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Oladayo AM, Odukoya O, Sule V, Molobe I, Busch T, Akodu B, Adeyemo WL, Gowans LJJ, Eshete M, Alade A, Awotoye W, Adeyemo AA, Mossey PA, Prince AER, Murray JC, Butali A. Perceptions and beliefs of community gatekeepers about genomic risk information in African cleft research. BMC Public Health 2024; 24:507. [PMID: 38365612 PMCID: PMC10873930 DOI: 10.1186/s12889-024-17987-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/05/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND A fundamental ethical issue in African genomics research is how socio-cultural factors impact perspectives, acceptance, and utility of genomic information, especially in stigmatizing conditions like orofacial clefts (OFCs). Previous research has shown that gatekeepers (e.g., religious, political, family or community leaders) wield considerable influence on the decision-making capabilities of their members, including health issues. Thus, their perspectives can inform the design of engagement strategies and increase exposure to the benefits of genomics testing/research. This is especially important for Africans underrepresented in genomic research. Our study aims to investigate the perspectives of gatekeepers concerning genomic risk information (GRI) in the presence of OFCs in a sub-Saharan African cohort. METHODS Twenty-five focus group discussions (FGDs) consisting of 214 gatekeepers (religious, community, ethnic leaders, and traditional birth attendants) in Lagos, Nigeria, explored the opinions of participants on genomic risk information (GRI), OFC experience, and the possibility of involvement in collaborative decision-making in Lagos, Nigeria. Transcripts generated from audio recordings were coded and analyzed in NVivo using thematic analysis. RESULTS Three main themes-knowledge, beliefs, and willingness to act-emerged from exploring the perspective of gatekeepers about GRI in this group. We observed mixed opinions regarding the acceptance of GRI. Many participants believed their role is to guide and support members when they receive results; this is based on the level of trust their members have in them. However, participants felt they would need to be trained by medical experts to do this. Also, religious and cultural beliefs were crucial to determining participants' understanding of OFCs and the acceptance and utilization of GRI. CONCLUSIONS Incorporating cultural sensitivity into public engagement could help develop appropriate strategies to manage conflicting ideologies surrounding genomic information in African communities. This will allow for more widespread access to the advances in genomics research in underrepresented populations. We also recommend a synergistic relationship between community health specialists/scientists, and community leaders, including spiritual providers to better understand and utilize GRI.
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Affiliation(s)
- Abimbola M Oladayo
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA.
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA.
| | - Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Veronica Sule
- Department of Operative Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Ikenna Molobe
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Tamara Busch
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | - Babatunde Akodu
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Wasiu L Adeyemo
- Department of Oral and Maxillofacial Surgery, University of Lagos, Lagos, Nigeria
| | - Lord J J Gowans
- Komfo Anokye Teaching Hospital and Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mekonen Eshete
- School of Medicine, Department of Surgery, Addis Ababa University, Addis Ababa, Ethiopia
| | - Azeez Alade
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | - Waheed Awotoye
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | | | - Peter A Mossey
- Department of Orthodontics, University of Dundee, Dundee, UK
| | | | - Jeffrey C Murray
- Department of Pediatrics, University of Iowa, Iowa City, IA, USA
| | - Azeez Butali
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA.
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA.
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Adeola J, Obiezu F, Odukoya O, Igwilo U, Usinoma A, Bahiru E, May FP. Barriers and Facilitators to Risk Reduction of Cardiovascular Disease in Hypertensive Patients in Nigeria. Ann Glob Health 2023; 89:88. [PMID: 38107602 PMCID: PMC10723016 DOI: 10.5334/aogh.4131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/14/2023] [Indexed: 12/19/2023] Open
Abstract
Background In Sub-Saharan Africa (SSA), the prevalence of hypertension is increasing due to many factors like rapid population growth, globalization, stress, and urbanization. We aimed to characterize the perceptions of cardiovascular disease (CVD) risk among individuals with hypertension living in Nigeria and identify barriers and facilitators to optimal hypertension management. Methods This cross-sectional survey study was conducted at a large teaching hospital in Lagos, Nigeria. We used a convenient sample of males and females, aged 18 or older, with a diagnosis of hypertension who presented for outpatient visits in the cardiology, nephrology, or family medicine clinics between November 1 and 30, 2020. A semiquantitative approach was utilized with a survey consisting of closed and open-ended questionnaires focused on patient knowledge, perceptions of CVD risk, and barriers and facilitators of behavioral modifications to reduce CVD risk. Results There were 256 subjects, and 62% were female. The mean age was 58.3 years (standard deviation (SD) = 12.6). The mean duration of the hypertension diagnosis was 10.1 years. Most participants were quite knowledgeable about hypertension; however, we observed some knowledge gaps, including a belief that too much "worrying or overthinking" was a major cause of hypertension and that an absence of symptoms indicated that hypertension was under control. Barriers to hypertension management include age, discomfort or pain, and lack of time as barriers to exercise. Tasteless meals and having to cook for multiple household members were barriers to decreasing salt intake. Cost and difficulty obtaining medications were barriers to medication adherence. Primary facilitators were family support or encouragement and incorporating lifestyle modifications into daily routines. Conclusion We identified knowledge gaps about hypertension and CVD among our study population. These gaps enable opportunities to develop targeted interventions by healthcare providers, healthcare systems, and local governments. Our findings also help in the promotion of community-based interventions that address barriers to hypertension control and promote community and family involvement in hypertension management in these settings.
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Affiliation(s)
- Janet Adeola
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, USA
| | - Fiona Obiezu
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, USA
| | - Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos and Lagos University Teaching Hospital, Nigeria
| | - Ugonnaya Igwilo
- Department of Community Health and Primary Care, College of Medicine, University of Lagos and Lagos University Teaching Hospital, Nigeria
| | - Adewunmi Usinoma
- Department of Community Health and Primary Care, College of Medicine, University of Lagos and Lagos University Teaching Hospital, Nigeria
| | - Ehete Bahiru
- Department of Cardiology, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, USA
| | - Folasade P. May
- Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
- UCLA Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity and Department of Health Policy and Management, Jonsson Comprehensive Cancer Center, Los Angeles, California, USA
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Oladayo A, Gowans LJJ, Awotoye W, Alade A, Busch T, Naicker T, Eshete MA, Adeyemo WL, Hetmanski JB, Zeng E, Adamson O, Adeleke C, Li M, Sule V, Kayali S, Olotu J, Mossey PA, Obiri‐Yeboah S, Buxo CJ, Beaty T, Taub M, Donkor P, Marazita ML, Odukoya O, Adeyemo AA, Murray JC, Prince A, Butali A. Clinically actionable secondary findings in 130 triads from sub-Saharan African families with non-syndromic orofacial clefts. Mol Genet Genomic Med 2023; 11:e2237. [PMID: 37496383 PMCID: PMC10568375 DOI: 10.1002/mgg3.2237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/23/2023] [Accepted: 06/28/2023] [Indexed: 07/28/2023] Open
Abstract
INTRODUCTION The frequency and implications of secondary findings (SFs) from genomic testing data have been extensively researched. However, little is known about the frequency or reporting of SFs in Africans, who are underrepresented in large-scale population genomic studies. The availability of data from the first whole-genome sequencing for orofacial clefts in an African population motivated this investigation. METHODS In total, 130 case-parent trios were analyzed for SFs within the ACMG SFv.3.0 list genes. Additionally, we filtered for four more genes (HBB, HSD32B, G6PD and ACADM). RESULTS We identified 246 unique variants in 55 genes; five variants in four genes were classified as pathogenic or likely pathogenic (P/LP). The P/LP variants were seen in 2.3% (9/390) of the subjects, a frequency higher than ~1% reported for diverse ethnicities. On the ACMG list, pathogenic variants were observed in PRKAG (p. Glu183Lys). Variants in the PALB2 (p. Glu159Ter), RYR1 (p. Arg2163Leu) and LDLR (p. Asn564Ser) genes were predicted to be LP. CONCLUSION This study provides information on the frequency and pathogenicity of SFs in an African cohort. Early risk detection will help reduce disease burden and contribute to efforts to increase knowledge of the distribution and impact of actionable genomic variants in diverse populations.
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Affiliation(s)
- Abimbola Oladayo
- Department of Oral Pathology, Radiology and Medicine, College of DentistryUniversity of IowaIowa CityIowaUSA
- Iowa Institute for Oral Health ResearchUniversity of IowaIowa CityIowaUSA
| | - Lord Jephthah Joojo Gowans
- Iowa Institute for Oral Health ResearchUniversity of IowaIowa CityIowaUSA
- Department of Biochemistry and BiotechnologyKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Waheed Awotoye
- Department of Oral Pathology, Radiology and Medicine, College of DentistryUniversity of IowaIowa CityIowaUSA
- Iowa Institute for Oral Health ResearchUniversity of IowaIowa CityIowaUSA
| | - Azeez Alade
- Department of Oral Pathology, Radiology and Medicine, College of DentistryUniversity of IowaIowa CityIowaUSA
- Department of Epidemiology, College of Public HealthUniversity of IowaIowa CityIowaUSA
| | - Tamara Busch
- Department of Oral Pathology, Radiology and Medicine, College of DentistryUniversity of IowaIowa CityIowaUSA
| | - Thirona Naicker
- Department of PediatricsUniversity of KwaZulu‐NatalPinetownSouth Africa
| | - Mekonen A. Eshete
- School Medicine, Surgical DepartmentAddis Ababa UniversityAddis AbabaEthiopia
| | - Wasiu L. Adeyemo
- Department of Oral and Maxillofacial SurgeryUniversity of LagosLagosNigeria
| | - Jacqueline B. Hetmanski
- Department of EpidemiologySchool of Public Health Johns Hopkins UniversityBaltimoreMarylandUSA
| | - Erliang Zeng
- Division of Biostatistics and Computational Biology, College of DentistryUniversity of IowaIowa CityIowaUSA
| | - Olawale Adamson
- Department of Oral and Maxillofacial SurgeryUniversity of LagosLagosNigeria
| | - Chinyere Adeleke
- Department of Oral Pathology, Radiology and Medicine, College of DentistryUniversity of IowaIowa CityIowaUSA
| | - Mary Li
- Department of Oral Pathology, Radiology and Medicine, College of DentistryUniversity of IowaIowa CityIowaUSA
| | - Veronica Sule
- Department of Operative Dentistry, College of DentistryUniversity of IowaIowa CityIowaUSA
| | - Sami Kayali
- Department of Oral Pathology, Radiology and Medicine, College of DentistryUniversity of IowaIowa CityIowaUSA
| | - Joy Olotu
- Department of AnatomyUniversity of Port HarcourtPort HarcourtNigeria
| | | | - Solomon Obiri‐Yeboah
- Department of Surgery, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Carmen J. Buxo
- Dental and Craniofacial Genomics CoreUniversity of Puerto Rico School of Dental MedicineSan JuanPuerto RicoUSA
| | - Terri Beaty
- Department of EpidemiologySchool of Public Health Johns Hopkins UniversityBaltimoreMarylandUSA
| | - Margaret Taub
- Department of EpidemiologySchool of Public Health Johns Hopkins UniversityBaltimoreMarylandUSA
| | - Peter Donkor
- Department of Surgery, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Mary L. Marazita
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, and Department of Human Genetics, Graduate School of Public HealthUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of MedicineUniversity of LagosLagosNigeria
| | | | | | - Anya Prince
- College of LawUniversity of IowaIowa CityIowaUSA
| | - Azeez Butali
- Department of Oral Pathology, Radiology and Medicine, College of DentistryUniversity of IowaIowa CityIowaUSA
- Iowa Institute for Oral Health ResearchUniversity of IowaIowa CityIowaUSA
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Ogunsola FT, Ejekam CS, Balogun M, Ugonna I, Odukoya O, Oduyebo O, Adeyemo WL, Oladele RO, Akanmu SA. Universal use of face mask for the prevention of the spread of COVID-19 in community settings in a South-western State of Nigeria: willingness and barriers. Antimicrob Resist Infect Control 2023; 12:64. [PMID: 37408082 PMCID: PMC10324105 DOI: 10.1186/s13756-023-01267-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/15/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES One of the major drivers of the novel coronavirus (SARS-CoV-2) pandemic is community transmission. Nigeria, like other countries globally, took to strict preventive public health measures including good respiratory and hand hygiene, physical distancing, and the use of face mask to control the spread of COVID-19 disease. Furthermore, the government of Lagos State in Nigeria made a pronouncement on the universal use of face mask in the community. While the use of face masks has proven to be an effective barrier to the transmission of respiratory diseases, its use in the community is uncommon. This study assessed the willingness and compliance with wearing face masks for the reduction of the community spread of COVID-19 and identified possible barriers to use of mask among residents in Lagos State. METHODS This was a descriptive cross-sectional study, that surveyed 552 respondents who were adult residents of Lagos State. Data collection was quantitative, using a pretested, interviewer-administered questionnaire, and findings were presented in frequencies and percentages. Pearson's chi-square and logistic regression analyses were used to test the association between variables. The level of significance was set at 5%. RESULTS A majority (75.7%) of the respondents were willing to wear a face mask in public areas but only 21.9% of the respondents were willing to wear a mask at all times. The most identified barriers to wearing mask were discomfort (72.5%) and inconvenience (77.7%). Two-thirds of the respondents reported they were compliant with always wearing a face mask when leaving home. Only 15.0% of the respondents wore the mask continuously and appropriately, covering the nose and mouth. Having a post-secondary education and being older (40 years and above) were found to be positive predictors of both willingness to wear a mask and compliance with universal mask policy (wearing masks continuously and appropriately). CONCLUSION Our findings suggest that willingness to wear a face mask influences compliance, and that having a post-secondary education and being older (> 40 years) were positive predictors of both willingness to wear a mask and compliance with universal mask policy (wearing it continuously and correctly). The major barriers to wearing masks were discomfort and inconvenience. Effective risk communication strategies to reach diverse groups for better compliance with public health measures are urgently needed even for the future.
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Affiliation(s)
- Folasade T Ogunsola
- Department Medical Microbiology, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| | - Chioma S Ejekam
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria.
| | - Mobolanle Balogun
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| | - Igwilo Ugonna
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| | - Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| | - Oyinlola Oduyebo
- Department Medical Microbiology, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| | - Wasiu L Adeyemo
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| | - Rita O Oladele
- Department Medical Microbiology, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| | - Sulaimon A Akanmu
- Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
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Odukoya O, Ladapo O, Okafor I, Osibogun O, Okuyemi K. Exposure to tobacco advertisements, promotions, and sponsorships among in-school adolescents in Lagos, Nigeria: A cross-sectional study. Ann Afr Med 2023; 22:333-339. [PMID: 37417022 PMCID: PMC10445717 DOI: 10.4103/aam.aam_76_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/17/2022] [Accepted: 02/17/2023] [Indexed: 07/08/2023] Open
Abstract
Background The Nigerian government implemented the National Tobacco Control Act (NTCA) in 2015, which prohibits tobacco advertising, promotion, and sponsorship (TAPS) exposure to children under 18 years of age. This study was conducted to assess the prevalence of attitudes and exposure to TAPS among in-school adolescents in Lagos State, Nigeria, 5 years after the implementation of the Act and to identify the factors associated with TAPS exposure among the adolescents. Materials and Methods This cross-sectional study was conducted among 968 in-school adolescents selected through multistage random sampling. The data were collected using self-administered questionnaires adapted from the Global Youth Tobacco Survey. Results Overall, 77% had been exposed to at least one form of TAPS in the past 30 days. The most frequently reported channel of exposure was through product placements, with 62% reporting exposure in films, TV, and videos. Up to 15.2% and 12.6% were exposed to TAPS through promotional activities and sponsorships, respectively. The majority (82.3%) had pro-tobacco attitudes, while about a third (33.1%) had pro-TAPS attitudes. Factors associated with TAPS exposure were having pro-TAPS attitudes (odds ratio [OR]: 3.5, 95% confidence interval [CI]: 2.3-5.3), being female (OR: 2, 95% CI: 1.4-2.7), and residing in a rural area (OR: 1.6, 95% CI: 1.2-2.3). Conclusion Five years after implementing the NTCA, more than two-thirds of the adolescents reported exposure to TAPS, mainly through films, TV, and videos. This suggests that the NTCA is poorly enforced. Efforts to ensure the effective implementation of comprehensive TAPS bans are warranted. Gender-sensitive strategies that target adolescents' attitudes and school-level factors should be emphasized.
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Affiliation(s)
- Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, Nigeria
| | - Olamide Ladapo
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Ifeoma Okafor
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Kolawole Okuyemi
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, Nigeria
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Odukoya O, Molobe I, Olufela O, Oluwole E, Yesufu V, Ogunsola F, Okuyemi K. Exploring church members' perceptions towards physical activity, fruits and vegetables consumption, and church's role in health promotion: implications for the development of church-based health interventions. J Public Health Afr 2023; 14:2112. [PMID: 36798843 PMCID: PMC9926555 DOI: 10.4081/jphia.2023.2112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 05/16/2022] [Indexed: 02/05/2023] Open
Abstract
Background The study explored the perceptions of church members towards physical activity (PA), the consumption of fruits and vegetables (FV), and the church's role in health promotion prior to the development of a church-based intervention for physical activity and fruit and vegetable consumption in Lagos, Nigeria. Method Sixteen focus group discussions (FGD) and eleven key Informant Interviews (KII) were conducted. Eight FGDs among adults and four among the youth and the elderly church members. Key informant interviews were held among church leaders and members of the church medical advisory. Study findings were categorized under thematic headings. Based on the data analysis, several key themes were identified: the knowledge of the concept of health and common health problems, opinions of physical activity, opinions of healthy eating and fruit and vegetable consumption, types and attitudes towards existing church-based health programs and the role of the church in health promotion and church-based health programs. Within each theme, several childthemes were noted such as the challenges with fruit and vegetable consumption, biblical support for physical activity and fruit & vegetable consumption, the role of the church leaders, program sustainability and barriers to participation. Results The participants perceived health not only as the absence of disease but as general well-being of the body and soul. Health was also related to the ability to perform religious activities. Common health problems included a mix of communicable and non-communicable diseases. They are aware that physical activity, fruits and vegetables are essential for healthy living. The youth saw it as a means of improving their physical appearance however the elderly expressed concerns about the possibility of associated trips and falls. Overall, they viewed fruits and vegetables as healthy foods while processed western foods were perceived as unhealthy. Fruits and vegetables were seen as beneficial primarily to aid food digestion, boost immunity, improve youthfulness, aid weight control and to prevent chronic disease. The study participants agreed that the church, as an institution, has a significant role to play in promoting the health of her members. Instituted health committees embedded within existing church structures often lead church-based health-promoting activities and are imperative for sustainability. Types of health programs included health talks, screening programs for common NCDs, sport competitions, distributions of FV during church ceremonies such as harvests, Lenten seasons, Love feasts and church bazaars. Health outreaches were seen as a means of evangelism, and it was unanimously agreed that the Bible supports PA and healthy eating. Generally, the respondents had positive attitudes towards church-based health programs and they advised that future programs include the use of technology and should be integrated into existing church activities to improve participation. The participants also noted that the opinion of the church leaders influences the behaviours of church members and their support is critical in the development and implementation of church-based health programs. Conclusion Church members are aware that physical activity and the consumption of fruits and vegetables are important for healthy living and expressed support for church-based health programs. They believe that the Bible supports the promotion of PA and FV consumption as healthy behaviours. Program integration, the use of technology and support of church leaders and existing church medical advisory groups are imperative for developing and sustaining church-based health programs.
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Affiliation(s)
- Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos & Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria,Department of Community Health and Primary Care, College of Medicine, University of Lagos & Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria. 234-8023200770.
| | - Ikenna Molobe
- Department of Community Health and Primary Care, College of Medicine, University of Lagos & Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | - Oridota Olufela
- Department of Community Health and Primary Care, College of Medicine, University of Lagos & Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | - Esther Oluwole
- Department of Community Health and Primary Care, College of Medicine, University of Lagos & Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | - Victoria Yesufu
- Department of Community Health and Primary Care, College of Medicine, University of Lagos & Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | - Folasade Ogunsola
- Department of Microbiology and Parasitology, College of Medicine, University of Lagos, Nigeria
| | - Kolawole Okuyemi
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
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Odukoya O, Nenrot D, Adelabu H, Katam N, Christian E, Holl J, Okonkwo A, Kocherginsky M, Kim KY, Akanmu S, Abdulkareem FB, Anorlu R, Musa J, Lesi O, Hawkins C, Okeke O, Adeyemo WL, Sagay S, Murphy R, Hou L, Ogunsola FT, Wehbe FH. Application of the research electronic data capture (REDCap) system in a low- and middle income country- experiences, lessons, and challenges. Health Technol (Berl) 2022; 11:1297-1304. [PMID: 35251887 PMCID: PMC8896572 DOI: 10.1007/s12553-021-00600-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The challenges of reliably collecting, storing, organizing, and analyzing research data are critical in low- and middle-income countries (LMICs), particularly in Sub-Saharan Africa where several healthcare and biomedical research organizations have limited data infrastructure. The Research Electronic Data Capture (REDCap) System has been widely used by many institutions and hospitals in the USA for data collection, entry, and management and could help solve this problem. This study reports on the experiences, challenges, and lessons learned from establishing and applying REDCap for a large US-Nigeria research partnership that includes two sites in Nigeria, (the College of Medicine of the University of Lagos (CMUL) and Jos University Teaching Hospital (JUTH)) and Northwestern University (NU) in Chicago, Illinois in the United States. The largest challenges to this implementation were significant technical obstacles: the lack of REDCap-trained personnel, transient electrical power supply, and slow/intermittent internet connectivity. However, asynchronous communication and on-site hands-on collaboration between the Nigerian sites and NU led to the successful installation and configuration of REDCap to meet the needs of the Nigerian sites. An example of one lesson learned is the use of Virtual Private Network (VPN) as a solution to poor internet connectivity at one of the sites, and its adoption is underway at the other. Virtual Private Servers (VPS) or shared online hosting were also evaluated and offer alternative solutions. Installing and using REDCap in LMIC institutions for research data management is feasible; however, planning for trained personnel and addressing electrical and internet infrastructural requirements are essential to optimize its use. Building this fundamental research capacity within LMICs across Africa could substantially enhance the potential for more cross-institutional and cross-country collaboration in future research endeavors.
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Affiliation(s)
- O Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos State, Nigeria
| | - D Nenrot
- College of Health Sciences, University of Jos, Plateau state, Nigeria
| | - H Adelabu
- AIDS Prevention Initiative of Nigeria, Lagos University Teaching Hospital, Lagos State, Nigeria
| | - N Katam
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA
| | - E Christian
- Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - J Holl
- Department of Neurology and Center for Healthcare Delivery Science and Innovation, Biological Sciences Division, University of Chicago, Chicago, IL, USA
| | - A Okonkwo
- Research Management Office, College of Medicine, University of Lagos, Lagos, Nigeria
| | - M Kocherginsky
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA.,Department of Preventive Medicine, Division of Biostatistics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - K-Y Kim
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA.,Department of Preventive Medicine, Division of Biostatistics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - S Akanmu
- AIDS Prevention Initiative of Nigeria, Lagos University Teaching Hospital, Lagos State, Nigeria
| | - F B Abdulkareem
- Department of Anatomic & Molecular Pathology, College of Medicine, University of Lagos, Lagos State, Nigeria
| | - R Anorlu
- Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, Lagos State, Nigeria
| | - J Musa
- College of Health Sciences, University of Jos, Plateau state, Nigeria.,Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA.,Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - O Lesi
- Department of Medicine, College of Medicine, University of Lagos, Lagos State, Nigeria
| | - C Hawkins
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA.,Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - O Okeke
- College of Health Sciences, University of Jos, Plateau state, Nigeria
| | - W L Adeyemo
- Department of Maxillofacial Surgery, College of Medicine, University of Lagos, Lagos State, Nigeria
| | - S Sagay
- College of Health Sciences, University of Jos, Plateau state, Nigeria
| | - R Murphy
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA.,Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - L Hou
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA.,Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - F T Ogunsola
- Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Lagos State, Nigeria
| | - F H Wehbe
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA
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Odukoya O, Nwaneri S, Odeniyi I, Akodu B, Oluwole E, Olorunfemi G, Popoola O, Osuntoki A. Development and Comparison of Three Data Models for Predicting Diabetes Mellitus Using Risk Factors in a Nigerian Population. Healthc Inform Res 2022; 28:58-67. [PMID: 35172091 PMCID: PMC8850175 DOI: 10.4258/hir.2022.28.1.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 08/11/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives This study developed and compared the performance of three widely used predictive models—logistic regression (LR), artificial neural network (ANN), and decision tree (DT)—to predict diabetes mellitus using the socio-demographic, lifestyle, and physical attributes of a population of Nigerians. Methods We developed three predictive models using 10 input variables. Data preprocessing steps included the removal of missing values and outliers, min-max normalization, and feature extraction using principal component analysis. Data training and validation were accomplished using 10-fold cross-validation. Accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUROC) were used as performance evaluation metrics. Analysis and model development were performed in R version 3.6.1. Results The mean age of the participants was 50.52 ± 16.14 years. The classification accuracy, sensitivity, specificity, PPV, and NPV for LR were, respectively, 81.31%, 84.32%, 77.24%, 72.75%, and 82.49%. Those for ANN were 98.64%, 98.37%, 99.00%, 98.61%, and 98.83%, and those for DT were 99.05%, 99.76%, 98.08%, 98.77%, and 99.82%, respectively. The best-performing and poorest-performing classifiers were DT and LR, with 99.05% and 81.31% accuracy, respectively. Similarly, the DT algorithm achieved the best AUC value (0.992) compared to ANN (0.976) and LR (0.892). Conclusions Our study demonstrated that DT, LR, and ANN models can be used effectively for the prediction of diabetes mellitus in the Nigerian population based on certain risk factors. An overall comparative analysis of the models showed that the DT model performed better than LR and ANN.
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Affiliation(s)
- Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos State, Nigeria
| | - Solomon Nwaneri
- Department of Biomedical Engineering, College of Medicine, University of Lagos, Lagos State, Nigeria
- Department of Biomedical Engineering, Faculty of Engineering, University of Lagos, Lagos State, Nigeria
| | - Ifedayo Odeniyi
- Endocrinology Unit, Department of Internal Medicine, College of Medicine, University of Lagos, Lagos State, Nigeria
| | - Babatunde Akodu
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos State, Nigeria
| | - Esther Oluwole
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos State, Nigeria
| | - Gbenga Olorunfemi
- Division of Epidemiology and Biostatistics, School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Oluwatoyin Popoola
- Department of Biomedical Engineering, College of Medicine, University of Lagos, Lagos State, Nigeria
- Department of Biomedical Engineering, Faculty of Engineering, University of Lagos, Lagos State, Nigeria
| | - Akinniyi Osuntoki
- Department of Biochemistry, College of Medicine, University of Lagos, Lagos State, Nigeria
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9
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Odukoya O, Fox RS, Hayman LL, Penedo FJ. The International Society for Behavioral Medicine (ISBM) and the Society of Behavioral Medicine (SBM) advocate for the inclusion of behavioral scientists in the implementation of the Global Action Plan for the prevention of non-communicable diseases (NCDs) in low- and middle-income countries. Transl Behav Med 2021; 11:1286-1288. [PMID: 33410489 DOI: 10.1093/tbm/ibaa128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Non-communicable diseases (NCDs) are the leading cause of death and disability in the world with the majority of deaths occurring in low- and middle-income countries (LMICs). The financial implications of disease and disability due to NCDs, combined with the costs of long-term management, are major causes of impoverishment and serve as barriers to socio-economic development. The transition from infectious diseases to NCDs as leading causes of mortality in LMICs is driven by several factors, primarily increasing globalization, urbanization, ageing of populations and economic development. Responding to these challenges will require local and comprehensive primary and secondary prevention efforts. The World Health Organization's Global Action Plan provides a road map and an array of policy options to achieve nine voluntary global targets by 2025. The primary responsibility of governments in responding to the challenge of NCDs includes international scientific cooperation to support national and local efforts. The implementation of such efforts to prioritize the prevention of NCDs will create an environment in which the rising trend of the NCD burden could be potentially halted and reversed. When developing NCD policies, stakeholders should consider evidence-based strategies which can be implemented by multidisciplinary teams that are led or have the participation of behavioral medicine scientists. Behavioral medicine strategies should be incorporated into the policy and intervention framework developed to target NCDs in LMICs.
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Affiliation(s)
- Oluwakemi Odukoya
- Department of Community Health and Primary Care, University of Lagos, Nigeria
| | - Rina S Fox
- Department of Medical Social Sciences, Northwestern, Chicago, IL
| | - Laura L Hayman
- Department of Nursing, University of Massachusetts Boston, Boston, MA
| | - Frank J Penedo
- Departments of Psychology and Medicine, University of Miami, Coral Gables, FL
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10
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Abayomi A, Balogun MR, Bankole M, Banke-Thomas A, Mutiu B, Olawepo J, Senjobi M, Odukoya O, Aladetuyi L, Ejekam C, Folarin A, Emmanuel M, Amodu F, Ologun A, Olusanya A, Bakare M, Alabi A, Abdus-Salam I, Erinosho E, Bowale A, Omilabu S, Saka B, Osibogun A, Wright O, Idris J, Ogunsola F. From Ebola to COVID-19: emergency preparedness and response plans and actions in Lagos, Nigeria. Global Health 2021; 17:79. [PMID: 34243790 PMCID: PMC8267235 DOI: 10.1186/s12992-021-00728-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 06/28/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Lagos state is the industrial nerve centre of Nigeria and was the epicentre of the 2014 Ebola outbreak in Nigeria as it is now for the current Coronavirus Disease (COVID-19) outbreak. This paper describes how the lessons learned from the Ebola outbreak in 2014 informed the emergency preparedness of the State ahead of the COVID-19 outbreak and guided response. DISCUSSION Following the Ebola outbreak in 2014, the Lagos State government provided governance by developing a policy on emergency preparedness and biosecurity and provided oversight and coordination of emergency preparedness strategies. Capacities for emergency response were strengthened by training key staff, developing a robust surveillance system, and setting up a Biosafety Level 3 laboratory and biobank. Resource provision, in terms of finances and trained personnel for emergencies was prioritized by the government. With the onset of COVID-19, Lagos state was able to respond promptly to the outbreak using the centralized Incident Command Structure and the key activities of the Emergency Operations Centre. Contributory to effective response were partnerships with the private sectors, community engagement and political commitment. CONCLUSION Using the lessons learned from the 2014 Ebola outbreak, Lagos State had gradually prepared its healthcare system for a pandemic such as COVID-19. The State needs to continue to expand its preparedness to be more resilient and future proof to respond to disease outbreaks. Looking beyond intra-state gains, lessons and identified best practices from the past and present should be shared with other states and countries.
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Affiliation(s)
- Akin Abayomi
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
- Lagos State Biosafety and Biosecurity Governing Council, Lagos, Nigeria
| | | | - Munir Bankole
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | | | - Bamidele Mutiu
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - John Olawepo
- School of Public Health, University of Nevada, Las Vegas, USA
| | - Morakinyo Senjobi
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | | | - Lanre Aladetuyi
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | | | - Akinsanya Folarin
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Madonna Emmanuel
- College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Funke Amodu
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Adesoji Ologun
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Abosede Olusanya
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Moses Bakare
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Abiodun Alabi
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Ismail Abdus-Salam
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
- Lagos State Biosafety and Biosecurity Governing Council, Lagos, Nigeria
| | - Eniola Erinosho
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Abimbola Bowale
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Sunday Omilabu
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
- College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Babatunde Saka
- Lagos State Biosafety and Biosecurity Governing Council, Lagos, Nigeria
- Global Emerging Pathogens Treatment Consortium, Lagos, Nigeria
| | - Akin Osibogun
- Lagos State Biosafety and Biosecurity Governing Council, Lagos, Nigeria
- College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Ololade Wright
- Lagos State Biosafety and Biosecurity Governing Council, Lagos, Nigeria
| | - Jide Idris
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
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11
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Zheng Y, Hawkins C, Okeke E, Duguru M, Odeghe E, Lesi O, Qu Y, Kim K, Joyce B, Wang J, Roberts L, Gursel D, Fatimah A, Akanmu A, Imade G, Wei JJ, Kocherginsky M, Kim KY, Odukoya O, Adeyemo W, Wehbe F, Achenbach C, Sagay A, Ogunsola F, Murphy R, Hou L. Abstract 83: Blood-Based Circulating Cell-Free DNA Epigenetic Age Is Accelerated Among HIV-Infected Patients with Hepatocellular Carcinoma in Nigeria. Cancer Epidemiol Biomarkers Prev 2021. [DOI: 10.1158/1538-7755.asgcr21-83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Purpose: Hepatocellular Carcinoma (HCC) is the leading cause of cancer-related mortality in Nigeria. HIV and viral hepatitis B (HBV) and C (HCV) co-infection are common in Nigeria that significantly accelerates liver disease progression including HCC. Aging-related DNA methylation signatures obtained in liquid biopsy, such as circulating cell-free DNA (ccfDNA) extracted from serum/plasma are promising minimally-invasive biomarkers that may inform HIV-associated HCC. We examined the epigenetic age acceleration (EpiAgeAccel) in ccfDNA in HCC patients with HIV.
Methods: The study included three groups of participants: a) HIV positive with HCC (n=7); b) HIV positive and cancer-free (n=45); and c) HIV negative with HCC (n=33). Epigenetic age was estimated by Horvath's calculator using genome-wide ccfDNA methylation data profiled by Illumina EPIC array. EpiAgeAccel was computed as the residuals of a linear model of epigenetic age on chronological age, namely the unexplained portion of epigenetic age by chronological age. We used multiple linear regression to compare EpiAgeAccel between HIV/HCC groups, adjusting for sex, age, education, alcohol intake, and HBV/HCV infection.
Results: Among HIV positive participants, there was a higher percentage of men (57% vs. 22%, p<0.001), HBV infection (29% vs. 11%, p=0.004), and HCV infection (57% vs. 2%, p<0.001) in the HCC group compared to the cancer-free group. EpiAgeAccel was 4.8 years higher in HIV positive patients with HCC compared to cancer-free HIV positives (p=0.02). Among HCC patients, EpiAgeAccel was 2.1 years higher in HIV positives compared to HIV negative but not statistically significant.
Conclusion: Epigenetic age in ccfDNA is accelerated in HIV-positive HCC patients. EpiAgeAccel measured in ccfDNA may be developed into a surrogate biomarker for minimally invasive HCC detection among HIV-infected patients in low- and middle-income countries.
Citation Format: Yinan Zheng, Claudia Hawkins, Edith Okeke, Mary Duguru, Emuobor Odeghe, Olufunmilayo Lesi, Yishu Qu, Kyeezu Kim, Brian Joyce, Jun Wang, Lewis Roberts, Demirkan Gursel, Abdulkareem Fatimah, Alani Akanmu, Godwin Imade, Jian-Jun Wei, Masha Kocherginsky, Kwang-Youn Kim, Oluwakemi Odukoya, Wasiu Adeyemo, Firas Wehbe, Chad Achenbach, Atiene Sagay, Folasade Ogunsola, Robert Murphy, Lifang Hou. Blood-Based Circulating Cell-Free DNA Epigenetic Age Is Accelerated Among HIV-Infected Patients with Hepatocellular Carcinoma in Nigeria [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 83.
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12
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Osibogun A, Balogun M, Abayomi A, Idris J, Kuyinu Y, Odukoya O, Wright O, Adeseun R, Mutiu B, Saka B, Osa N, Lajide D, Abdus-Salam I, Osikomaiya B, Onasanya O, Adebayo B, Oshodi Y, Adesola S, Adejumo O, Erinoso O, Abdur-Razzaq H, Bowale A, Akinroye K. Outcomes of COVID-19 patients with comorbidities in southwest Nigeria. PLoS One 2021; 16:e0248281. [PMID: 33720975 PMCID: PMC7959379 DOI: 10.1371/journal.pone.0248281] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 02/23/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Data on the comorbidities that result in negative outcomes for people with COVID-19 are currently scarce for African populations. This study identifies comorbidities that predict death among a large sample of COVID-19 patients from Nigeria. METHODS This was a retrospective analysis of medical records for 2184 laboratory confirmed cases of COVID-19 in Lagos, southwest Nigeria. Extracted data included age, sex, severity of condition at presentation and self-reported comorbidities. The outcomes of interest were death or discharge from facility. RESULTS Most of the cases were male (65.8%) and the median age was 43 years (IQR: 33-55). Four hundred and ninety-two patients (22.5%) had at least one comorbidity and the most common amongst them were hypertension (74.2%) and diabetes (30.3%). The mortality rate was 3.3% and a significantly higher proportion of patients with comorbidities died compared to those with none. The comorbidities that predicted death were hypertension (OR: 2.21, 95%CI: 1.22-4.01), diabetes (OR: 3.69, 95% CI: 1.99-6.85), renal disease (OR: 12.53, 95%CI: 1.97-79.56), cancer (OR: 14.12, 95% CI: 2.03-98.19) and HIV (OR: 1.77-84.15]. CONCLUSION Comorbidities are prevalent and the associated risk of death is high among COVID-19 patients in Lagos, Nigeria. Public enlightenment, early identification and targeted care for COVID-19 cases with comorbidities are recommended as the pandemic evolves.
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Affiliation(s)
- Akin Osibogun
- Lagos State COVID-19 Incident Command System/Emergency Operation Centre, Lagos, Nigeria
- Department of Community Health and Primary Care, College of Medicine University of Lagos, Lagos, Nigeria
| | - Mobolanle Balogun
- Department of Community Health and Primary Care, College of Medicine University of Lagos, Lagos, Nigeria
| | - Akin Abayomi
- Lagos State COVID-19 Incident Command System/Emergency Operation Centre, Lagos, Nigeria
- Lagos State Ministry of Health, Lagos, Nigeria
| | - Jide Idris
- Lagos State COVID-19 Incident Command System/Emergency Operation Centre, Lagos, Nigeria
| | - Yetunde Kuyinu
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine, Lagos, Nigeria
| | - Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine University of Lagos, Lagos, Nigeria
| | - Ololade Wright
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine, Lagos, Nigeria
| | - Remi Adeseun
- Lagos State COVID-19 Incident Command System/Emergency Operation Centre, Lagos, Nigeria
| | - Bamidele Mutiu
- Lagos State Biosafety and Biosecurity Governing Council, Lagos, Nigeria
| | - Babatunde Saka
- Lagos State Biosafety and Biosecurity Governing Council, Lagos, Nigeria
| | - Nike Osa
- Lagos State COVID-19 Incident Command System/Emergency Operation Centre, Lagos, Nigeria
| | - Dayo Lajide
- Lagos State COVID-19 Incident Command System/Emergency Operation Centre, Lagos, Nigeria
| | - Ismael Abdus-Salam
- Lagos State COVID-19 Incident Command System/Emergency Operation Centre, Lagos, Nigeria
| | - Bodunrin Osikomaiya
- Lagos State Blood Transfusion Service, Lagos State Ministry of Health, Lagos, Nigeria
| | | | - Bisola Adebayo
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine, Lagos, Nigeria
| | - Yewande Oshodi
- Department of Psychiatry, College of Medicine University of Lagos, Lagos, Nigeria
| | | | | | - Olufemi Erinoso
- Department of Oral and Maxillofacial Surgery, Lagos State University Teaching Hospital, Ikeja, Nigeria
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13
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Castaldelli-Maia JM, Harutyunyan A, Herbec A, Kessel T, Odukoya O, Kemper KE, Hays J, Vardavas C. Tobacco dependence treatment for special populations: challenges and opportunities. Braz J Psychiatry 2021; 43:75-82. [PMID: 32491035 PMCID: PMC7861180 DOI: 10.1590/1516-4446-2019-0782] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 01/31/2020] [Indexed: 12/19/2022]
Abstract
Although smoking rates have declined in most of the countries in the world, there are population groups within these countries whose smoking rates remain significantly higher than the general population. These "forgotten groups" who have not been receiving the needed attention in tobacco control policies and tobacco cessation efforts include people with serious mental illness, substance use disorders, tuberculosis, people living with human immunodeficiency virus (HIV), lesbian-gay-bisexual-transgender-queer people, and pregnant women. A number of steps are needed at the national level in countries where these disparities exist, including modifications to national smoking cessation treatment guidelines that address the special needs of these populations, as well as targeted smoking cessation research, since these populations are often not included in clinical trials. Because of the higher smoking prevalence in these populations, as well as their lower smoking cessation treatment success rates than the general population, more resources are needed if we are to reduce health disparities in these vulnerable populations. Additionally, we believe that more effort should be focused on integrating smoking cessation treatment in the specialized care settings frequented by these subpopulations.
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Affiliation(s)
- João M. Castaldelli-Maia
- Clínica Clima, São Paulo, SP, Brazil
- Departamento de Neurociência, Centro Universitário Saúde ABC, Faculdade de Medicina do ABC, Santo André, SP, Brazil
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
- Global Bridges Healthcare Alliance for Tobacco Dependence Treatment, Mayo Clinic, Rochester, MN, USA
| | - Arusyak Harutyunyan
- Global Bridges Healthcare Alliance for Tobacco Dependence Treatment, Mayo Clinic, Rochester, MN, USA
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - Aleksandra Herbec
- Global Bridges Healthcare Alliance for Tobacco Dependence Treatment, Mayo Clinic, Rochester, MN, USA
- Research Department of Clinical Education and Health Psychology, University College London, London, UK
- Health Promotion Foundation, Warsaw, Poland
| | - Tzvia Kessel
- Global Bridges Healthcare Alliance for Tobacco Dependence Treatment, Mayo Clinic, Rochester, MN, USA
- Meuhedet, Tel Aviv, Israel
| | - Oluwakemi Odukoya
- Global Bridges Healthcare Alliance for Tobacco Dependence Treatment, Mayo Clinic, Rochester, MN, USA
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idi-Araba, Lagos State, Nigeria
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Katherine E. Kemper
- Global Bridges Healthcare Alliance for Tobacco Dependence Treatment, Mayo Clinic, Rochester, MN, USA
| | - J.T. Hays
- Global Bridges Healthcare Alliance for Tobacco Dependence Treatment, Mayo Clinic, Rochester, MN, USA
| | - Constantine Vardavas
- Global Bridges Healthcare Alliance for Tobacco Dependence Treatment, Mayo Clinic, Rochester, MN, USA
- European Network for Smoking Prevention, Brussels, Belgium
- Institute of Public Health, The American College of Greece, Paraskevi, Grecce
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14
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Erim DO, Oke GA, Adisa AO, Odukoya O, Ayo-Yusuf OA, Erim TN, Tsafa TN, Meremikwu MM, Agaku IT. Associations of Government-Mandated Closures and Restrictions With Aggregate Mobility Trends and SARS-CoV-2 Infections in Nigeria. JAMA Netw Open 2021; 4:e2032101. [PMID: 33471117 PMCID: PMC7818105 DOI: 10.1001/jamanetworkopen.2020.32101] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/10/2020] [Indexed: 12/12/2022] Open
Abstract
Importance To prepare for future coronavirus disease 2019 (COVID-19) waves, Nigerian policy makers need insights into community spread of COVID-19 and changes in rates of infection associated with government-mandated closures and restrictions. Objectives To measure the association of closures and restrictions with aggregate mobility and the association of mobility with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and to characterize community spread of COVID-19. Design, Setting, and Participants This cross-sectional study used aggregated anonymized mobility data from smartphone users in Nigeria who opted to provide location history (from a pool of up to 40 million individuals) collected between February 27 and July 21, 2020. The analyzed data included daily counts of confirmed SARS-CoV-2 infections and daily changes in aggregate mobility across 6 categories: retail and recreation, grocery and pharmacy, parks, transit stations, workplaces, and residential. Closures and restrictions were initiated on March 30, 2020, and partially eased on May 4, 2020. Main Outcomes and Measures Interrupted time series were used to measure associations of closures and restrictions with aggregate mobility. Negative binomial regression was used to evaluate associations between confirmed SARS-CoV-2 infections and mobility categories. Averted infections were estimated by subtracting cumulative confirmed infections from estimated infections assuming no closures and restrictions. Results Closures and restrictions had negative associations with mean change in daily aggregate mobility in retail and recreation (-46.87 [95% CI, -55.98 to -37.76] percentage points; P < .001), grocery and pharmacy (-28.95 [95% CI, -40.12 to -17.77] percentage points; P < .001), parks (-43.59 [95% CI, -49.89 to -37.30] percentage points; P < .001), transit stations (-47.44 [95% CI, -56.70 to -38.19] percentage points; P < .001), and workplaces (-53.07 [95% CI, -67.75 to -38.39] percentage points; P < .001) and a positive association with mobility in residential areas (24.10 [95% CI, 19.14 to 29.05] percentage points; P < .001). Most of these changes reversed after closures and restrictions were partially eased (retail and recreation: 14.63 [95% CI, 10.95 to 18.30] percentage points; P < .001; grocery and pharmacy: 15.29 [95% CI, 10.90 to 19.67] percentage points; P < .001; parks: 6.48 [95% CI, 3.98 to 8.99] percentage points; P < .001; transit stations: 17.93 [95% CI, 14.03 to 21.83] percentage points; P < .001; residential: -5.59 [95% CI, -9.08 to -2.09] percentage points; P = .002). Additionally, every percentage point increase in aggregate mobility was associated with higher incidences of SARS-CoV-2 infection in residential areas (incidence rate ratio [IRR], 1.03 [95% CI, 1.00 to 1.07]; P = .04), transit stations (IRR, 1.02 [95% CI, 1.00 to 1.03]; P = .008), and workplaces (IRR, 1.01 [95% CI, 1.00 to 1.02]; P = .04). Lastly, closures and restrictions may have been associated with averting up to 5.8 million SARS-CoV-2 infections over the study period. Conclusions and Relevance In this cross-sectional study, closures and restrictions had significant associations with aggregate mobility and were associated with decreased SARS-CoV-2 infections. These findings suggest that future anticontagion measures need better infection control and contact tracing in residential areas, transit stations, and workplaces.
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Affiliation(s)
| | - Gbemisola A. Oke
- Department of Periodontology and Community Dentistry, University of Ibadan, Nigeria
| | | | - Oluwakemi Odukoya
- Department of Community Health and Primary Care, University of Lagos, Nigeria
| | | | | | | | - Martin M. Meremikwu
- Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Israel T. Agaku
- Department of Oral Epidemiology, Harvard Dental School, Boston, Massachusetts
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Abayomi A, Odukoya O, Osibogun A, Wright O, Adebayo B, Balogun M, Abdus-Salam I, Bowale A, Mutiu B, Saka B, Adejumo M, Yenyi S, Agbolagorite R, Onasanya O, Erinosho E, Obasanya J, Adejumo O, Adesola S, Oshodi Y, Akase IE, Ogunbiyi S, Lajide D, Erinoso F, Abdur-Razzaq H. Presenting Symptoms and Predictors of Poor Outcomes Among 2,184 Patients with COVID-19 in Lagos State, Nigeria. Int J Infect Dis 2021; 102:226-232. [PMID: 33075534 PMCID: PMC7566672 DOI: 10.1016/j.ijid.2020.10.024] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/06/2020] [Accepted: 10/08/2020] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Lagos state remains the epicentre of COVID-19 in Nigeria. We describe the symptoms and signs of the first 2,184 PCR-confirmed COVID-19 patients admitted at COVID-19 treatment centers in Lagos State. We also assessed the relationship between patients' presenting symptoms, sociodemographic and clinical characteristics and COVID-19 deaths.. METHODS Medical records of PCR-confirmed COVID-19 patients were extracted and analyzed for their symptoms, symptom severity, presence of comorbidities and outcome. RESULTS The ages of the patients ranged from 4 days to 98 years with a mean of 43.0(16.0) years. Of the patients who presented with symptoms, cough (19.3%) was the most common presenting symptom. This was followed by fever (13.7%) and difficulty in breathing, (10.9%). The most significant clinical predictor of death was the severity of symptoms and signs at presentation. Difficulty in breathing was the most significant symptom predictor of COVID-19 death (OR:19.26 95% CI 10.95-33.88). The case fatality rate was 4.3%. CONCLUSION Primary care physicians and COVID-19 frontline workers should maintain a high index of suspicion and prioritize the care of patients presenting with these symptoms. Community members should be educated on such predictors and ensure that patients with these symptoms seek care early to reduce the risk of deaths associated with COVID-19.
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Affiliation(s)
| | | | - Akin Osibogun
- College of Medicine University of Lagos; Lagos State Primary Health Care Board; Lagos University Teaching Hospital.
| | | | | | | | | | | | | | | | | | - Sam Yenyi
- World Health Organization, Nigeria Office
| | | | | | | | | | | | | | - Yewande Oshodi
- College of Medicine University of Lagos; Lagos University Teaching Hospital
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Odukoya O, Badejo O, Sodeinde K, Olubodun T. Behavioral risk factors for hypertension among adults living with HIV accessing care in secondary health facilities in Lagos State, Nigeria. J Family Med Prim Care 2020; 9:3450-3457. [PMID: 33102312 PMCID: PMC7567202 DOI: 10.4103/jfmpc.jfmpc_544_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 04/26/2020] [Accepted: 05/11/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Excess risk for cardiovascular disease, especially hypertension, may exist among human immunodeficiency virus infection (HIV)-positive persons. This study was carried out to assess the prevalence of the behavioral risk factors for hypertension, including their awareness of these factors and their attitudes toward them. Methods: This descriptive cross-sectional study was conducted among 400 HIV-infected adults who accessed care in nine secondary health facilities in Lagos State, Nigeria. Respondents were selected by multistage sampling and data elicited using a structured, interviewer-administered questionnaire. Blood pressure (BP) was measured thrice and a respondent was considered as having raised BP if the mean of the last two measurements is ≥140 mm Hg (systolic BP) or ≥90 mm Hg (diastolic BP) or if respondents are currently taking anti-hypertensive. Results: Prevalence of key behavioral risk factors for hypertension was high. For instance, 82.0% of the respondents were physically inactive. Stress and physical inactivity were the two most known risks of hypertension, identified by 87.3% and 70.5% of the respondents, respectively. Majority (66.0%) had positive attitudes toward hypertension risk factors and 26.7% of them had raised BP. Lower age, that is, 30 years and below (OR = 2.89, 95% CI = 1.26–6.64), BMI of less than 25 (OR = 1.87, 95 CI = 1.16–3.01), and being diagnosed of HIV for 5 years and less (OR = 1.62, 95% CI = 1.006–2.62) were significantly associated with normal BP measurements among respondents. Conclusion: The proportion of people living with HIV/AIDS who show known behaviors that place them at risk for hypertension is high. Measures to address these risk factors among them are warranted.
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Affiliation(s)
- Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idi-Araba, Lagos State, Nigeria.,Department of Community Health and Primary Care, Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | | | - Kolawole Sodeinde
- Department of Community Medicine and Primary Care, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
| | - Tope Olubodun
- Department of Community Health and Primary Care, Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
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Odukoya O, Fayemi M. A Rural-Urban Comparison of Knowledge, Risk- Factors and
Preventive Practices for Colorectal Cancer among Adults in
Lagos State. Asian Pac J Cancer Prev 2019; 20:1063-1071. [PMID: 31030475 PMCID: PMC6948893 DOI: 10.31557/apjcp.2019.20.4.1063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective: To assess and compare the knowledge, risk-factors and preventive practices for colorectal cancer among adults in Lagos State. Material and methods: This was a cross-sectional comparative study conducted among 607 respondents selected from one rural (Ikorodu) and one urban (Surulere) LGA using a multistage sampling technique. Data were collected using a pre-tested questionnaire administered by trained research assistants between April and September 2017.Data was analyzed using Epi-info statistical software version 3.5.1. Univariate and bivariate analysis was carried out and -p values of ≤0.05 were considered statistically significant. Results: Respondents’ knowledge of colorectal cancer was generally low, (rural-78.2%, urban- 62.2%, p<0.001). Urban respondents were significantly more knowledgeable than their rural counterparts (rural- 21.8%, urban- 37.8%, p<0.001). The presence of CRC risk-factors were higher among urban respondents (urban-49.3%, rural-42.6%, p= 0.09), however this difference was not statistically significant. Preventive practices were generally poor in both groups, although more (18.1%) urban respondents significantly took preventive actions against CRC compared with rural (6.9%) respondents, (p<0.001).Increasing levels of education were significantly associated with higher knowledge level in both groups (p≤0.05). Conclusion: The level of knowledge of colorectal cancer was generally poor in both groups but significantly poorer among rural respondents. The presence of known risk- factor was higher among urban respondents while preventive practices were poor in both groups.
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Affiliation(s)
- Oluwakemi Odukoya
- Department of Community Health and Primary Care,College of Medicine,University of Lagos, Idi-Araba, Lagos State, Nigeria.
| | - Modupeola Fayemi
- Department of Community Health and Primary Care,College of Medicine,University of Lagos, Idi-Araba, Lagos State, Nigeria.
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Odukoya O, Faseru B, Uguru N, Jamda M, Onigbogi O, James O, Leischow S, Ayo-Yusuf O. Text messaging promoting physician-led brief intervention tobacco cessation: A before-and-after study among physicians in three tertiary hospitals in Nigeria. Subst Abus 2018; 41:186-190. [PMID: 30373478 DOI: 10.1080/08897077.2018.1526844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background: Physician-led smoking cessation services are suboptimal in Nigeria. Objectives: This study evaluated a text messaging intervention designed to increase the knowledge and practices of physicians in Nigeria to help smokers quit. Methods: Using a pre-post study design, all physicians (N = 946) in 3 tertiary care hospitals located in 3 geopolitical zones in Nigeria were sent 2-3 text messages weekly over a 13-week period to create awareness and improve cessation practices using the "Ask, Advise and Refer" (AAR) model. The primary outcomes were the awareness of AAR and the proportion of physicians who offered each of the components of the brief intervention (AAR) to at least half of eligible patients. Secondary outcomes included the attitudes and self-reported effects of the messages on motivation to offer AAR to patients who smoke. Results: Of the 946 eligible respondents, only 165 responded to both the before and after intervention surveys (17.4% participation rate). Participants were more likely to indicate awareness of the AAR approach after the intervention (60%) than before (21.2%). Overall, physicians' practice of each component of the AAR changed significantly after the intervention (P < .001; McNemar test). Of the participants, 71.5% reported reading the messages most/all of the time and 84.8% reported that the frequency of the messages was just adequate. Conclusions: A brief and low-cost text messaging intervention to physicians increased the awareness and practice of AAR in those who participated in the study. However, the relatively low participation rate highlights the importance of new research to improve and expand text messaging as an intervention among physicians to help them foster tobacco treatment among their patients.
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Affiliation(s)
- Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idi-Araba, Lagos State, Nigeria
| | - Babalola Faseru
- Department of Preventive Medicine and Public Health, and Department of Family Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Nkolika Uguru
- Department of Preventive Dentistry, College of Medicine, University of Nigeria, Enugu Campus, Nigeria
| | - Mustapha Jamda
- Department of Community Medicine, University of Abuja Teaching Hospital, Gwagwalada, Federal Capital Territory, Nigeria
| | - Olanrewaju Onigbogi
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idi-Araba, Lagos State, Nigeria
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Ofonakara U, Ilo M, Odukoya O, Ikpe C. P2.10-12 Prevalence, Pattern and Factors Associated with Dual Tobacco Use in a Rural Community in South Eastern Nigeria. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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20
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Odukoya O, Jamda M, Onigbogi O, Uguru N, Onigbogi M, James F, Faseru B, Leischow S, Ayo-Yusuf O. Tobacco Cessation Interventions in Tertiary Hospitals in Nigeria: An Audit of Patient Records. Nicotine Tob Res 2018; 19:983-989. [PMID: 28180901 DOI: 10.1093/ntr/ntw397] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 12/28/2016] [Indexed: 11/14/2022]
Abstract
Background Patient medical records are an objective tool for the systematic identification and treatment of tobacco users. The aim of this study was to assess brief intervention tobacco cessation activities documented by physicians in some select tertiary hospitals in Nigeria. Methods We conducted a cross-sectional descriptive study using information obtained from 1588 randomly selected patient records in six teaching hospitals participating in a study to capacitate physicians to deliver brief advice. Trained data collectors collected data using a uniform checklist prior to the training of the physicians in these hospitals. Results Of the audited health records, 33.1% of patients had documentation of physicians' inquiry of their tobacco use mostly during out-patient clinics (37%) and by a resident doctor/medical officer (42.9%). Among identified tobacco users, it was documented that 12.9% were offered some form of tobacco cessation advice; readiness to quit was recorded in 2.6%; assistance with quitting was documented for 1.5% of tobacco users, while only 0.8% showed documentation of patient follow-up. Males and patients admitted to the hospital were 1.86 times and 2.14 times respectively more likely to have records of physicians' inquiry of their tobacco use. Patients who had tobacco-related morbidities and the unemployed were also more likely to have records of inquiry of their tobacco use. Conclusions There was poor documentation of tobacco use by physicians in these hospitals and many opportunities for brief intervention activities were missed. Efforts to educate the physicians on the importance of documenting tobacco use in clinical notes are recommended. Implications This study provides empirical evidence showing that there is poor documentation of tobacco use inquiry and brief intervention among physicians in tertiary hospitals in Nigeria. Records showing implementation of the 5A's were abysmally low and opportunities for brief intervention may have been missed. In line with the World Health Organization recommendations of Article 14 of the Framework Convention on Tobacco Control, efforts to promote brief intervention among physicians in tertiary hospitals in Nigeria should include an emphasis on appropriate documentation of tobacco control interventions in patient clinical notes.
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Affiliation(s)
- Oluwakemi Odukoya
- Department of Community health and Primary Care, College of Medicine, University of Lagos, Idi-Araba,Nigeria
| | - Mustapha Jamda
- Department of Community Medicine, University of Abuja Teaching Hospital, Gwagwalada,Nigeria
| | - Olanrewaju Onigbogi
- Department of Community health and Primary Care, College of Medicine, University of Lagos, Idi-Araba,Nigeria
| | - Nkolika Uguru
- Department of Preventive Dentistry, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Modupe Onigbogi
- Department of Community Medicine, Lagos University Teaching Hospital, Idi-Araba,Nigeria
| | | | - Babalola Faseru
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS.,Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS
| | | | - Olalekan Ayo-Yusuf
- Office of the Executive Dean, Sefako Makgatho Health Sciences University, Limpopo, South Africa
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Odukoya O, Olaleye M, Kotey T. Smoking cessation practices among ethnic minorities. A case for ethnically-tailored smoking cessation services in Lagos State, Nigeria. Tob Induc Dis 2018. [DOI: 10.18332/tid/84275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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22
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Ezenwa B, Oseni O, Akintan P, Aligwekwe P, Chukwukelu B, Fashola O, Ogunmokun A, Odukoya O. Higher order multiple births in Nigeria: Experiences, challenges and neonatal outcomes in a private health facility. Niger J Clin Pract 2018; 20:1439-1443. [PMID: 29303129 DOI: 10.4103/njcp.njcp_71_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The aim of this study is to describe the experience and outcome of higher order multiple (HOM) births in a private tertiary health facility in Nigeria. MATERIALS AND METHODS This was a retrospective review of records of HOM over 3 years in a private tertiary health facility in Nigeria. Relevant data on HOM births were extracted from both the patients' case notes, admission registers and maternity ward and delivery records of the hospital using a predesigned pro forma. Data were analyzed using Statistical Package for Social Sciences Version 22.0. RESULTS The prevalence of HOM births was 0.72% of 1950 births over the 3 years study period; while for triplets, quadruplets, and quintuplets were 0.56%, 0.1% and 0.05%, respectively. The mean gestational age was 32 ± 3 weeks, and all except three sets of triplets were by Assisted Reproductive Technology (ART). Respiratory distress syndrome, neonatal jaundice, and neonatal sepsis accounted for more than 80% of the neonatal complications noted in HOM births. However, there was no significant difference between neonatal survival of HOM as compared to twin deliveries, P = 0.08. CONCLUSION HOM is becoming increasingly common in Nigeria. The strongest risk factor is ART, and neonatal complications are common reinforcing the need to streamline ART protocols in Nigeria.
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Affiliation(s)
- B Ezenwa
- Department of Paediatrics, The Eko Hospital, Ikeja, Nigeria
| | - O Oseni
- Department of Paediatrics, The Eko Hospital, Ikeja, Nigeria
| | - P Akintan
- Department of Paediatrics, LUTH, Lagos, Nigeria
| | - P Aligwekwe
- Department of Paediatrics, The Eko Hospital, Ikeja, Nigeria
| | - B Chukwukelu
- Department of Obstetrics and Gynaecology, The Eko Hospital, Ikeja, Nigeria
| | - O Fashola
- Department of Family Medicine, The Eko Hospital, Ikeja, Nigeria
| | - A Ogunmokun
- Department of Family Medicine, The Eko Hospital, Ikeja, Nigeria
| | - O Odukoya
- Department of Family Medicine, The Eko Hospital, Ikeja, Nigeria
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Dada O, Odukoya O, Okuyemi K. Risk perception and correlates of alcohol use among out-of-school youth in motor parks in Lagos State, Nigeria. Malawi Med J 2016; 28:19-25. [PMID: 27217913 DOI: 10.4314/mmj.v28i1.5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND AIM The prevalence of alcohol use has increased globally. Out-of-school youth are a vulnerable group who might have missed opportunities for learning healthy behaviours in a formal school environment. The purpose of this study was to determine the risk perception, pattern of use, and correlates of alcohol use among out-of-school youth in Lagos, Nigeria. METHODS A cross-sectional study was conducted among 380 out-of-school youth in motor parks in Lagos State, Nigeria, using interviewer administered questionnaires. RESULTS The lifetime prevalence of alcohol use was 61.1%, while 55.5% were current drinkers. Beer (57.3%) was the most consumed type of alcohol, followed by distilled spirits (29.8%). Using the CAGE scoring system, more than half (57.8%) of the current drinkers had a drinking problem. Almost three quarters (70.1%) had experienced at least one episode of alcohol intoxication within the past month. A considerable number of current drinkers (63.5%) desired to reduce their alcohol intake or stop drinking, while 45.5% had made unsuccessful attempts to do so within the past year. Only 28.9% had received assistance to quit or reduce their drinking and of these less than half (39.3%) received assistance from a professional or healthcare worker. Males were more likely to be current drinkers and to have experienced episodes of alcohol intoxication. Parental and peer drinking were associated with alcohol use but not with intoxication. CONCLUSIONS It is important to design specific programmes to reduce alcohol use among out-of-school youth in these settings.
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Affiliation(s)
- O Dada
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - O Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - K Okuyemi
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
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Odukoya O, Poluyi E, Aina B, Ejekam C, Faseru B. Pharmacist-led smoking cessation: The attitudes and practices of community pharmacists in Lagos state, Nigeria: A mixed methods survey. Tob Prev Cessat 2016. [DOI: 10.18332/tpc/61546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
BACKGROUND Patent medicine vendors (PMVs) play an important role in the treatment of malaria, especially in the rural areas. Nigeria recently changed her antimalarial treatment policy from chloroquine to artemisinin-based combination therapy (ACT). OBJECTIVES To determine the response of PMVs to the new policy. METHODS A baseline study was conducted in two local government areas (LGAs) of Lagos state Nigeria as the first phase in an intervention study aimed at improving the malarial treatment practices of PMVs in rural Lagos. A mixed method design involving a questionnaire survey of 180 PMVs and four key informant interviews were used. An antimalarial drug (AMD) audit was also performed. RESULTS More than 80% of respondents were aware of the policy change in malaria treatment, but only 23.9% sold an ACT for the last case of malaria treated in an under five child. The main determining factor of the particular AMD sold was PMV's personal choice (70.6%). About half (58.9%) of the shops stocked ACTs, the newly recommended antimalarials. CONCLUSIONS The high awareness of the policy change did not translate to a commensurate increase in the sale of the new drugs. Factors beyond the PMVs need to be addressed for a successful adoption of the new policy.
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Affiliation(s)
- Abisoye Oyeyemi
- Department of Community Medicine, Faculty of Clinical Sciences, College of Health Sciences, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria
| | - Babatunde Ogunnowo
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
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Uguru NP, Mbachu C, Ibe OP, Uguru CC, Odukoya O, Okwuosa C, Onwujekwe O. Investigating male tobacco use and expenditure patterns across socio-economic groups in Nigeria. PLoS One 2015; 10:e0122021. [PMID: 25856074 PMCID: PMC4391936 DOI: 10.1371/journal.pone.0122021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 02/06/2015] [Indexed: 11/18/2022] Open
Abstract
The magnitude of variation in economic costs of tobacco consumption among socio-economic status (SES) groups in Nigeria is unclear. Understanding the factors that influence tobacco use and expenditure among different socio-economic groups would inform decisions on interventions for tobacco control in Nigeria. Secondary data was obtained from the 2008 National demographic and health survey. Information on tobacco use and expenditure in households and individual males were extracted from the database. A total of 34,070 households and 15,846 individual males were sampled. Analysis was done using descriptive statistics and binary logistic regression analysis. Information on wealth index obtained were categorized into socio-economic quintile groups (Q1 to Q5), representing poorest to richest socio-economic groups. To estimate expenditure on cigarettes, the average cost of a stick of cigarette was obtained and multiplied with the number of sticks smoked per day. The proportion of households that use tobacco in Nigeria is 5.25% with a greater percentage (89.6%) residing in the rural areas. Prevalence of cigarette smoking in individual males is 8.59%, and the poorer SES group smoked more cigarettes (20.9%) and spent more (0.60–1.19USD) than the richest SES group. Low education level, traditional beliefs, literacy levels, SES and employment status all influence cigarette smoking in adult males. Although poor people smoked more and spent more of their income on cigarettes, other factors like educational level and traditional beliefs were found to influence practice of cigarette smoking in men. This implies that tobacco control legislation through increased taxes alone may not effectively reduce the use of tobacco and its products in Nigeria. A consolidated approach that includes behavioral change procedures, enforcing bans on tobacco advertisement and the use of strong graphic anti-tobacco messages targeted at both the poor and rich as well as the educated and uneducated need to be effected to reduce tobacco use.
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Affiliation(s)
- Nkoli P. Uguru
- Department of Preventive Dentistry, Faculty of Dentistry, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
- * E-mail:
| | - Chinyere Mbachu
- Department of Community Medicine, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Ogochukwu P. Ibe
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Chibuzo C. Uguru
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Oluwakemi Odukoya
- Department of Community Medicine, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Chinenye Okwuosa
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Obinna Onwujekwe
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
- Department of Health Administration and Management, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
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Onigbogi OO, Odukoya O, Onigbogi M, Sekoni O. Knowledge and attitude toward smoke-free legislation and second-hand smoking exposure among workers in indoor bars, beer parlors and discotheques in Osun State of Nigeria. Int J Health Policy Manag 2015; 4:229-34. [PMID: 25844384 DOI: 10.15171/ijhpm.2015.44] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 02/26/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND One of the requirements of the Osun State smoke-free legislation is to ensure smoke-free enclosed and partially enclosed workplaces. This survey was conducted to assess the knowledge and attitude of workers in indoor bars, beer parlors and discotheques to smoke-free legislation in general and the Osun State smoke-free law in particular. METHODS A convenience sampling of 36 hospitality centers was conducted. Interviewer-administered questionnaires were used to elicit responses about the objectives from non-smoking workers. The questionnaires had sections on knowledge of the Osun State smoke-free law, attitude toward the law and smoke-free legislation in general and exposure to second-hand tobacco smoke by the workers. Questions were also asked about the second-hand tobacco smoking status of these workers. The data were analyzed using SPSS version 15.0. RESULTS We had 154 participants recruited into the study. There were 75 males (48.0%) and 79 females (52.0%). On the overall, respondents had a good knowledge of the effects of second-hand smoke on health (70.2%) with 75.0% of them being aware of the general smoke-free law and 67.3% being aware of the Osun State smoke-free law although none of them had ever seen a copy of the law. A high proportion (60.0%) was in support of the Osun smoke-free law although all of them think that the implementation of the law could reduce patronage and jeopardize their income. Attitude toward second-hand smoking was generally positive with 72.0% of them having no tolerance for second-hand tobacco smoke in their homes. Most participants (95.5%) had been exposed to tobacco smoke in the workplace within the past week. CONCLUSION Despite the high level of awareness of the respondents about the dangers of second hand smoke and their positive attitude to smoke-free laws, nearly all were constantly being exposed to second hand smoke at work. This calls for policy level interventions to improve the implementation of the smoke-free law.
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Affiliation(s)
| | - Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Modupe Onigbogi
- Department of Community Health, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Oluwakemi Sekoni
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
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Balogun M, Sekoni A, Meloni ST, Odukoya O, Onajole A, Longe-Peters O, Ogunsola F, Kanki PJ. Trained community volunteers improve tuberculosis knowledge and attitudes among adults in a periurban community in southwest Nigeria. Am J Trop Med Hyg 2014; 92:625-32. [PMID: 25510722 DOI: 10.4269/ajtmh.14-0527] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Nigeria has the world's 10th largest tuberculosis (TB) burden. Targeted community-based interventions can potentially help reduce TB incidence. We designed an intervention in a periurban community where 10 community volunteers were trained to provide community TB education and also detect and refer TB suspects to a nearby clinic. To determine the effect of the intervention on knowledge, attitude, and preventive practices of TB, we compared results from a pre-intervention survey with those of a post-intervention survey. Pre-intervention, respondents had a mean knowledge score of 10.6 ± 7.0 of a possible 34, a mean attitude score of 5.8 ± 3.3 of a possible 10, and a mean practice score of 5.3 ± 1.4 of a possible 7. The intervention significantly increased the mean knowledge score to 16 ± 5.4 (P < 0.001) and mean attitude score to 7.0 ± 1.8 (P < 0.001); however, there was no statistically significant difference in the mean practice score. Eight TB suspects were referred to the clinic, and one suspect was subsequently diagnosed with TB. The use of trained community volunteers to share information on TB improved the overall knowledge and attitudes of respondents. Continued empowerment of the community should be encouraged to promote TB prevention and care.
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Affiliation(s)
- Mobolanle Balogun
- Department of Community Health and Primary Care, College of Medicine of the University of Lagos, Lagos, Nigeria; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Community Health, Lagos University Teaching Hospital, Lagos, Nigeria; Department of Medical Microbiology and Parasitology, College of Medicine of the University of Lagos, Lagos, Nigeria
| | - Adekemi Sekoni
- Department of Community Health and Primary Care, College of Medicine of the University of Lagos, Lagos, Nigeria; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Community Health, Lagos University Teaching Hospital, Lagos, Nigeria; Department of Medical Microbiology and Parasitology, College of Medicine of the University of Lagos, Lagos, Nigeria
| | - Seema Thakore Meloni
- Department of Community Health and Primary Care, College of Medicine of the University of Lagos, Lagos, Nigeria; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Community Health, Lagos University Teaching Hospital, Lagos, Nigeria; Department of Medical Microbiology and Parasitology, College of Medicine of the University of Lagos, Lagos, Nigeria
| | - Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine of the University of Lagos, Lagos, Nigeria; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Community Health, Lagos University Teaching Hospital, Lagos, Nigeria; Department of Medical Microbiology and Parasitology, College of Medicine of the University of Lagos, Lagos, Nigeria
| | - Adebayo Onajole
- Department of Community Health and Primary Care, College of Medicine of the University of Lagos, Lagos, Nigeria; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Community Health, Lagos University Teaching Hospital, Lagos, Nigeria; Department of Medical Microbiology and Parasitology, College of Medicine of the University of Lagos, Lagos, Nigeria
| | - Olukemi Longe-Peters
- Department of Community Health and Primary Care, College of Medicine of the University of Lagos, Lagos, Nigeria; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Community Health, Lagos University Teaching Hospital, Lagos, Nigeria; Department of Medical Microbiology and Parasitology, College of Medicine of the University of Lagos, Lagos, Nigeria
| | - Folasade Ogunsola
- Department of Community Health and Primary Care, College of Medicine of the University of Lagos, Lagos, Nigeria; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Community Health, Lagos University Teaching Hospital, Lagos, Nigeria; Department of Medical Microbiology and Parasitology, College of Medicine of the University of Lagos, Lagos, Nigeria
| | - Phyllis J Kanki
- Department of Community Health and Primary Care, College of Medicine of the University of Lagos, Lagos, Nigeria; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Community Health, Lagos University Teaching Hospital, Lagos, Nigeria; Department of Medical Microbiology and Parasitology, College of Medicine of the University of Lagos, Lagos, Nigeria
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Ogundana OM, Ajayi OF, Odukoya O. Analysis of Elastic Tissue in Histological Variants of Pleomorphic Salivary Adenoma seen at the Lagos University Teaching Hospital over a period of 35 Years. West Afr J Med 2014; 33:167-171. [PMID: 26070819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Pleomorphic salivary adenoma (PSA), is known for its morphologic diversity. While reports of elastic tissue in PSA have been documented, the distribution of this tissue in histological variants of the tumour has not been documented. Perhaps such features may influence biological behaviour of these variants. OBJECTIVE To classify PSA in our series into histological variants, and determine possible variation in elastic tissue distribution in them. METHODS Eighty eight histologically diagnosed cases of PSA in the oral biopsy archives of the department of Oral Biology and Pathology, Lagos University Teaching Hospital, were retrieved. New H&E sections were cut to reconfirm diagnosis and Verhoeff-Van Gieson's stained sections were cut for demonstration of elastic tissue. Seifert et al.'s (1976) histological classification was applied and elastic tissue presence was determined and quantified for each case. Parameters studied included; sex, age, site, histological subtypes and presence of elastic tissue. Statistical analysis was undertaken using the EPI-INFO version 3.4. RESULTS Male:female ratio was 1:1.3. Most cases (63.6%) occurred in the age group of 21-40 years. Generally, palate (42.0%) was the most commonly affected site, while 53.4% of cases were in the minor salivary glands. Seifert et al. classified subtype II lesions were the most frequently observed (39.7%) and elastic tissue was confirmed in 91.0% of cases. No association was noted between proportion of elastic tissue and histological variants. CONCLUSION Seifert et al subtype II was the most frequently observed and no association was observed between proportion of elastic tissue and the histological variant of PSA.
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Affiliation(s)
- O M Ogundana
- Department of Oral Biology and Oral Pathology, College of Medicine, University of Lagos, Lagos, Nigeria
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Upadhyay RP, Krishnan A, Rai SK, Chinnakali P, Odukoya O. Need to focus beyond the medical causes: a systematic review of the social factors affecting neonatal deaths. Paediatr Perinat Epidemiol 2014; 28:127-37. [PMID: 24354747 DOI: 10.1111/ppe.12098] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Reducing the global total of 3.3 million neonatal deaths is crucial to meeting the fourth Millennium Development Goal. Until recently, attention has been on the medical causes of the neonatal deaths, while the social factors contextualising these deaths have largely remained unaddressed. The current review aimed to quantify the role of these factors in neonatal deaths. METHODS A systematic search was performed through PubMed, Google scholar, Cochrane library, Medline, IndMed, Embase, World Health Organization and Biomed central databases. Studies published from 1995 to 2011 were included. Random effects meta-analysis was performed to derive at an estimate of the burden of delays, as defined by the 'three delays model' by Thadeus and Maine. RESULTS A total of 17 studies were reviewed. The majority of them (n = 10) were from the African continent. Level 3 delay, i.e. delay in receiving appropriate treatment upon reaching a health facility (38.7%, 95% CI, 21.7%-57.3%) and delay in deciding to seek care for the illness (Level 1 delay) (28%, 95% CI, 16%-43%) were the major contributors to neonatal deaths. Level 2 delay, i.e. delay in reaching a health facility (18.3%, 95% CI, 2.6-43.8%) contributed least to the neonatal deaths. CONCLUSION Creating awareness among caregivers regarding early recognition and treatment seeking for neonatal illness along with improving the quality of neonatal care provided at the health facilities is essential to reduce neonatal mortality.
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Affiliation(s)
- Ravi Prakash Upadhyay
- Department of Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Upadhyay RP, Chinnakali P, Odukoya O, Yadav K, Sinha S, Rizwan SA, Daral S, Chellaiyan VG, Silan V. High neonatal mortality rates in rural India: what options to explore? ISRN Pediatr 2012; 2012:968921. [PMID: 23213561 PMCID: PMC3506889 DOI: 10.5402/2012/968921] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Accepted: 09/16/2012] [Indexed: 11/27/2022]
Abstract
The neonatal mortality rate in India is amongst the highest in the world and skewed towards rural areas. Nonavailability of trained manpower along with poor healthcare infrastructure is one of the major hurdles in ensuring quality neonatal care. We reviewed case studies and relevant literature from low and middle income countries and documented alternative strategies that have proved to be favourable in improving neonatal health. The authors reiterate the fact that recruiting and retaining trained manpower in rural areas by all means is essential to improve the quality of neonatal care services. Besides this, other strategies such as training of local rural healthcare providers and traditional midwives, promoting home-based newborn care, and creating community awareness and mobilization also hold enough potential to influence the neonatal health positively and efforts should be made to implement them on a larger scale. More research is demanded for innovations such as “m-health” and public-private partnerships as they have been shown to offer potential in terms of improving the standards of care. The above proposed strategy is likely to reduce morbidity among neonatal survivors as well.
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Affiliation(s)
- Ravi Prakash Upadhyay
- Department of Community Medicine, Vardhman Mahavir Medical College and Safdarjang Hospital, New Delhi 110049, India
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Eweka OM, Agbelusi GA, Odukoya O. Prevalence of oral lesions and the effects of HAART in adult HIV patients attending a tertiary hospital in Lagos, Nigeria. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/ojst.2012.23036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Upadhyay R, Jarhyan P, Odukoya O. Methodological Issues in Treatment Adherence Studies. North Am J Med Sci 2012; 4:244. [PMID: 22655287 PMCID: PMC3359439 DOI: 10.4103/1947-2714.95912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Omoregie FO, Odukoya O, Ojo MA, Saheeb BD. Melanin pigmented periradicular lesions of extracted teeth: a report of 3 cases and review of the literature. Afr J Med Med Sci 2011; 40:277-281. [PMID: 22428524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This article reports 3 cases of melanin pigmented lesions among 75 histologically diagnosed periradicular lesions of extracted teeth. Case 1 was a 25-year old male who presented with one week history of toothache involving a tender carious left mandibular second molar tooth (37), with periapical radiolucency and diagnosed clinically as acute apical periodontitis. The lesion was diagnosed histologically (using Haematoxylin and Eosin) as periapical granuloma, while histochemical examination (using Masson-Fontana technique) showed the presence of round/oval shaped melanin pigmented macrophages (melanophage) in the lesion. Case 2 was a 54-year old male with one week history of toothache associated with tender carious right maxillary first molar tooth (16) with periapical radiolucency. A clinical diagnosis of acute apical periodontitis was made, but histological and histochemical examination showed a melanin pigmented periapical granuloma with spindle shaped melanophage. Case 3 was a 28-year old female who presented with 4 days history of toothache, involving the tender left mandibular first molar tooth (36). The lesion had periapical radiolucency and a clinical diagnosis of acute apical periodontitis. On examination histologically and histochemically, the lesion was diagnosed as an intraosseous melanocytic naevi with dark-brown nests of round naevus cells. In conclusion, this article shows the rarity of melanin pigmented periradicular lesions in the jaws. The cases reported suggest that the trigger for formation of melanin-pigmented cells in the periradicular lesions may be related to the acute phase of the lesions. Further study is recommended to determine if the remnants of the migratory neural crest cells are the precursors of melanin-pigmented cells in the periradicular region.
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Affiliation(s)
- F O Omoregie
- Department of Oral and Maxillofacial Surgery and Pathology, School of Dentistry, College of Medical Sciences, University of Benin, Benin City, Nigeria.
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Effiom OA, Adewole RA, Odukoya O. Clinicopathological characteristics of odontogenic myxoma in Nigerians. West Afr J Med 2011; 30:255-261. [PMID: 22669829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Odontogenic myxoma (OM) is a locally aggressive neoplasm whose clinicopathological characteristics have not been extensively reported in Nigerians. OBJECTIVE To describe the clinicopathological characteristics of cases of OM seen at the Lagos University Teaching Hospital in Nigeria. METHODS A review of both clinical and histopathological records of sixty-three cases of OM diagnosed over a period of thirty-seven years was undertaken. The cases were analyzed for age, sex, site, size, duration and histological contents of collagenization, odontogenic epithelium and calcification. RESULTS Odontogenic myxoma represented 63(11.2%) cases of odontogenic tumours, was commonest in the second to forth decades and rare below age 10 and above 70 years. It was more common in females. Maxillary lesions were more common with respect to both central and peripheral histologic types, but occurred in equal frequencies in mandible and maxilla with respect to the central histologic type. Forty-seven (74.6%) cases were fibromyxoma and sixteen (25.4%) myxoma. Odontogenic epithelium was rare and observed in 5 (9.5%) cases while calcific material was present in sixteen (25.4%) cases. Late presentation was a common feature and surgical excision was the treatment of choice. CONCLUSION Odontogenic myxoma is un-common among Nigerians when compared with ameloblastoma. Clinicopathological characteristics in this series are similar to information in the scientific literature.
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Affiliation(s)
- O A Effiom
- Department of Oral Biology and Oral Pathology, College of Medicine, University of Lagos. P.M.B.12003, Lagos, Nigeria
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Odukoya O, Effiom OA. Clinicopathological study of 100 Nigerian cases of ameloblastoma. Niger Postgrad Med J 2008; 15:1-5. [PMID: 18408774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Clinicopathological analysis and growth rate study of 100 cases of ameloblastoma was undertaken. The tumour had site predilection for the mandible (91.0%) and occurred more in males than in females (ratio 1:0.9). 62.0% of patients in the series were less than 20 years of age. The estimated monthly growth rate (EMGR) of ameloblastoma was observed to be slower in males although the mean tumour volume recorded in females was lower than males in the series. The biologic aggression of 4 various types of ameloblastoma was predicted using EMGR and average volume of tumour at hospital presentation as predictive markers. Solid multicystic ameloblastoma was observed with the fastest EMGR of 0.81 cm(3)/month. Peripheral ameloblastoma was observed with the slowest EMGR of 0.17 cm(3)/ month. It was concluded that all the 4 types of ameloblastoma observed were clinically distinct and showed varying biologic aggression. The solid multicystic type with the highest growth rate (0.81 cm(3)/month) was considered the most aggressive while the peripheral type (growth rate = 0.17 cm(3)/month) was the least aggressive. It is therefore necessary to distinguish between the various clinical types of ameloblastoma before a clinician proceeds with definitive treatment.
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Affiliation(s)
- O Odukoya
- Department of Oral Pathology and Biology, School of Dental Sciences, College of Medicine University of Lagos, Nigeria
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Effiom OA, Odukoya O. Adenomatoid odontogenic tumour: a clinico-pathological analysis and melanin pigmentation study of 31 Nigerian cases. Niger Postgrad Med J 2005; 12:131-5. [PMID: 15997264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
AIM Clinicopathological analysis and melanin pigmentation occurrence in adenomatoid odontogenic tumour (AOT) diagnosed and managed at the Lagos University Teaching Hospital during a 29- year period. METHODS Records of 31 cases were reviewed and standard epidemiological data were obtained. Haematoxylin and eosin stained slides of the cases were retrieved and reevaluated for reconfirmation of diagnosis. Celloidinised paraffin sections of all cases were subjected to Fontana Masson stain and melanin bleach to assess presence of melanin pigment. RESULTS AOT is an uncommon type of odontogenic tumour that is commoner in younger age group (8-35 years) with site predilection for the anterior maxilla (64.5%). Occurrence of melanin pigment in AOT was very rare as there was positive melanin pigmentation in only one case in spite of the fact that the study was carried out in a predominantly Black population. CONCLUSION Pattern of occurrence of AOT observed in this Lagos series is similar to previous studies in the scientific literature. Melanin pigmentation is rarely demonstrated in AOT even in a predominantly Black population.
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Affiliation(s)
- O A Effiom
- Department of Oral Pathology and Biology, School of Dental Sciences, College of Medicine, University of Lagos, Nigeria
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Abstract
This article presents a clinico-pathologic analysis of 197 cases of ectodermal odontogenic tumours archived in the Lagos University Teaching Hospital, Lagos Nigeria over a 21-year period. They were categorized according to the WHO classification of odontogenic tumours. Of the 197 cases, 182 (92.3%) were benign while 15 (7.6%) were malignant. Central ameloblastoma, which accounted for 88.3% in this series, was the most common benign neoplasm demonstrating predilection for males (58.6%) and the mandible (83.3%). The mean age of occurrence (+/-SD) was 31.00 +/- 13.9 (range 9-82 years). Similarly ameloblastic carcinoma was the most prevalent malignant tumour (5.6%) with a predilection for females (63.6%) and the mandible (81.8%). The mean age of occurrence (+/-SD) was 30.1+/- 20.7 (range 16-85) years. Follicular ameloblastoma was found to be the commonest histologic subtype seen in Nigeria.
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Affiliation(s)
- K E Adebiyi
- Department of Oral Biology and Pathology, School of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria.
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Affiliation(s)
- Y M Wong
- Department of Obstetrics and Gynaecology, Jessop Hospital for Women, Sheffield, UK
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Afolabi OC, Odukoya O, Arole G, Banjo AF. Evaluation of nucleolar organizer regions in tumours of the jaw bones. Niger Postgrad Med J 2001; 8:7-11. [PMID: 11487776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
Nucleolar organizer regions [NORS] are loops of DNA that transcribe to ribosomal RNA. They can be visualized as intranuclear black dots by histochemical staining with a colloid silver solution. Silver stained nucleolar proteins (AgNORs) were counted in a variety of jaw bone tumours. In osteosarcomas, the number of AgNORs was also quantified before and after chemotherapy. Malignant bone tumour cells possessed more than five small AgNORs (5.54 +/- 0.44). Nuclei of benign jaw bone tumour cells had less than three (2. 97 +/-0.61). A significant difference in the number of AgNORs between osteosarcoma before chemotherapy (5.76 +/- 0.50) and after chemotherapy (3.89 +/- 1.65) was observed. (P < 0.05). The number ofAgNORs in recurrent osteosarcoma, recurrent ameloblastic carcinoma and recurrent chondrosarcoma was much higher than in their respective primary lesion but without statistical significant difference. The results of the present study indicate that the AGNOR count might help in determining malignancy, evaluating the effect of chemotherapy, and deciding the prognosis.
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Affiliation(s)
- O C Afolabi
- Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
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Afolabi OC, Odukoya O, Arole G, Banjo AF. Nucleolar organizer regions in jaw tumours of cartilaginous origin. West Afr J Med 2001; 20:17-21. [PMID: 11505882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Nucleolar organizer regions [NORs] are loops of DNA that transcribe to ribosomal RNA. They can be visualized as intranuclear black dots by histochemical staining with a colloid silver solution. Silver-stained nucleolar proteins [AgNORs] were counted in cases comprising of primary chondrosarcomas of three histologic grades, in chondromyxoid fibroma and in controls comprising of normal bone and cartilage tissues of the jaw bones. The AgNOR counts increased step-wisely from normal bone tissue [1.11 0.4], chondromyxoid fibroma [2.66 0.78], grade I chondrosarcoma [3.94 0.34], grade II chondrosarcoma [4.32 0.52], and grade III chondrosarcoma [5.54 0.44]. There was a statistically significant difference in the mean AgNOR counts between grade 1 and grade III chondrosarcoma [p < 0.05]. The mean AgNOR counts for benign cartilaginous [chondromyxoid fibroma] tumour was significantly lower than the mean, AgNOR count for malignant cartilaginous tumours [chondrosarcomas] [p < 0.05]. The results in the present study indicate that silver colloid staining is a useful technique for evaluating the proliferative activity of chondrosarcoma and benign cartilaginous tumour such as chondromyxoid fibroma.
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Affiliation(s)
- O C Afolabi
- Nigerian Institute of Medical Research, Yaba, Nigeria
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al-Khateeb TL, Odukoya O, el-Hadidy MA. Panoramic radiographic study of mental foramen locations in Saudi Arabians. Afr Dent J 1998; 8:16-9. [PMID: 9590882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A panoramic radiographic study was carried out on 404 dentate Saudi Arabians, to locate positions of the mental foramen. Results show that 83.7% of the mental foramen locations occurred in the interdental space between the mandibular premolars and apical to the mandibular second premolar. 9.35% occurred posterior to the mandibular second premolar, and 6.95% occurred apical/anterior to the mandibular first premolar. In female Saudis, the most common location of the mental foramen was apical to the mandibular second premolar (45.9%), while the most common location in male Saudis was the interdental space between the mandibular premolars (45.5%). Asymmetry of the mental foramen location, which was observed in 15.6% of the cases, was observed more often in males (17.9%) than in females (12.3%).
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Affiliation(s)
- T L al-Khateeb
- Department of Oral and Maxillofacial Rehabilitation, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
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Ogunlewe MO, Odukoya O, Akinwande JA. Epithelial jaw cysts: analysis of 126 Nigerian cases. Afr Dent J 1998; 10:1-8. [PMID: 9590886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
One hundred and twenty-six Nigerian cases of epithelial jaw cysts were retrieved from case notes and biopsy records of the Department of Oral and Maxillofacial Surgery and Department of Oral Pathology and Oral Biology of the Lagos University Teaching Hospital. The cases were analysed for age, sex, site and methods of management. Results show that developmental odontogenic cysts (57.14%) were more common than inflammatory odontogenic cysts (26.94%). Dentigerous cyst (22.22%) was the most common epithelial jaw cyst, followed by radicular cyst (21.43%). Developmental non-odontogenic cysts were more than twice as common in females as in males. Sixty-eight per cent of epithelial jaw cysts were treated by enucleation, 10% by marsupialisation, 13% by jaw resection and 9% by surgical excision.
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Affiliation(s)
- M O Ogunlewe
- Department of Oral & Maxillofacial Surgery, College of Medicine, University of Lagos, Nigeria
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Abstract
OBJECTIVE Serum endometrial antibodies have been found inconsistently in patients with endometriosis. Soluble CD23 is elevated in diseases associated with B cell activation. We evaluated serum levels of soluble CD23 and endometrial IgG antibodies in patients with endometriosis to determine whether there is B cell activation in this condition. DESIGN Fifty-seven patients with pelvic pain diagnosed as endometriosis and 40 patients without pelvic pain or endometriosis who had laparoscopic sterilisation were sequentially recruited into the study. Blood was collected and the sera assayed by ELISA for endometrial IgG antibodies and soluble CD23. RESULTS There was a significant difference between endometriosis and control group in both the serum IgG endometrial antibodies (p < 0.05) and soluble CD23 (p < 0.05). There was significant but weak correlation between endometrial antibodies and soluble CD23 (r = 0.3, p = 0.039), particularly in mild but not severe endometriosis. CONCLUSIONS These data suggest the existence of B cell activation in patients with endometriosis with a significant correlation between endometrial antibodies and soluble CD23. Mild endometriosis appears to be immunologically more active than the severe form. The value of soluble CD23 in the management of endometriosis needs further evaluation.
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Affiliation(s)
- O Odukoya
- University Department, Jessop Hospital for Women, Sheffield, UK
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Abstract
Two hundred and eighty-nine cases of odontogenic tumors that accumulated in the files of the biopsy service of the Lagos University Teaching Hospital during a period of 21 years were analysed and categorised according to the most recent WHO classification of odontogenic tumors. Odontogenic tumors constituted 19% of all oral/jaw tumors and tumor-like lesions. Ameloblastoma, which accounted for 58.5% of odontogenic tumors in the series, was the most common, and showed a predilection for males and the posterior mandible. 94.8% of odontogenic tumors were benign, while malignant odontogenic tumors accounted for 5.2%. Odontogenic carcinoma was the most prevalent malignant odontogenic tumor; it showed a prediction for the mandible and occurred at a mean age of 37 years.
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Affiliation(s)
- O Odukoya
- Department of Oral Biology & Oral Pathology, College of Medicine, University of Lagos, Nigeria
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Odukoya O. Orofacial granulomatosis: report of two Nigerian cases. J Trop Med Hyg 1994; 97:362-6. [PMID: 7966539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Two cases of orofacial granulomatosis are reported. One case is that of a 24-year-old Nigerian female, who presented with a complete form of Melkersson-Rosenthal syndrome. The second case is that of a 32-year-old Nigerian male who presented with a form of orofacial granulomatosis which is consistent with Miescher's cheilitis granulomatosa, and who also gave a history of intolerance to some food items. The relevant literature is reviewed.
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Affiliation(s)
- O Odukoya
- Department of Oral Biology and Oral Pathology, College of Medicine of the University of Lagos, Nigeria
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Abstract
An ameloblastoma with histologic evidence of clear cells in a 15-year-old Nigerian male patient, who presented with a slow-growing, intraosseous, anterior mandibular swelling, is reported. The lesion was treated by surgery alone, and has not shown any recurrence 5 years after initial surgery.
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Affiliation(s)
- O Odukoya
- Department of Oral Biology and Oral Pathology, College of Medicine, University of Lagos, Nigeria
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Odukoya O, MacDonald DG, Moore IA, Brown IL. Light microscopic, cytochemical and ultrastructural studies of a rat odontogenic epithelial cell line. J Oral Pathol Med 1991; 20:41-5. [PMID: 1705983 DOI: 10.1111/j.1600-0714.1991.tb00886.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
An odontogenic epithelial cell line, ROE-2B, was established by propagating disaggregated immature, unmineralized maxillary third molar tooth germs from 11-day old Sprague-Dawley rats on a feeder layer of Mitomycin-C treated NIH 3T3 embryonic mouse fibroblasts. The cell line has been maintained for more than 6 months and through 7 passages. Light microscopic examination of cells revealed colonies with epithelial morphology. Electron microscopic examination confirmed the epithelial nature by the demonstration of tonofilaments, desmosomes and basal lamina. Cells were also shown to have secretory vacuoles, an abundance of granular endoplasmic reticulum, free ribosomes, Golgi complex and mitochondria. Surface activity in the form of pseudopodia-like projections and micropinocytosis were noted. Epithelial cells forming keratin were demonstrated by a positive histochemical reaction with Rhodanile Blue. Immunohistochemical studies showed a positive reaction for CAM 5.2 indicating that the ROE-2B cells express the cytokeratins of simple or glandular epithelia. The ROE-2B cell line will be useful for studies on in vitro biological behaviour of odontogenic epithelial cells, and may allow the establishment of in vitro models of odontogenic tumours.
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Affiliation(s)
- O Odukoya
- Department of Oral Medicine and Pathology, Glasgow Dental Hospital and School, UK
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Allen AO, Odukoya O, Ashiru OA. Effect of oral contraceptive on early DMBA carcinogenesis of the rat palatal mucosa. West Afr J Med 1990; 9:6-15. [PMID: 2125463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Experiments were undertaken to find out whether administration of oral contraceptive (OC) per nasogastric tube could accelerate or inhibit early carcinogenesis of the rat palatal mucosa induced by painting 0.5% solution of 7,12-Dimethyl benz (a) anthracene (DMBA) in liquid paraffin. Forty female Sprague-Dawley rats were divided into 8 groups consisting of 5 animals per group. Group I--DMBA; Group II--DMBA + Oral Contraceptive I (13.0gm% Norethindrone + 8.7mg% ethyl estradiol); Group III--DMBA + Oral Contraceptive II (6.5mg% Norethindrone + 4.3% ethyl estradiol). Group IV--Oral Contraceptive I, Group V--Oral Contraceptive II, Group VI--liquid paraffin, Group VII--Corn oil and Group VIII--untreated control. Each animal was sacrificed at 18 weeks, the palatal mucosa degloved, fixed in 10% formal saline, sectioned in paraffin at 5u, stained with Hematoxylin and Eosin and evaluated histologically for features of epithelial dysplasia. Morphometric analysis was performed on epithelial and keratin thickness. Results indicate higher mean grade of epithelial dysplasia for group II when compared to group I (P less than 0.01) thereby suggesting a cocarcinogenic action for the Oral Contraceptive I. Lower dose Oral Contraceptive II was, however, unable to produce any significant mean grade of dysplasia in group III, suggesting further that the cocarcinogenic action of the Oral Contraceptive used was dose dependent. Morphometric analysis shows a decrease (P less than 0.01) in Keratin and palatal epithelium in DMBA treated animals and further decrease (P less than .001) in those two structures when Oral Contraceptive was used in combination with DMBA, suggesting that the cocarcinogenic action of Oral Contraceptive could result from the induced atrophy of keratin/epithelium and subsequent improved access of the DMBA to target cells in the basal layer of the epithelium. It is suggested that Oral Contraceptive accelerated the induction of early DMBA carcinogenesis of the rat palatal mucosa in this study.
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Affiliation(s)
- A O Allen
- Department of Anatomy, College of Medicine, University of Lagos
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