Prevalence and sociodemographic determinants of adult obesity: A large representative household survey in a resource-constrained African setting with double burden of undernutrition and overnutrition

BACKGROUND The obesity epidemic has continued to spread across the globe involving even poor nations of the world. METHOD Household population survey of adults aged 20-60 years. Multistage stratified cluster randomised sampling involving both urban and rural statewide representative population samples. Anthropometric measurements were taken using standard methods. Prevalences were weighted and multinomial regression analyses were done. RESULTS A total of 6628 individuals from 2843 households were surveyed. The weighted overall prevalence for underweight was 9.1% (95% CI 8.1 to 10.1), 65.1% (95% CI 63.6 to 66.6) for normal weight, 19.0% (95% CI 17.8 to 20.3) for overweight and 6.8% (95% CI 6.0 to 7.5) for obese. Men were less likely to be overweight (adjusted OR (AOR) 0.79; 95% CI 0.68 to 0.92) and obese (AOR 0.24; 95% CI 0.19 to 0.31) than women. Urban residents were more likely to be overweight (AOR 1.42; 95% CI 1.18 to 1.71) and obese (AOR 2.09; 95% CI 1.58 to 2.76) than rural residents. Each additional 1-year increase in age increased the risk of overweight by 1.012 (AOR 1.012; 95% CI 1.005 to 1.018) and that of obesity by 1.03 (AOR 1.03; 95% CI 1.02 to 1.04). The low-income class was less likely to be overweight (AOR 0.694; 95% CI 0.507 to 0.951) and obese (AOR 0.44; 95% CI 0.28 to 0.67). CONCLUSION The prevalence of obesity and overweight in Enugu Nigeria is high and fast approaching that of underweight. Women, urban dwellers, older adults and high-income earners are at higher risk for obesity and overweight. The study provides robust information for public health policies towards the prevention of obesity in Nigeria

Causal attribution of mental illness in south-eastern Nigeria

Background: Understanding of mental illness in sub-Saharan Africa has remained under-researched in spite of the high and increasing neuropsychiatric burden of disease in the region. Aims: This study investigated the causal beliefs that the Igbo people of south-eastern Nigeria hold about schizophrenia, with a view to establishing the extent to which the population makes psychosocial, biological and supernatural attributions. Method: Multi-stage sampling was used to select participants (N = 200) to which questionnaires were administered. Results: Mean comparison of the three causal models revealed a significant endorsement of supernatural causation. Logistic regressions revealed significant contributions of old age and female gender to supernatural attribution; old age, high education and Catholic religious denomination to psychosocial attributions; and high education to biological attributions. Conclusions: It is hoped that the findings would enlighten, augment literature and enhance mental health care service delivery

Pathways to mental healthcare in south-eastern Nigeria

In sub-Saharan Africa, traditional and faith healers provide competing services alongside biomedical professionals. This may be associated with delays in reaching specialised mental health services, and hence with longer duration of untreated illness. As first line care constitutes a crucial stage in accessing of psychiatric care, investigating pathways to mental healthcare can highlight help-seeking choices. This study explored the pathways to care for mental illness preferred by a non-clinical sample of the population in south-eastern Nigeria. Multistage sampling was used to select participants (N = 706) who completed questionnaires on help-seeking. Results showed a significant preference for biomedical (90.8%) compared to spiritual (57.8%) and traditional (33.2%) pathways. Higher education predicted preference for the biomedical model, while low education was associated with traditional and spiritual pathways. Protestants preferred the spiritual pathway more than did Catholics. The use of biomedical care is potentially undermined by poor mental health infrastructure, a lack of fit between the culture of biomedical care and the deep-seated cultural/religious worldviews of the people, stigma surrounding mental illness, and the likelihood of a social desirability bias in responses. A complementary model of care is proposed

HIV/AIDS-related knowledge, sexual practices and predictors of condom use among long-distance truck drivers in Nigeria

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Voluntary Counseling and Willingness to Screen among Nigerian Long Distance Truck Drivers

Background: Voluntary counseling and testing (VCT) is an important preventive strategy in the control of HIV/AIDS and Long distance truck drivers (LDTD) have been identified as an important group in the transmission of HIV/AIDS. This study aims to assess knowledge and perception of Nigerian long distance truck drivers on HIV/AIDS, voluntary counseling and testing and their willingness to undergo HIV screening. Materials and Methods: One hundred and ninety seven LDTD in Enugu, Nigeria were surveyed using pre tested structured questionnaires. Results: Awareness of HIV/AIDS was high (94.9%) amongst the drivers and the media was their commonest source of information. Similarly the awareness of VCT was high (94.4%). One hundred and eight (54.8%) respondents were willing to undergo HIV screening test if offered freely and 86 (43.7%) others have previously been screened. Educational status was a significant determinant of willingness to undergo HIV screening p<0.05. The reasons for screening were mainly doctors′ recommendation (19.3%) and voluntary self screening (18.8%). The commonest reasons for not wanting to undergo screening were the feeling of not being at risk (27.9%), fear of a positive result (10.2%) and cost of screening test (9.6%). Conclusion: There is a critical need to improve HIV screening participation amongst Long distance drivers in Nigeria

Granular Cell Tumor - a Rare Tumor of the Mons Pubis: Case Report and Literature Review

Objective: Granular cell tumor of the mons pubis is rare. A case is reported with literature review.Material and Method: Study of the management and outcome of a 23 year old Nigerian woman with granular cell tumor in the mons pubis. Literature review was done utilizing a Medline search for the last ten years.Results: The diagnosis of granular cell tumor is often missed clinically and requires histological evidence. Adequate surgical excision, patient counseling and efficient follow up result in good outcome.Conclusion: Clinicians and pathologist need to be aware of the clinico-pathological characteristics of granular cell tumors in order to facilitate its appropriate management.Key Words: Granular Cell Tumor, Mons Pubi

Physical Activity and Outdoor Leisure Time Physical Exercise: A Population Study of Correlates and Hindrances in a Resource-Constrained African Setting

Purpose: The study evaluated the burden of physical inactivity, its correlates, and the self-reported hindrances to outdoor leisure-time physical exercises in Enugu Nigeria. It also evaluated the prevalence of leisure-time outdoor physical exercise and its correlates in Enugu Nigeria. Patient and methods: This is a cross-sectional household survey involving 6628 individuals aged 20 to 60 years from 2848 households in Enugu Nigeria. Binary logistic regression and multinomial regression analyses were carried out as appropriate. Estimates were weighted to account for the actual population distribution of important sociodemographic variables and reported with the 95% confidence interval. Results: The burden of physical inactivity was 32.68% (95% CI: 31.24-34.12%). Urban dwellers were less likely to be physically active than rural dwellers (AOR = 0.477; 95% CI = 0.410-0.555). For each year increase in age, the odds of being physically active decreases by a factor of 0.993 (AOR = 0.993; 95% CI= 0.988-0.998). Gender, income level and education did not predict physical inactivity. Physical inactivity significantly increases the odds of being obese by a factor of 1.428 (AOR: 1.428; 95% CI: 1.190-1.714). Only 6.45% (95% CI: 5.82%-7.09%) participants reported at least once a week outdoor leisure-time physical exercise. The major barriers include lack of time and lack of interest in outdoor leisure-time physical exercise. Conclusion: The burden of physical inactivity is high, while the level of outdoor physical exercise is low in Enugu, Nigeria. Urban dwelling and increasing age are risk factors for physical inactivity. Living in urban areas, being less than 40 years of age, having a university education, and a high personal income are factors that positively drive outdoor leisure-time physical exercises. Policies that will promote awareness of the health benefits of physical activity and outdoor physical exercise are needed if Nigeria is to achieve the global mandate of reducing physical inactivity by 10% in the year 2025

The effect of short interpregnancy interval on birthweight and other pregnancy outcomes in Enugu, Southeast Nigeria

The time interval between one pregnancy and the next is a modifiable risk factor, and has an effect on pregnancy outcomes. This study compared the effects of short interpregnancy interval (IPI) on fetal birthweight and selected pregnancy outcomes amongst parturients in Enugu, Nigeria. Group A (Subjects) consisted of parturients with short IPI (IPI < 18 months), while group B (Controls) consisted of parturients with normal IPI (IPI ≥ 18 months). Relevant obstetric data were collected at delivery. Mean birthweight was 2664.13 ± 339.25g vs 3670.63 ± 452.69g in women with short IPI and normal IPI respectively (p < .0001). Women with short IPI were more likely to have low birthweight babies compared to those with normal IPI (OR = 7.331, p < .001). Maternal anaemia, preeclampsia and caesarean delivery were significantly more associated with short IPI. Women with short IPI are at greater risk of delivering newborn babies with significantly lower mean birthweight and other associated pregnancy complications than women with normal IPI.Impact Statement What is already known on this subject? Short interpregnancy interval has an adverse effect on pregnancy outcomes as shown in studies from Europe and the Americas. What do the results of this study add? This study adds to the body of evidence of the deleterious effects of inadequately spaced pregnancies and draws attention to this in West Africa, sub-Saharan Africa, and an area with low contribution to studies on the effect of short IPI on pregnancy outcomes. What are the implications of these findings for clinical practice and/or further research? With evidence from our own environment, it will further boost evidence for proper education of our mothers on the need for adequate birth spacing to avoid the adverse effects of a short IPI on the next pregnancy