Prevalence, Trends and Predictors of Small Size Babies in Nigeria: Analysis of Data from Two Recent Nigeria Demographic and Health Surveys

Background: Despite low birth weight (LBW) role on child growth, development, and survival in developing countries, it has not been given the desired priority in terms of research, at the national level in Nigeria. Our study aims to estimate the trend in the prevalence of small size babies and to identify its predictors using nationally representative data. Methods: We used the 2013 and 2018 data from the Nigeria Demographic and Health Survey using the statistical methods of descriptive analysis and logistic regression modelling. Results: The proportion of babies reported to have small size at birth in Nigeria declined from 14.9% in 2013 to 13.7% in 2018. Various factors from demographic, socio-economic, and health-seeking behaviour were identified as significant predictors. Women who received iron pills and tetanus toxoids during pregnancy had at most 79% and 80% less risk of having small size babies, respectively, than those who received none of these two. Female children had at least 21% more chance of being small in size than male children. Other key predictors were geopolitical region, maternal age at child birth, maternal literacy level, wealth status, religion, source of water supply, number of ANC visits during pregnancy, and desirousness of pregnancy. Conclusion: In light of the adverse effects of low birth weight on child well-being, we recommend the implementation and prioritization of active, resourceful public health interventions that account for the findings of this study, if Nigeria is to sustain the progress achieved so far in reducing its current high rate

Estimation of the Family and Community Unobserved Heterogeneity Effects on the Risk of Under-Five Mortality in Nigeria using Frailty Model

The Under-five mortality (U5M) rate is an important determinant of societal and national advancement- a key marker of wellbeing, value, and access. In spite of efforts to identify the predictors of U5M to reduce its high level in Nigeria, the problem remains a major cause for concern. This study estimated the potential role of unmeasured/unobserved factors at both family and community levels, using shared frailty models on the 2013 Nigeria Demographic and Health Survey (2013 NDHS) data. The Log-rank test was used to identify variables associated with U5M- hazard ratio estimates with P<0.05 were considered as statistically significant. Our findings suggested region, marital status, place of residence and place of delivery were significant determinants of U5M in both frailty models. We also found evidence of frailty effect on the risk, particularly at the community level- heterogeneity due to unmeasured/unobserved factors, which are generally ignored when we assess the risk using only observed variables. We, therefore, suggest that to achieve the sustainable development goals relating to child health in Nigeria, more significant efforts should be directed at identifying more determinants, such as to reduce the influence of unobserved factors and facilitate an extension of interventions to these factors

Self-medication practices and associated factors in the prevention and/or treatment of COVID-19 virus : a population-based survey in Nigeria

Background: The anxiety caused by the emergence of the novel coronavirus disease (COVID-19) globally has made many Nigerians resort to self-medication for purported protection against the disease, amid fear of contracting it from health workers and hospital environments. Therefore, the aim of this study was to estimate the knowledge level, causes, prevalence, and determinants of self-medication practices for the prevention and/or treatment of COVID-19 in Nigeria. Methods: A web-based cross-sectional survey was conducted between June and July 2020 among the Nigerian population, using a self-reported questionnaire. Statistical analysis of descriptive, bivariate, and multivariate analyses was done using STATA 15. Results: A total of 461 respondents participated in the survey. Almost all the respondents had sufficient knowledge about self-medication (96.7%). The overall prevalence of self-medication for the prevention and treatment of COVID-19 was 41%. The contributing factors were fear of stigmatization or discrimination (79.5%), fear of being quarantine (77.3%), and fear of infection or contact with a suspected person (76.3%). The proximal reasons for self-medication were emergency illness (49.1%), delays in receiving hospital services (28.1%), distance to the health facility (23%), and proximity of the pharmacy (21%). The most commonly used drugs for self-medication were vitamin C and multivitamin (51.8%) and antimalarials (24.9%). These drugs were bought mainly from pharmacies (73.9%). From the multivariate logistic regression model, male gender (OR: 0.79; 95% CI: 0.07–0.54), and sufficient knowledge on SM (OR: 0.64; 95% CI: 0.19–0.77) were significantly associated with self-medication. Conclusion: Despite the high knowledge and the risks associated with self-medication among the respondents, the practice is prevalent for perceived COVID-19 prevention and treatment. Based on the findings of this study the media and the community-based should be engaged to create awareness on the dangers of self-medication and the need for positive health behaviour concerning COVID-19. Pharmacies, patent medicine vendors, and traditional medicine practitioners have a role to play since most of the drugs are bought from them. A review and activation of relevant laws on drug use are also suggested.Publisher PDFPeer reviewe

Health care cost associated with the use of enzyme-inducing and non-enzyme–active antiepileptic drugs in the UK: a long-term retrospective matched cohort study

Further details on the calculation of health care resource use and costs. Table S1. Variables on which the cohorts were significantly different at baseline. Table S2. Most common incident diagnoses during the post-index period. (DOCX 26 kb

A systematic review of the reporting of Data Monitoring Committees' roles, interim analysis and early termination in pediatric clinical trials

<p>Abstract</p> <p>Background</p> <p>Decisions about interim analysis and early stopping of clinical trials, as based on recommendations of Data Monitoring Committees (DMCs), have far reaching consequences for the scientific validity and clinical impact of a trial. Our aim was to evaluate the frequency and quality of the reporting on DMC composition and roles, interim analysis and early termination in pediatric trials.</p> <p>Methods</p> <p>We conducted a systematic review of randomized controlled clinical trials published from 2005 to 2007 in a sample of four general and four pediatric journals. We used full-text databases to identify trials which reported on DMCs, interim analysis or early termination, and included children or adolescents. Information was extracted on general trial characteristics, risk of bias, and a set of parameters regarding DMC composition and roles, interim analysis and early termination.</p> <p>Results</p> <p>110 of the 648 pediatric trials in this sample (17%) reported on DMC or interim analysis or early stopping, and were included; 68 from general and 42 from pediatric journals. The presence of DMCs was reported in 89 of the 110 included trials (81%); 62 papers, including 46 of the 89 that reported on DMCs (52%), also presented information about interim analysis. No paper adequately reported all DMC parameters, and nine (15%) reported all interim analysis details. Of 32 trials which terminated early, 22 (69%) did not report predefined stopping guidelines and 15 (47%) did not provide information on statistical monitoring methods.</p> <p>Conclusions</p> <p>Reporting on DMC composition and roles, on interim analysis results and on early termination of pediatric trials is incomplete and heterogeneous. We propose a minimal set of reporting parameters that will allow the reader to assess the validity of trial results.</p

Programming challenges of sampling controls to cases from the dynamic risk sets in nested case control studies

Pharmacoepidemiological studies based on the cohort design are simpler to analyse and their results easier to interpret. However, these may not reflect real-life drug use which is a major strength of such studies. The nested case-control design is often used instead to avoid the computational burden associated with time-dependent explanatory variables. Unlike the classical case-control design which is generally easy to programme, that of the nested case-control can pose a number of challenges. Subjects can be chosen as controls more than once and a subject who is chosen as a control can later become a case. Indeed controls are chosen from among those in the cohort who are at risk of the event at that time (i.e. we sample from the risk set defined by the case). We highlight the main programming challenges of the design as well as describe and demonstrate approaches for resolution and appropriate implementation