Patterns of chronic illness among older patients attending a university hospital in Nigeria

Background: The rising burden of chronic diseases has attracted the attention of public health researchers and policymakers worldwide. Objectives: To assess the demographic, morbidity and outcome patterns of chronic illness among the older patients at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Design: Retrospective study Setting: Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Participants: Seven hundred and eighty-eight (788) adults (60 years and over) hospitalized between 2010 and 2014 in the hospital. Interventions: None Results: The age of the selected study population ranged from 60 to 99 years with a mean of 76.08(±10.42). More than half (53.0%) were between 60–69 years, with a subsequent decline. Male patients accounted for 64.0%, but females were more frequent among patients 80 years and older. The most common health conditions were heart diseases (22.5%), neoplasm (13.2%), cerebrovascular accident (12.4%), and gastrointestinal diseases (14.5%). The records showed that 14.9% were referred to other institution for various reasons (including further management, lack of space, industrial action by workers, discharged against medical advice or dead). Conclusion: Heart diseases were the major chronic illnesses among the older adults followed by neoplasm conditions, while musculoskeletal conditions were the least. It also found that there was a poor outcome of conditions amongolder adults in this setting. Therefore, efforts should be made towards the prevention and reduction of chronic illnesses, as well as improving the outcome of care. Keywords: chronic diseases, older adults, health care, retrospective, demographic Funding: Doctoral Fellowship from Consortium for Advanced Research Training in Afric

Prognostic performance of pretreatment systemic immune-inflammation index in women with epithelial ovarian cancer

Purpose: This study investigated the prognostic performance of the systemic immune-inflammation index (SII) in patients with epithelial ovarian cancer (EOC) in Lagos, Nigeria. Methods: We performed a secondary analysis of the data of 91 women who had treatment for EOC between 2009 and 2018. The associations between pretreatment SII and survivals were tested. Results: Pretreatment SII more than 610.2 was a significant independent predictor of reduced progression-free survival (HR = 2.68; 95% CI, 1.17 to 6.09) while SII greater than 649.0 was a significant independent predictor of reduced 3-year overall survival (HR = 2.01; 95% CI, 1.01 to 3.99). Conclusion: These findings suggest that high SII may be a potential prognostic indicator and useful marker for more intensive surveillance and design of personalized treatment in patients with EOC

Prevalence of surgically correctable conditions among children in a mixed urban-rural community in Nigeria using the SOSAS survey tool:Implications for paediatric surgical capacity-building

BackgroundIn many low- and middle-income countries, data on the prevalence of surgical diseases have been derived primarily from hospital-based studies, which may lead to an underestimation of disease burden within the community. Community-based prevalence studies may provide better estimates of surgical need to enable proper resource allocation and prioritization of needs. This study aims to assess the prevalence of common surgical conditions among children in a diverse rural and urban population in Nigeria.MethodsDescriptive cross-sectional, community-based study to determine the prevalence of congenital and acquired surgical conditions among children in a diverse rural-urban area of Nigeria was conducted. Households, defined as one or more persons 'who eat from the same pot' or slept under the same roof the night before the interview, were randomized for inclusion in the study. Data was collected using an adapted and modified version of the interviewer-administered questionnaire-Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey tool and analysed using the REDCap web-based analytic application.Main resultsEight-hundred-and-fifty-six households were surveyed, comprising 1,883 children. Eighty-one conditions were identified, the most common being umbilical hernias (20), inguinal hernias (13), and wound injuries to the extremities (9). The prevalence per 10,000 children was 85 for umbilical hernias (95% CI: 47, 123), and 61 for inguinal hernias (95% CI: 34, 88). The prevalence of hydroceles and undescended testes was comparable at 22 and 26 per 10,000 children, respectively. Children with surgical conditions had similar sociodemographic characteristics to healthy children in the study population.ConclusionThe most common congenital surgical conditions in our setting were umbilical hernias, while injuries were the most common acquired conditions. From our study, it is estimated that there will be about 2.9 million children with surgically correctable conditions in the nation. This suggests an acute need for training more paediatric surgeons

Antenatal Care Services Utilization and Factors Influencing it Among Pregnant Women in a Teaching Hospital, Lagos, Nigeria

Antenatal care (ANC) is the care provided by skilled health-care professionals to pregnant women and adolescent girls in order to ensure the best health conditions for both mother and foetus during pregnancy. ANC services help pregnant women and care providers to identify early, complications associated with pregnancy. This study assessed level of utilization of ANC services and also identified factors influencing its utilization among Pregnant Women at Lagos University Teaching Hospital in Lagos, Nigeria. A descriptive cross-sectional study was conducted among 182 pregnant women attending antenatal clinic at Lagos University Teaching Hospital (LUTH) in Lagos, Nigeria. Data was collected using a structured self-administered questionnaire and analysed descriptively and inferentially using Statistical Package of Social Science SPSS version 20.  Results showed that majority of the respondents (81.4%) had good level of utilization of ANC services. Availability of facilities (81.4%), affordability of ANC services (75.4%), waiting time (70.1%), attitude of the healthcare providers (59.9%), Schedule of ANC clinic (58.7%) and accessibility of ANC services (59.3%) were the factors influencing utilization of ANC services by the pregnant women. There was no statistically significant association between respondents’ level of utilization of antenatal services and their socio-demographic characteristics (Age: x2 = 10.719, P =0.153, educational qualification:  x2 = 0.735, P =0.692 and Income monthly: x2 = 5.868, P =0.118. The study concluded that there was high level of utilization of ANC services among the women. Affordability and accessibility of ANC services were the major factors influencing utilization of ANC services among pregnant women. Therefore, the management should look into the cost of the services rendered and make the ANC services affordable and accessible. Keywords: Utilization, Antenatal Care Services, Influencing Factors, Pregnant women. &nbsp

Prognostic performance of pretreatment systemic immune-inflammation index in women with epithelial ovarian cancer

Purpose: This study investigated the prognostic performance of the systemic immune-inflammation index (SII) in patients with epithelial ovarian cancer (EOC) in Lagos, Nigeria. Methods: We performed a secondary analysis of the data of 91 women who had treatment for EOC between 2009 and 2018. The associations between pretreatment SII and survivals were tested. Results: Pretreatment SII more than 610.2 was a significant independent predictor of reduced progression-free survival (HR = 2.68; 95% CI, 1.17 to 6.09) while SII greater than 649.0 was a significant independent predictor of reduced 3-year overall survival (HR = 2.01; 95% CI, 1.01 to 3.99). Conclusion: These findings suggest that high SII may be a potential prognostic indicator and useful marker for more intensive surveillance and design of personalized treatment in patients with EOC

Comparative Assessment of p16/Ki-67 Dual Staining Technology for cervical cancer screening in women living with HIV (COMPASS-DUST)-Study protocol.

The risk of progression of low-grade (CIN1) to high-grade cervical intraepithelial neoplasia (CIN2/3) is 3-5 times higher for women living with HIV (WLHIV) than for HIV-negative women. Evidence suggests that the current cervical cancer screening methods perform less effectively in WLHIV. An emerging screening method-p16/Ki-67 dual staining technology (DUST) is a safe and rapid assay that could be used to detect CIN2/3 with higher sensitivity and specificity. The study in this protocol will evaluate the performance of DUST in cervical cancer screening among WLHIV. We will conduct an intra-participant comparative study (Phase 1) to enrol n = 1,123 sexually active WLHIV aged 25-65 years at two accredited adult HIV treatment centres in Lagos, Nigeria to compare the performance of DUST to the currently used screening methods (Pap smear, hr-HPV DNA, or VIA testing) in detecting high-grade CIN and cancer (CIN2+). Subsequently, a prospective cohort study (Phase 2) will be conducted by enrolling all the WLHIV who are diagnosed as having low-grade CIN (CIN1) in Phase 1 for a 6-monthly follow-up for 2 years to detect the persistence and progression of CIN1 to CIN2+. The findings of this study may provide evidence of the existence of a better performance screening method for the primary and triage detection of CIN2+ in WLHIV. It may also demonstrate that this high-performance test can improve the long-term predictive accuracy of screening by extending the intervals between evaluations and thus decrease the overall cost and increase screening uptake and follow-up compliance in WLHIV

Study framework.

Study framework.</p