Factors Influencing The Practice Of Exclusive Breastfeeding In Three Regions Of Nigeria

Background: Breastfeeding is the super food for babies and is sufficient if given exclusively in the first six months of a baby's life. In Nigeria, the practice of breastfeeding is high but Exclusive Breastfeeding (EBF) rates remain low at 13%. Several interrelating factors directly or indirectly affect the decision or ability of mothers to practice EBF. The objective of this study was to assess the factors influencing EBF in Nigeria.Methodology: A cross sectional survey among 433 mothers of children between six and twenty-four months old was conducted in urban and peri-urban/rural parts of Zaria, Abakaliki, and Ibadan. The study adopted a mixed research methodology that consisted of key informant interviews, structured questionnaires, and focus group discussions. Descriptive statistic was used to analyze the quantitative data while the themes in the qualitative data were analyzed using manual content analysis.Results: Approximately 90% of all mothers interviewed had heard about EBF, although with variations in the exact definition of EBF as many interpreted it to be just till the start of 6 months. The practice of EBF is low - Ibadan (16%), Abakaliki (10%) and Zaria (2%).Inaccurate knowledge of EBF, occupation, antenatal care attendance, age of mothers, supportive environment from stakeholders are some factors associated with the practice of EBF.Conclusion: The findings in this study indicate that several factors affect the practice of EBF in Nigeria. Improving the practice of EBF in the country will require a multifaceted approach and concerted efforts from stakeholders to address the deterring factors limiting its practice.Keywords: Exclusive Breastfeeding, Interrelating factors, social activity and significant others, and Nigeri

Clinical characterisation and management outcomes of COVID-19 infection in pregnancy in a Nigerian tertiary hospital

Background: Literature on the antenatal and perinatal management and outcomes of COVID-19 infection in pregnancy in Nigeria and sub-Saharan Africa is gradually emerging but sparse. There is an urgent need to build up the knowledge base of COVID-19 infection in Nigerian pregnant women. The objective of the current study was to determine the clinical characteristics and management outcomes of COVID-19 infection in pregnancy at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria.Methods: A one-year retrospective review of all cases of COVID-19 infection in pregnancy managed at the OAUTHC. Relevant data were extracted from the case records of all cases managed using a purpose-designed proforma. Data collected was analysed using IBM-SPSS, version 24. Associations between categorical variables were assessed using chi square, with level of significance set at <0.05.Results: A total of 22 cases were managed. Majority (15, 68.2%) of the women were either asymptomatic or had mild symptoms. The commonest symptom was cough (8, 36.4%). The mean duration of admission was 6.6±4.2 days. The most common maternal and perinatal complication was preterm delivery/birth (3, 13.6%). There was no maternal mortality. The mean birth weight of the babies was 3226g±597g, with mean 1- and 5- minutes Apgar scores of 8.0±1.3 and 9.5±0.6 respectively.Conclusions: Although COVID-19 infection in pregnancy is an asymptomatic or mild infection in the majority of cases in Ile-Ife, Nigeria, it is associated with adverse maternal and perinatal outcomes. Further studies are recommended to determine transplacental transmission of COVID-19 infection and antibodies

Liver mitochondrial membrane permeability modulation in insulin-resistant, uninephrectomised male rats by Clerodendrum volubile P. Beauv and Manihot esculenta Crantz

Background: Non-alcoholic fatty liver disease, which occurs in people who are not alcohol drinkers, describes some of the pathogenic conditions that may be in the least characterized by simple steatosis or can be as serious as non-alcoholic steatohepatitis and cirrhosis. Its mechanistic pathogenesis has been said to arise from insulin resistance and oxidative stress, which may be compounded by obesity. An experimental model showing, systemic insulin resistance, obesity and accumulated hepatic fatty acids was created in adult male rats using high-fat diet manipulation and surgical removal of the left kidney (uninephrectomy). This study sought to identify the impact of these multiple burdens on the liver mitochondrial membrane permeability transition pore opening, and the possible in vitro effects of the extracts of Clerodendrum volubile and Manihot esculenta leaves on the membrane permeabilization. Results: The results indicated that the methanolic extract of Clerodendrum volubile leaf inhibited mitochondrial membrane pore opening in the insulin resistance condition or when it is followed by uni-nephrectomy, while the ethanolic extract of Manihot esculenta leaf does the same in the insulin resistance condition both prior to and following uni-nephrectomy. Conclusion: Since the vegetable extracts were able to abrogate mitochondrial pore opening at low concentrations, the structural integrity of the mitochondria can possibly be restored over time if treated by the vegetable extracts. Research efforts should, therefore, be made to harness the drugability of the bioactives of these vegetables for use in the treatment of non-alcoholic fatty liver disease arising from insulin resistance and renal failure.Fil: Ajayi, Ebenezer Idowu O. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigación Médica Mercedes y Martín Ferreyra. Universidad Nacional de Córdoba. Instituto de Investigación Médica Mercedes y Martín Ferreyra; Argentina. Osun State University; Nigeria. National Institute of Pharmaceutical Education and Research; IndiaFil: Molehin, Olorunfemi R.. Ekiti State University; NigeriaFil: Oloyede, Omotade I.. Ekiti State University; NigeriaFil: Kumar, Vinodu. National Institute of Pharmaceutical Education and Research; IndiaFil: Amara, Venkateswara R.. National Institute of Pharmaceutical Education and Research; IndiaFil: Kaur, Jasmine. National Institute of Pharmaceutical Education and Research; IndiaFil: Karpe, Pinakin. National Institute of Pharmaceutical Education and Research; IndiaFil: Tikoo, Kulbhushan B.. National Institute of Pharmaceutical Education and Research; Indi

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Parental intention to vaccinate adolescents with HPV vaccine in selected communities in Ibadan, Southwest Nigeria: an application of Integrated Behavioral Model

Parents have important roles to play for adolescents to get the human papillomavirus (HPV) vaccine, an effective measure in the prevention of cervical and other HPV-related cancers. It is important to understand the intention of parents to have their adolescents vaccinated for optimal uptake of the vaccine in Nigeria. This study investigated the intention of parents in five selected communities to get their adolescents vaccinated with HPV vaccine in Ibadan, Nigeria using the Integrated Behavioral Model (IBM). Cross sectional study design was employed and 678 parents were interviewed. Pearson correlation, chi-square test and multiple regression were used for data analysis at α = 0.05. Mean age of the parents was 42.5 ± 10.0 years and 230(33.9%) were males. Almost all of the parents (96.8%) had the intention to vaccinate their adolescents with HPV vaccine. This intention was significantly correlated with experiential attitude (r = 0.74, p = <.01), instrumental attitude (r = 0.33, p = <.01), injunctive norm (r = 0.39, p = <.01), descriptive norm (r = 0.32, p = <.01), perceived control (r = 0.32, p = <.01) and self-efficacy (r = 0.46, p ≤ .01). A higher proportion of parents older than 65 years significantly had no intention to vaccinate their adolescents with HPV vaccine. Intention to vaccinate adolescents with HPV vaccine was predicted by experiential attitude (OR = 0.88, 95% CI: 0.80–0.95), personal agency (OR = 0.22, 95% CI: 0.15–0.29) and injunctive norm (OR = 0.08, 95% CI: 0.02–0.13). Parental intention to vaccinate adolescents with HPV vaccine was high among the parents in this study. The reluctance of older parents about HPV vaccine for adolescents requires further investigation

Socio-cultural issues in child health care in Nigeria

No Abstract.Archives of Ibadan Medicine Vol. 8 (2) 2007: pp. 49-5

Stated preferences for human papillomavirus vaccination for adolescents in selected communities in Ibadan, Southwest Nigeria: A discrete choice experiment

Administration of the human papillomavirus (HPV) vaccine in early adolescence is effective in preventing cervical cancer, a common cancer in sub-Saharan Africa. Nigeria is in the pre-introduction era of the HPV vaccine. Understanding the preferences of the population for the vaccine can help design the HPV immunization program to ensure high uptake of the vaccine. This study explored the preferences for the HPV vaccine among stakeholders in selected communities in Ibadan, Nigeria. A discrete choice experiment survey based on six attributes of the HPV vaccine (which were the number of doses, the efficacy of the vaccine, cost of the vaccine, location of the service point, other benefits of the vaccine apart from prevention of cervical cancer and the odds of a side effect from the vaccine) was carried out in five communities. Data were analyzed using conditional and mixed logit models. Seven hundred community members were recruited, 144 (20.7%) were adolescents and 248 (35.4%) were males. In line with expectations, respondents preferred vaccines with higher efficacy, less severe side effects and lower costs. Preference heterogeneity was identified for adolescents that were less price-sensitive and other community members who were less likely to prefer using schools as the service point. The high socioeconomic class preferred a vaccine that also prevents genital warts. There were variabilities in the preferences for the attributes of the HPV vaccine in the study communities. These variabilities need to be considered in the introduction of the HPV vaccine to ensure high uptake of the vaccine