Factors associated with sexual dysfunction among female patients in a Nigerian ambulatory primary care setting

Background: Sexual dysfunction is a common but under-reported problem of public health importance among female adults in  Nigeria. Empirical evidence on sexual dysfunction among female Nigerians is scarce.Objectives: To determine the prevalence and risk factors associated with sexual dysfunction among female patients presenting at the General Outpatient Clinic (GOPC), University College Hospital (UCH), Ibadan, Nigeria.Methods: This was a cross-sectional study of 480 married female patients who presented consecutively at the GOPC, UCH, Ibadan, Nigeria. The 28-item Sexual Function Questionnaire (SFQ-28) was used to determine sexual dysfunction. Information on their sociodemographic characteristics, obstetric and gynecological history were obtained. Bivariate and multivariate analyses were carried out and alpha was set at 0.05.Results: Point prevalence of sexual dysfunction was 80.0%. The most common sexual dysfunction was problems with sexual desire (99.4%), while the least common was problems with arousal cognition (5.8%). There was a significant association between the prevalence of sexual dysfunction and age, years of relationship, number of children alive, parity, level of education, age at coitarche and family dysfunction. Age (OR=0.893; 95% CI=0.821–0.972, p=0.008), parity (OR=3.093; 95% CI=1.174– 8.151, p=0.022), having family dysfunction (OR=2.096; 95% CI= 1.129–3.891, p=0.019) and having>10 years of formal education (OR=4.808; 95% CI= 2.604–8.928, p<0.0001) were found to be the predictors of sexual dysfunction.Conclusion: Sexual dysfunction among female married adults in our setting was high. We propose that modifiable factors such as socio-demographic and gynaecological variables should be evaluated during the consultation of female patients at first contact Keywords: Female, Sexual dysfunction, Primary care, Nigeri

Factors associated with low back pain among cleaners in a tertiary hospital in Nigeria

Objective: To determine the magnitude and factors associated with low back pain (LBP) among hospital cleaners at the University College Hospital (U.C.H), Ibadan.Method: This is a cross-sectional study conducted amongst all the cleaners working at U.C.H, Ibadan. The main outcome measurements were prevalence of LBP, socio-demographic characteristics and description of cleaning activities.Results: One hundred and forty-nine hospital cleaners (136 females and 13 males) with a mean ± age of 34.7 ± 8.5 years were interviewed. The point prevalence of LBP was 77.2%. The respondents worked an average of 8.3 hours (4 -12 hours) each day. Cleaning activities were performed an average of 3 times each day (1 - 6 times). The prevalence of LBP was significantly associated with working more than 8 hours a day (p = 0.031), living above the poverty line (p = 0.021), completion of at least 9 years of formal education (p = 0.027) and not being in marriage (p = 0.003).Conclusion: The high prevalence of LBP among hospital cleaners in our setting is worrisome and efforts should be made by physicians to detect the presence of modifiable factors associated with low back pain among hospital cleaners they encounter during clinical consultations.Keywords: Cleaners; low back pain; risk factors; prevalence

Factors associated with sarcopenia among older patients attending a geriatric clinic in Nigeria

Context: Aging is characterized by progressive and generalized loss of skeletal muscle mass and strength called sarcopenia which causes poor health and  disability. There is paucity of data on this syndrome of public health importance among older Nigerians. Aim: This study determined the prevalence and factors associated with sarcopenia among persons aged 60 years and above at a geriatric center in Nigeria.Materials and Methods: A cross‑sectional study of 642 persons aged ≥60 years who attended the geriatric center between March and July 2014. Sarcopenia was diagnosed using the European Working Group on Sarcopenia in Older People criteria. Bivariate and multivariate analyses were carried out using SPSS 20. Alpha was set at 0.05.Results: The mean age ± standard deviation of the respondents was 69.1 ± 7.2 years, and 378 (60.6%) were females. The point prevalence of sarcopenia was 5.4% which was significantly higher among the females compared with the males (7.1% vs. 2.8%) P = 0.02. Low muscle mass and low gait speed were found in 10.9% and 36.1%, respectively. Logistic regression analysis showed age (odds ratio [OR] =1.090; 95% confidence interval [CI] =1.034–1.149, P = 0.01), having no formal education (OR = 2.810; 95% CI = 1.043–7.573, P = 0.04), malnutrition (OR = 5.817; 95% CI = 1.471–23.434, P = 0.01), and female gender (OR = 3.068; 95% CI = 1.068–8.817, P = 0.04) to be the predictors of sarcopenia.Conclusion: Older people in this setting are at risk of developing sarcopenia,  especially the females. Healthcare workers should address the social and health‑related factors which could lead to sarcopenia.Keywords: Geriatric clinic, Nigeria, older patients, sarcopeni

Prevalence of obesity among women attending a Nigerian primary care clinic.

The objective was to determine the prevalence of obesity and associated risk factors among women in a Nigerian Out-Patient clinic. A pre-tested structured questionnaire was administered on women at the General Outpatients' Department (G.O.P.D.) of the University College Hospital (U.C.H.), Ibadan. The prevalence of obesity was 41.8%. Age was significantly associated with obesity, p=0.001. Majority of the obese participants (68.9%) in comparison to non obese (46.4%) were traders, p=0.001. Many of the obese respondents were married (82.6%) in comparison to non obese respondents who were widowed (67.4%), p=0.001. Many of the obese respondents were multiparous (44.3 %) having more than 4 children in comparison to the non obese respondents with the highest proportion of women with no children (36.1%), p=0.001. Fewer of the obese women had no formal education (28.1%) and no primary education (26.4%), in comparison to the non obese with 32.2% having secondary education and 27% having post-secondary education, p=0.015.Majority of the obese women (62.3%) were pre-menopausal in comparison to the non obese with 79.0% being pre-menopausal, p=0.001. Multivariate analysis done using logistic regression showed that risk factors for obesity included age group 50-59 years (Odds Ratio 15.914, 95% CI=1.389-182.26, p=0.026), and being menopausal (Odds Rat io 1.452. 95%CI=0.587-3.594,p=0.017).Having greater than five children was also found to be a risk factor for obesity (OR=3.321,95%CI=1.236-8.921,p=0.017). The prevalence of obesity among Nigerian women remains high. There is a need to plan and implement measures for control.Keywords: Prevalence, obesity, women, primary care, Nigeria

Family characteristics and childhood predictors of overweight and obesity in adults attending general outpatient clinic, Ibadan

Background: The World Health Organization has reported that there is an increasing rate of overweight and obesity and this has reached an epidemic proportion. Parental influence during childhood and family routine characteristics are been proposed as contributing factors for overweight and obesity. Objective: The study therefore sought to determine the relationship between familycharacteristics, childhood predictors and overweight/obesity.Methodology: This was a case-control study amongst adult patients aged 18 -60 years. Cases were respondents with Body Mass Index (BMI) ≥ 25 kg/m2 ; they were age and sex matched with controls (BMI 18.5 < 25 kg/m2 ), in ratio 1:1 (N=342). Interviewer administered questionnaires were applied to consenting patients to gather information on socio-demography, parental influence during childhood, family routine characteristics. The pattern of family meals was assessed with the Family Ritual Questionnaire dinnertime scale. Data was analysed with SPSS version 22. McNemar Chi-square and logistic regression were used to draw inferences at p<0.05 level of significance. Result: The mean BMI of the case and control groups was 30.08(±4.25) kg/m2 and 21.74(±2.35) kg/m respectively. Amongst thecases, 102 (59.6%) were overweight while 69(40.4%) were obese. There was no significant difference in the socio-demographicprofiles of the groups. Having a self-reported history of childhood/adolescent obesity, family history of obesity, desire for large bodysize and having a poor family mealtime routine were statistically associated with overweight and obesity with p-value < 0.05.Respondents with history of obesity in childhood/adolescent and family history of obesity were 3.6 and 3 times respectively morelikely to be overweight or obesity than if there was no such history.Conclusion: Childhood/adolescent obesity and family history of obesity are predictors of obesity. Involving the family as a unit inweight loss control may be beneficial for both the identified patient and his/her (immediate) family members who are at increased riskof becoming overweight and obese themselves. Keywords: Family characteristics, Childhood Predictors, Overweight and Obesit

The ASOS Surgical Risk Calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications

Background: The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. The objective of this study was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications. Methods: ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was constructed with a multivariable logistic regression model for the outcome of in-hospital mortality and severe postoperative complications. The following preoperative risk factors were entered into the model; age, sex, smoking status, ASA physical status, preoperative chronic comorbid conditions, indication for surgery, urgency, severity, and type of surgery. Results: The model was derived from 8799 patients from 168 African hospitals. The composite outcome of severe postoperative complications and death occurred in 423/8799 (4.8%) patients. The ASOS Surgical Risk Calculator includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.805 and good calibration with c-statistic corrected for optimism of 0.784. Conclusions: This simple preoperative risk calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance. © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.Medical Research Council of South Africa gran