-sectional study.Methods: Two hundred eighty-five sexually active women were recruited using a pre-tested, semi-structured, validated, interviewer-administered questionnaire. The questionnaire assessed the respondent’s socio-demographic characteristics, obstetrics and gynaecological history, and contraceptive history. Relevant clinical parameters were measured and recorded. Data were analysed using SPSS version 21. Multivariable logistic regression analysis was done using a 5% significance level to identify the determinants of unmet needs for family planning.Results: The prevalence of unmet family planning needs for prevention, spacing and limiting were 28.8%, 33.1% and 38.1%, respectively, with 58.2% overall prevalence of unmet needs. The commonest reason for the non-uptake of contraceptives among those with unmet need was the fear of side effects (66.3%). The odds of having unmet needs for family planning were higher for respondents with four or fewer children (adjusted odds ratio (AOR): 7.731; 95% confidence interval (CI): 28.504–2.907, p = 0.002) and those with one partner (AOR: 2.008; 95% CI: 3.669–1.090, p = 0.025).Conclusion: A high rate of unmet family planning needs was found in the study. This requires specific interventions and policies towards increasing contraceptive uptake, such as intensified health education aimed at allaying fears related to the side effects