Decision making autonomy and maternal healthcare utilization among Nigerian women

Background and Objectives: Low assess to ante-natal care (ANC) services continue to pose a major public health challenge leading to high maternal mortality rates in developing countries. Non-utilization of ANC services among about a quarter of Nigerian women of reproductive age remains a major concern in the actualization of Sustainable Development Goals. Considering the complexity of healthcare utilization in Nigeria, the relationship between a particular health care utilization pattern and women autonomy has not been fully examined. This study examines the patterns of women autonomy and their relationships with ANC utilization in Nigeria. Methods: This was a cross-sectional analysis of the 2013 nationally representative data from the Nigerian Demographic and Health Survey (NDHS). Factor analysis/score were used to construct women autonomy index, while chi-square and logistic regression were used to establish the relationships between the response and exposure variables. Results: There is a strong relationship between women decision making autonomy status and ANC services among Nigeria women. The odds of utilizing ANC services among women with more decision making autonomy were significantly 3.79 higher than among women with low decision-making autonomy. The use of ANC increases as age, education and wealth status of respondents increase. Conclusions and Global Health Implications: These results indicate that women autonomy is undoubtedly a major determinant of ANC utilization in Nigeria

How much does paediatric femoral lengthening cost? A cost comparison between magnetic lengthening nails and external fixators

Aim: Motorised intramedullary lengthening nails are considered more expensive than external fixators for limb lengthening. This research aims to compare the cost of femoral lengthening in children using the PRECICE magnetic lengthening nail with external fixation. Methods: Retrospective analysis of 50 children who underwent femoral lengthening. One group included patients who were treated with PRECICE lengthening nails, the other group included patients who had lengthening with external fixation. Each group included 25 patients aged between 11 and 17 years. The patients in both groups were matched for age. Cost analysis was performed following micro-costing and analysis of the used resources during the different phases of the treatments. Results: Each group's mean patient age was 14.7 years. Lengthening nails were associated with longer operative times compared with external fixators, both for implantation and removal surgery (p-values of 0.007 and < 0.0001, respectively). Length of stay following the implantation surgery, frequency of radiographs and frequency of outpatient department appointments were all lower with lengthening nails. The overall cost of lengthening nails was £1393 more than external fixators, however, this difference was not statistically significant (p-value = 0.088). Conclusion: The difference in the mean costs between femoral lengthening with lengthening nails versus external fixators was not statistically significant. Further research to review the effectiveness of the devices and the quality of life during the lengthening process is crucial for robust health economic evaluation

Impact of dietary patterns, individual and workplace characteristics on blood pressure status among civil servants in Bida and Wushishi communities of Niger State, Nigeria

The global burden estimate of hypertension is alarming and results in several million deaths annually. A high incidence of sudden deaths from cardiovascular diseases in the civil workforce in Nigeria is often reported. However, the associations between Dietary Patterns (DPs), individual, and workplace characteristics of hypertension among this workforce have not been fully explored. This study aimed to identify DP in the Bida and Wushishi Communities of Niger State and establish its relationship with hypertension along with other individual and workplace characteristics. Factor analysis was used to establish DP, Chi-square test to identify their relationships with hypertension, and logistic regression to determine the predictor risk factors. The prevalence of hypertension was 43.7%; mean weight, height, and body fat were: 72.8±15 kg, 166±8.9 mm and 30.4%, respectively. Three DPs: “Efficient Diet,” “Local diet,” and “Energy Boost Diet” were identified. The factor loading scores for these factors were divided into quintiles Q1–Q5; none of them had a significant effect on hypertension status. Conversely, increase in age, the Ministry, Department, and Agency (MDA) of employment, frequency of eating in restaurants, and obesity were identified as significant risk factors. After adjusting for confounders (age, body mass index, MDA, and eating habits), a high score (Q5) in “efficient diet pattern” was significantly related to a lower likelihood of hypertension than a low score (Q1). The prevalence of hypertension among the participants was relatively very high. An increase in age and working in educational sector were risk factors associated with hypertension. Therefore, it is recommended that civil servants engage in frequent exercise and undergo regular medical checkups, especially as they get older. These findings highlight the need for large-scale assessment of the impact of variables considered in this study on hypertension, among the civil workforce across Niger state and Nigeria

Evaluating the reasons for partial and non-immunization of children in Wushishi local government area, Niger state, Nigeria : methodological comparison

Immunization of children against childhood preventable diseases has remained one of the most important cost effective and public health strategies to reduce childhood preventable morbidity and mortalities arising from infectious diseases. A recent report released by World Health Organization (WHO) stated that 1 in 10 infants did not receive vaccination in 2016. Also, a survey conducted in Bida Emirate Area of Niger State Nigeria in 2015 found that full routine immunization coverage in this area was less than 30%. The aim of this study was to establish the full routine immunization status and the reasons for its partial and non-immunization of children in Wushishi Local Government Area using WHO recommended cluster survey method and contrast with Factor Analysis (FA) method to see if the same results were achieved. The findings showed that the full immunization status for this area was very low (36%) and the results of analysis of reasons for failure from both methods seem contradictory. However, it reflected that lack of proper information was strongest for both methods. The disparity obtained in the two methods might be a result of methodological issues. The health implication is that much is expected to be done in the area of enlightenment campaign of the need for immunization and the need to complete the required basic dose especially in the rural areas

Evaluating the Reasons for Partial and Non-immunization of Children in Wushishi Local Government Area, Niger State, Nigeria: Methodological Comparison

Immunization of children against childhood preventable diseases has remained one of the most important cost effective and public health strategies to reduce childhood preventable morbidity and mortalities arising from infectious diseases. A recent report released by World Health Organization (WHO) stated that 1 in 10 infants did not receive vaccination in 2016. Also, a survey conducted in Bida Emirate Area of Niger State Nigeria in 2015 found that full routine immunization coverage in this areawas less than 30%. The aim of this study was to establish the full routine immunization status and the reasons for its partial and non-immunization of children in Wushishi Local Government Area using WHO recommended cluster survey method and contrast with Factor Analysis (FA) method to see if the same results were achieved. The findings showed that the full immunization status for this area was very low (36%) and the results of analysis of reasons for failure from both methods seem contradictory. However, it reflected that lack of proper information was strongest for both methods. The disparity obtained in the two methods might be a result of methodological issues. The health implication is that much is expected to be done in the area of enlightenment campaign of the need for  immunization and the need to complete the required basic dose especially in the rural areas. (Afr J Reprod Health 2018; 22[4]: 113-122).Keywords: Vaccination, Factor Analysis, Principal Component Analysis, In-complete immunizatio

Elucidating tricuspid Doppler signal interpolation and its implication for assessing pulmonary hypertension

Doppler echocardiography plays a central role in the assessment of pulmonary hypertension (PAH). We aim to improve quality assessment of systolic pulmonary arterial pressure (SPAP) by applying a cubic polynomial interpolation to digitized tricuspid regurgitation (TR) waveforms. Patients with PAH and advanced lung disease were divided into three cohorts: a derivation cohort (n = 44), a validation cohort (n = 71), an outlier cohort (n = 26), and a non-PAH cohort (n = 44). We digitized TR waveforms and analyzed normalized duration, skewness, kurtosis, and first and second derivatives of pressure. Cubic polynomial interpolation was applied to three physiology-driven phases: the isovolumic phase, ejection phase, and “shoulder” point phase. Coefficients of determination and a Bland−Altman analysis was used to assess bias between methods. The cubic polynomial interpolation of the TR waveform correlated strongly with expert read right ventricular systolic pressure (RVSP) with R2 &gt; 0.910 in the validation cohort. The biases when compared to invasive SPAP measured within 24 h were 6.03 [4.33; 7.73], −2.94 [1.47; 4.41], and −3.11 [−4.52; −1.71] mmHg, for isovolumic, ejection, and shoulder point interpolations, respectively. In the outlier cohort with more than 30% difference between echocardiographic estimates and invasive SPAP, cubic polynomial interpolation significantly reduced underestimation of RVSP. Cubic polynomial interpolation of the TR waveform based on isovolumic or early ejection phase may improve RVSP estimates.QC 20230607</p