Breastfeeding in Nigeria: A systematic review

Breastfeeding confers numerous benefits on babies and mothers. Early initiation, ‘exclusive breastfeeding’ and breastfeeding for at least two years post-delivery are the recommended practices. This study aims to examine the trends of breastfeeding practice in Nigeria by reviewing available published studies. The online databases of PubMed, Science Direct and the Web of Knowledge were searched using relevant terms. Studies identified were screened for eligibility and those that met the inclusion criteria were included in this review. Graphs and regression equations were generated using Microsoft Excel® to illustrate the duration of and trends in, breastfeeding practices in Nigeria. This review adopts the WHO standard definitions for breastfeeding categories. A total of 24 studies met the inclusion criteria but only two of these adopted the standard WHO breastfeeding categories in estimating the rates of breastfeeding. The regression equations and graphs generated show a declining trend in the rates of ‘exclusive breastfeeding’ and an increasing trend in the mean duration of breastfeeding. The rate of ‘any breastfeeding’ was high. Breastfeeding duration varies across Nigeria, a possible reflection of differences in sociocultural practices. Various reasons were cited for discontinuation of breastfeeding, the commonest of these were maternal health problems and the demands of work.Breastfeeding is commonly practiced in Nigeria. However, the rate of ‘exclusive breastfeeding’ is low and declining. It is recommended that future studies on breastfeeding in Nigeria adopt the standard WHO definitions

Determinants of neonatal mortality in rural and urban Nigeria: Evidence from a population-based national survey

Background Significant reduction in the global burden of neonatal mortality was achieved through the millennium development goals. In Nigeria, however, only a marginal reduction was realized. This study assesses the rural–urban differences in neonatal mortality rate (NMR) and the associated risk factors in Nigeria. Methods The dataset from the 2013 Nigeria demographic and health survey (NDHS), disaggregated by rural–urban residence (n = 20 449 and 9935, respectively), was explored using univariate, bivariate, and multivariable analysis. Complex samples analysis was applied to adjust for the unequal selection probabilities due to the multi-stage cluster sampling method used in the 2013 NDHS. The adjusted relationship between the outcome and predictor variables was assessed on multi-level logistic regression analysis. Results NMR for rural and urban populations was 36 and 28 deaths per 1000 live births, respectively. Risk factors in urban residence were lack of electricity access (adjusted OR [AOR], 1.555; 95%CI: 1.089–2.220), small birth size (as a proxy for low birthweight; AOR, 3.048; 95%CI: 2.047–4.537), and male gender (AOR, 1.666; 95%CI: 1.215–2.284). Risk factors in rural residence were small birth size (a proxy for low birthweight; AOR, 2.118; 95%CI: 1.600–2.804), and birth interval \u3c 2 years (AOR, 2.149; 95%CI: 1.760–2.624). Cesarean delivery was a risk factor both in rural (AOR, 5.038; 95%CI: 2.617–9.700) and urban Nigeria (AOR, 2.632; 95%CI: 1.543–4.489). Conclusions Determinants of neonatal mortality were different in rural and urban Nigeria, and rural neonates had greater risk of mortality than their urban counterparts

Climate change and malaria control: The importance of mitigation and a call to action

Malaria has remained an important target for global disease control efforts for decades. The streams of funds and, consequently, availability of effective interventions for the disease have resulted in considerable reduction in its burden, globally. Despite the relative success of such global efforts, malaria remains a significant threat in over a hundred countries, worldwide, leading to about one million deaths and hundreds of millions of hospital visits, annually. Many researchers and health commentators have argued that global warming, a consequence of climate change, could be linked – directly or indirectly – to the persistence as well as the re-emergence of malaria epidemics. Although the association between climate change and malaria spread is complex and remains a subject of controversy and debates, this paper argues that the spread and severity of malaria in several places and the increased incidences of the disease in some regions could indeed be associated with the effects and consequences of climate change. The paper maintains that the biology of the Plasmodium spp, the ecology of mosquitoes, and even the susceptibility of humans to malaria could all be affected directly/indirectly by extreme climatic events. Based on the growing body of evidence on this subject, this paper makes a call for all stakeholders to come to a consensus on the significance of climate change mitigation to malaria control, and offers some recommendations on the way forward

Relationship of cognition and Alzheimer’s disease with gastrointestinal tract disorders: A large-scale genetic overlap and mendelian randomisation analysis

Emerging observational evidence suggests links between cognitive impairment and a range of gastrointestinal tract (GIT) disorders; however, the mechanisms underlying their relationships remain unclear. Leveraging large-scale genome-wide association studies’ summary statistics, we comprehensively assessed genetic overlap and potential causality of cognitive traits and Alzheimer’s disease (AD) with several GIT disorders. We demonstrate a strong and highly significant inverse global genetic correlation between cognitive traits and GIT disorders — peptic ulcer disease (PUD), gastritis-duodenitis, diverticulosis, irritable bowel syndrome, and gastroesophageal reflux disease (GERD), but not inflammatory bowel disease (IBD). Further analysis detects 35 significant (p \u3c 4.37 × 10 − 5) bivariate local genetic correlations between cognitive traits, AD, and GIT disorders (including IBD). Mendelian randomisation analysis suggests a risk-decreasing causality of educational attainment, intelligence, and other cognitive traits on PUD and GERD, but not IBD, and a putative association of GERD with cognitive function decline. Gene-based analysis reveals a significant gene-level genetic overlap of cognitive traits with AD and GIT disorders (IBD inclusive, pbinomial-test = 1.18 × 10 − 3 – 2.20 × 10 − 16). Our study supports the protective roles of genetically-influenced educational attainments and other cognitive traits on the risk of GIT disorders and highlights a putative association of GERD with cognitive function decline. Findings from local genetic correlation analysis provide novel insights, indicating that the relationship of IBD with cognitive traits (and AD) will depend largely on their local effects across the genome

A large-scale genome-wide cross-trait analysis reveals shared genetic architecture between Alzheimer’s disease and gastrointestinal tract disorders

Consistent with the concept of the gut-brain phenomenon, observational studies suggest a relationship between Alzheimer’s disease (AD) and gastrointestinal tract (GIT) disorders; however, their underlying mechanisms remain unclear. Here, we analyse several genome-wide association studies (GWAS) summary statistics (N = 34,652–456,327), to assess the relationship of AD with GIT disorders. Findings reveal a positive significant genetic overlap and correlation between AD and gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), gastritis-duodenitis, irritable bowel syndrome and diverticulosis, but not inflammatory bowel disease. Cross-trait meta-analysis identifies several loci (Pmeta-analysis \u3c 5 × 10−8) shared by AD and GIT disorders (GERD and PUD) including PDE4B, BRINP3, ATG16L1, SEMA3F, HLA-DRA, SCARA3, MTSS2, PHB, and TOMM40. Colocalization and gene-based analyses reinforce these loci. Pathway-based analyses demonstrate significant enrichment of lipid metabolism, autoimmunity, lipase inhibitors, PD-1 signalling, and statin mechanisms, among others, for AD and GIT traits. Our findings provide genetic insights into the gut-brain relationship, implicating shared but non-causal genetic susceptibility of GIT disorders with AD’s risk. Genes and biological pathways identified are potential targets for further investigation in AD, GIT disorders, and their comorbidity

Cesarean delivery in Nigeria: Prevalence and associated factors -a population-based cross-sectional study

Objective To investigate the prevalence and factors associated with caesarean delivery in Nigeria. Design This is a secondary analysis of the nationally representative 2013 Nigeria Demographic and Health Survey (NDHS) data. We carried out frequency tabulation, χ2 test, simple logistic regression and multivariable binary logistic regression analyses to achieve the study objective. Setting Nigeria. Participants A total of 31 171 most recent live deliveries for women aged 15–49 years (mother–child pair) in the 5 years preceding the 2013 NDHS was included in this study. Outcome measure Caesarean mode of delivery. Results The prevalence of caesarean section (CS) was 2.1% (95% CI 1.8 to 2.3) in Nigeria. At the region level, the South-West had the highest prevalence of 4.7%. Factors associated with increased odds of CS were urban residence (adjusted OR (AOR): 1.51, 95% CI 1.15 to 1.97), maternal age ≥ 35 years (AOR: 2.12, 95% CI 1.08 to 4.11), large birth size (AOR: 1.39, 95% CI 1.10 to 1.74) and multiple births (AOR: 4.96, 95% CI 2.84 to 8.62). Greater odds of CS were equally associated with maternal obesity (AOR: 3.16, 95% CI 2.30 to 4.32), Christianity (AOR: 2.06, 95% CI 1.58 to 2.68), birth order of one (AOR: 3.86, 95% CI 2.66 to 5.56), husband’s secondary/higher education level (AOR: 2.07, 95% CI 1.29 to 3.33), health insurance coverage (AOR: 2.01, 95% CI 1.37 to 2.95) and ≥ 4 antenatal visits (AOR: 2.84, 95% CI 1.56 to 5.17). Conclusions The prevalence of CS was low, indicating unmet needs in the use of caesarean delivery in Nigeria. Rural–urban, regional and socioeconomic differences were observed, suggesting inequitable access to the obstetric surgery. Intervention efforts need to prioritise women living in rural areas, the North-East and the North-West regions, as well as women of the Islamic faith

Estimating the prevalence and health risks awareness of smoking in nigeria:A meta-analysis approach

Background:The increase use of tobacco products in Nigeria, and lack of common aggregated data on its associate diseases and deaths are parts of emerging public concerns.Objective:This paper estimated national and zonal prevalence of smoking and health risks awareness in Nigeria.Methods:Random effects meta-analysis was conducted on estimates from 19 studies selected across 13 states, within the six-geopolitical zones of Nigeria, to pool nation-wide estimates of the prevalence and health risk awareness of smoking.Results:The sample and aggregated mean ages are 14.7 and 22.4 years, respectively. The overall pooled prevalence of current smoking in Nigeria was 19.7% (95%CI: 14.0-25.5), with male and female at 18.9% (CI:13.3-24.4) and 6.8% (CI:4.1-9.6), respectively.Conclusion:The findings suggest a relatively high prevalence of smoking among the youths in Nigeria. The authors recommend smokers’ counseling services among the youth to reduce health hazards and secure youth contributions to sustainable economic development

Home childbirth among young mothers aged 15–24 years in Nigeria: a national population-based cross-sectional study

Objective To estimate the prevalence and identify factors associated with home childbirth (delivery) among young mothers aged 15–24 years in Nigeria. Design A secondary analysis of cross-sectional data from the 2013 Nigeria Demographic and Health Survey (NDHS). Setting Nigeria. Participants A total of 7543 young mothers aged 15–24 years. Outcome measure Place of delivery. Results The prevalence of home delivery among young mothers aged 15–24 years was 69.5% (95% CI 67.1% to 71.8%) in Nigeria—78.9% (95%CI 76.3% to 81.2%) in rural and 43.9% (95%CI 38.5% to 49.5%, p<0.001) in urban Nigeria. Using the Andersen’s behavioural model, increased odds of home delivery were associated with the two environmental factors: rural residence (adjusted OR, AOR: 1.39, 95% CI 1.06 to 1.85) and regions of residence (North-East: AOR: 1.97, 95% CI 1.14 to 3.34; North-West: AOR: 2.94, 95% CI 1.80 to 4.83; and South-South: AOR: 3.81, 95% CI 2.38 to 6.06). Three of the enabling factors (lack of health insurance: AOR: 2.34, 95% CI 1.16 to 4.71; difficulty with distance to healthcare facilities: AOR: 1.48, 95% CI 1.15 to 1.88; and <4 times antenatal attendance: AOR: 3.80, 95% CI 3.00 to 4.85) similarly increased the odds of home delivery. Lastly, six predisposing factors—lack of maternal and husband’s education, poor wealth index, Islamic religion, high parity and low frequency of listening to radio—were associated with increased odds of home delivery. Conclusions Young mothers aged 15–24 years had a higher prevalence of home delivery than the national average for all women of reproductive age in Nigeria. Priority attention is required for young mothers in poor households, rural areas, North-East, North-West and South-South regions. Faith-based interventions, a youth-oriented antenatal care package, education of girls and access to health insurance coverage are recommended to speed up the reduction of home delivery among young mothers in Nigeria

Prevalence and factors associated with non-utilization of healthcare facility for childbirth in rural and urban Nigeria: Analysis of a national population-based survey

Aim: The aim of this study was to assess the rural–urban differences in the prevalence and factors associated with non-utilization of healthcare facility for childbirth (home delivery) in Nigeria. Methods: Dataset from the Nigeria demographic and health survey, 2013, disaggregated by rural–urban residence were analyzed with appropriate adjustment for the cluster sampling design of the survey. Factors associated with home delivery were identified using multivariable logistic regression analysis. Results: In rural and urban residence, the prevalence of home delivery were 78.3% and 38.1%, respectively (p < 0.001). The lowest prevalence of home delivery occurred in the South-East region for rural residence (18.6%) and the South-West region for urban residence (17.9%). The North-West region had the highest prevalence of home delivery, 93.6% and 70.5% in rural and urban residence, respectively. Low maternal as well as paternal education, low antenatal attendance, being less wealthy, the practice of Islam, and living in the North-East, North-West and the South-South regions increased the likelihood of home delivery in both rural and urban residences. Whether in rural or urban residence, birth order of one decreased the likelihood of home delivery. In rural residence only, living in the North-Central region increased the chances of home delivery. In urban residence only, maternal age ⩾ 36 years decreased the likelihood of home delivery, while ‘Traditionalist/other’ religion and maternal age < 20 years increased it. Conclusion: The prevalence of home delivery was much higher in rural than urban Nigeria and the associated factors differ to varying degrees in the two residences. Future intervention efforts would need to prioritize findings in this study

Disinfection of water with new chitosan-modified hybrid clay composite adsorbent

Hybrid clay composites were prepared from Kaolinite clay and Carica papaya seeds via modification with chitosan, Alum, NaOH, and ZnCl2 in different ratios, using solvothermal and surface modification techniques. Several composite adsorbents were prepared, and the most efficient of them for the removal of gram negative enteric bacteria was the hybrid clay composite that was surface-modified with chitosan, Ch-nHYCA1:5 (Chitosan: nHYCA = 1:5). This composite adsorbent had a maximum adsorption removal value of 4.07 × 106 cfu/mL for V. cholerae after 120 min, 1.95 × 106 cfu/mL for E. coli after ∼180 min and 3.25 × 106 cfu/mL for S. typhi after 270 min. The Brouers-Sotolongo model was found to better predict the maximum adsorption capacity (qmax) of Ch-nHYCA1:5 composite adsorbent for the removal of E. coli with a qmax of 103.07 mg/g (7.93 × 107 cfu/mL) and V. cholerae with a qmax of 154.18 mg/g (1.19 × 108 cfu/mL) while the Sips model best described S. typhi adsorption by Ch-nHYCA1:5 composite with an estimated qmax of 83.65 mg/g (6.43 × 107 cfu/mL). These efficiencies do far exceed the alert/action levels of ca. 500 cfu/mL in drinking water for these bacteria. The simplicity of the composite preparation process and the availability of raw materials used for its preparation underscore the potential of this low-cost chitosan-modified composite adsorbent (Ch-nHYCA1:5) for water treatment