Predictors of Health-related Quality of Life in Patients with Non-specific Low Back Pain

This study examined the health-related quality of life (HRQOL) of patients with non-specific LBP and its predictors at a physiotherapy outpatient clinic in a tertiary health institution located in Abeokuta, southwestern Nigeria. The subjects were asked to complete the SF 36, Oswestry disability questionnaire (ODQ) and Quadruple Visual Analogue scale (QVAS). Socio-demographic and LBP-related information were also obtained using a specially designed proforma. Multiple linear regression analysis was used to examine the influence of the sociodemographic and LBP-related variables on the HRQOL of the respondents. Absence of numbness in the lower limb (p=0.043) and being a female were significant positive predictors of total quality of life (TQOL) score. Increasing age (p=0.005), pain (p=0.038) and level of disability (p<0.0001) were significant negative predictors of TQOL score. Evidence from this study shows that increasing age and level of disability adversely affected the HRQOL of LBP patients more than just the pain (which affects the physical component of HRQOL more). Female patients reported better HRQOL. The presence of numbness in the lower limb is the major symptom that significantly affects all the components of HRQOL adversely. The predictor of HRQOL in this population is not different from that in Asian and Caucasian populations

Factors associated with undernutrition and overweight in elderly patients presenting at a primary care clinic in Nigeria

Background: Undernutrition and overweight are commonly overlooked health problems of the elderly, often due to the implicit assumption that undernutrition is a rare occurrence in old age and overweight is an invariable consequence of ageing. Method: A cross-sectional descriptive study of 500 patients aged 60 years and above who presented consecutively at the general outpatient department, University College Hospital, Ibadan, between September and October 2009, was undertaken. The main outcome measures were prevalence of nutritional problems (undernutrition and overweight), healthcare utilisation pattern and morbidities. The Mini Nutritional Assessment (MNA) tool was used to assess undernutrition, while body mass index was used to assess body weight. Results: The prevalence of undernutrition and overweight was 7.8% and 54.1%, respectively. Previous hospital admission (p < 0.001) and chronic morbidities like hypertension (p < 0.001), osteoarthritis (p < 0.001) and psychosomatic disease (p < 0.001) were significantly associated with undernutrition, but not with overweight. Logistic regression analysis showed that previous hospital admission (OR = 2.105, 95% CI 1.479-2.996) and hypertension (OR = 0.122, 95% CI 0.048-0.306) were the most important factors contributing to the development of undernutrition. Conclusion: Nutritional problems were prevalent among the elderly in this setting. Co-morbidities in the elderly constitute risk factors to be addressed in order to reduce the occurrence of nutritional problems. Health workers should always assess the elderly for nutritional problems, together with other morbidities with which they may present, and institute appropriate management.Keywords: elderly; primary care, Nigeria; overweight; undernutritio

How Mistimed and Unwanted Pregnancies Affect Timing of Antenatal Care Initiation in three Districts in Tanzania

Early antenatal care (ANC) initiation is a doorway to early detection and management of potential complications associated with pregnancy. Although the literature reports various factors associated with ANC initiation such as parity and age, pregnancy intentions is yet to be recognized as a possible predictor of timing of ANC initiation. Data originate from a cross-sectional household survey on health behaviour and service utilization patterns. The survey was conducted in 2011 in Rufiji, Kilombero and Ulanga districts in Tanzania on 910 women of reproductive age who had given birth in the past two years. ANC initiation was considered to be early only if it occurred in the first trimester of pregnancy gestation. A recently completed pregnancy was defined as mistimed if a woman wanted it later, and if she did not want it at all the pregnancy was termed as unwanted. Chisquare was used to test for associations and multinomial logistic regression was conducted to examine how mistimed and unwanted pregnancies affect timing of ANC initiation. Although 49.3% of the women intended to become pregnant, 50.7% (34.9% mistimed and 15.8% unwanted) became pregnant unintentionally. While ANC initiation in the 1st trimester was 18.5%, so was 71.7% and 9.9% in the 2nd and 3rd trimesters respectively. Multivariate analysis revealed that ANC initiation in the 2nd trimester was 1.68 (95% CI 1.10‒2.58) and 2.00 (95% CI 1.05‒3.82) times more likely for mistimed and unwanted pregnancies respectively compared to intended pregnancies. These estimates rose to 2.81 (95% CI 1.41‒5.59) and 4.10 (95% CI 1.68‒10.00) respectively in the 3rd trimester. We controlled for gravidity, age, education, household wealth, marital status, religion, district of residence and travel time to a health facility. Late ANC initiation is a significant maternal and child health consequence of mistimed and unwanted pregnancies in Tanzania. Women should be empowered to delay or avoid pregnancies whenever they need to do so. Appropriate counseling to women, especially those who happen to conceive unintentionally is needed to minimize the possibility of delaying ANC initiation.\u

Demographic factors determining compliance to iron supplementation in pregnancy in Oyo State, Nigeria

No Abstract. Nigerian Journal of Medicine Vol. 15(3) July-September 2006: 241-24

Supplementation of micronutrients in community micronutrient deficiency prevention programmes

Micronutrient deficiency affects about 2 billion people all over the world. The major micronutrient deficiencies which are of public health importance include vitamin A, iron and iodine deficiencies. The deficiencies of these micronutrients cause a variety of morbidities and increased mortality which are most severe in children, adolescent girls and pregnant women. Despite the magnitude of these deficiencies, research has shown thatthey are correctable using simple strategies. This review examines the strategies employed to reduce micronutrient deficiencies worldwide by reviewing bibliographic databases, monograms and journals up tothe year 2007. These strategies include food based and micronutrient supplementation. Although micronutrient supplementation is widely embraced as a strategy to combat micronutrient deficiencies, they are most suitable when used as a measure to combat severe deficiencies.Food based strategies such as food fortification and dietary diversification are more effective than micronutrient supplementation which should only be used as a short term measure. Supplementation programmes should be evidence based, multi-nutrient in approach and backed up with other complementary public health interventions.Keywords: Supplementation, iron, vitamin A, iodine, combined strateg