West African journal of medicine最新文献

{"title":"Outcomes of Cervical Cerclage for Pregnancies at Risk of Cervical Insufficiency in a Nigerian Teaching Hospital.","authors":"I O Awowole, O O Sowemimo, A E Ubom, M O Ameen, S B Bola-Oyebamiji, O A Adeniyi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and objectives: </strong>Preterm births are leading contributors to neonatal, infant and under-five mortality globally. A significant proportion of mid-trimester pregnancy losses and preterm births are due to cervical insufficiency (CI). Cervical cerclage (CC) remains the mainstay of treatment for CI, but information about the clinical outcomes remains insufficient. This study appraised the perinatal outcome of pregnancies that had CC at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Nigeria.</p><p><strong>Methods: </strong>In a retrospective study, relevant data of all patients who had CC between January 1, 2011, and December 31, 2021 was extracted using a purpose-designed proforma. The data was analysed using the IBM SPSS® 24.0. Associations between categorical independent variables and outcome variables were compared where applicable, using Chi-square, with level of significance set at <0.05.</p><p><strong>Results: </strong>One hundred and thirty-five CCs were performed within the study period, at a mean gestational age (GA) of 15.7 ± 4.5weeks. Sixteen pregnancies (11.9%) were complicated by miscarriages at GA <25weeks. Ninety-six women (71.1%) delivered after GA of 34weeks, with an overall mean GA of 34.5 ± 5.9 weeks at delivery. Elective cerclage, cervical dilatation of ≤2cm at CC insertion and singleton pregnancy were significantly associated with delivery at EGA ≥34 weeks. (p=0.037, 0.040 and < 0.011 respectively).</p><p><strong>Conclusion: </strong>If susceptible pregnant women are identified and CC inserted appropriately, pregnancies that are complicated with CI have about 70% chance of progressing beyond 34weeks. The role of tocolytics and antibiotic therapy as adjunctive treatment for CI however requires further evaluation.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"42 3","pages":"163-168"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and Enablers of Antihypertensive Adherence Among a Nigerian Adult Hypertensive Population Seeking Care in Public Secondary Health Facilities in Delta State, Nigeria: A Mixed Methods Study.","authors":"P Oyibo, O Uwomano, K O Obohwemu, I F Ndioho, E O Eke, E M Umuerri","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Poor adherence to prescribed anti-hypertensive treatments remains a significant public health challenge in Nigeria. This study assessed the barriers and enablers of anti-hypertensive medication adherence among hypertensives seeking care in public secondary health facilities in Delta State, Nigeria.</p><p><strong>Methods: </strong>A mixed quantitative and qualitative method was employed to assess the barriers and enablers of anti-hypertensive medication adherence among a random multistage sample of 451 adult hypertensives. Data were collected using an interviewer-administered semi-structured questionnaire and a focus group discussion guide. Descriptive and inferential analyses of the data collected were carried out using the IBM SPSS version 26 software.</p><p><strong>Results: </strong>The mean age of the study participants was 53.5 (SD = 9.9) years, with 80.7% (n = 364) reporting poor anti-hypertensive medication adherence. Those with good adherence were likely to be at least 50 years old (AOR = 2.625; 95% CI: 1.353 - 4.485; P = 0.014), have tertiary education (AOR = 7.797; 95% CI: 3.359 - 9.758; P = 0.009), belong to the upper socio-economic class (AOR = 2.546; 95% CI: 1.968 - 4.761; P < 0.001) and living with hypertension for at least five years (AOR=1.752; 95% CI: 1.367 - 7.456; P = 0.003).</p><p><strong>Conclusion: </strong>Anti-hypertensive medication adherence was generally poor among the study participants. There is a need for concerted efforts by health providers to regularly screen for anti-hypertensive adherence and provide qualitative health education targeted at improving adherence to medication among hypertensives.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"42 3","pages":"240-247"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Insufficient Hydroxyvitamin D Levels in Diabetic Foot Ulcers in Rivers State Nigeria.","authors":"U D Batubo, B Oyan, U Umoren, S Ogbamba, S Abere, C N Unachukwu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The global increase in diabetes, especially in developing nations, has escalated complications like diabetic foot ulcers. Hypovitaminosis D is considerably prevalent among individuals with Type 2 Diabetes Mellitus (T2DM) and chronic vascular complications. The aim of this study was to determine the association between vitamin D levels and foot ulcers among patients with T2DM.</p><p><strong>Methods: </strong>This study population comprised 88 individuals with diabetic foot ulcers (DFUs) and 88 individuals with T2DM without DFUs. Vitamin D levels were assayed using blood samples according to standard methods. An independent t-test was done to analyze the difference between serum vitamin D levels in both groups. Pearson's correlation coefficient and linear regression analysis were also performed.</p><p><strong>Results: </strong>Majority of participants in the DFU group presented with Grade 2 and Grade 3 ulcers (Wagner's classification). There was a significant difference in serum vitamin D levels, indicating lower levels among cases (mean of 19.6 ng/ml ± 13.6) compared to controls (mean of 36.2 ng/ml ± 11.4) with a p-value of 0.014. Data shows 84.1% of persons with foot ulcers had deficient/insufficient serum vitamin D levels, while only 29.5% persons without DFU had deficient/insufficient vitamin D levels. Regression analysis shows that persons with DFU were 12.6 (6.0 - 26.2) times likely to have deficient/insufficient vitamin D levels. Chi-square analysis shows that the distribution of the DFU severity was significantly higher among persons with deficient serum Vitamin D levels (p = 0.0001).</p><p><strong>Conclusion: </strong>Lower serum vitamin D levels are significantly associated with diabetic foot ulcers (DFUs). Screening for and correcting vitamin D deficiency may potentially improve the outcome in patients with diabetic foot ulcers.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"42 3","pages":"225-230"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Numbers: Stemming the Rising Tide of Hypertension and Cardiovascular Disease.","authors":"G E Erhabor","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"42 3","pages":"159-161"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Study of the Prevalence of Hypertension and Electrocardiographic Left Ventricular Hypertrophy in Oil-and Gas-Polluted Communities in the Niger Delta Region.","authors":"A C Mankwe, T C Ugwu, J S Aprioku, A W Obianime","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Hypertension with its associated sequelae is the most important risk factor for cardiovascular disease and the leading cause of mortality worldwide. The multifactorial associations of environmental influence on blood pressure seem to play a key role in the etiopathogenesis of hypertension and should be more intently investigated.</p><p><strong>Objective: </strong>This study evaluated the prevalence of hypertension and electrocardiographic left ventricular hypertrophy of residents in three oil producing (exposed) communities in Rivers State (Mbodo-Aluu, K-Dere and Engeni) and a non-oil producing (control) community in Anambra State (Mgbeke-Uli).</p><p><strong>Methods: </strong>A total of 570 subjects were recruited for this study. Sociodemographic, anthropometric, electrocardiographic parameters, and blood pressure were obtained from the subjects in a standardized manner.</p><p><strong>Results: </strong>Showed that the mean value of the systolic and diastolic blood pressures of subjects in the exposed communities were higher (p<0.001) than those of the controls. Furthermore, the prevalence of hypertension and left ventricular hypertrophy in exposed communities were higher (p<0.001) when compared with the control.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"42 3","pages":"190-201"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary Diversity and Food Insecurity among Medical Students of the University of Ibadan: A Cross-sectional Study.","authors":"D A Oladipo, O O Akintimehin, F O Samuel","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The global prevalence of food insecurity presents particular challenges for university students, with medical students experiencing compounded risks due to financial limitations and academic pressures. These constraints frequently manifest in poor dietary diversity, creating a bidirectional relationship where food insecurity limits access to nutritious foods, while monotonous diets exacerbate health and academic consequences. Understanding this connection is crucial for developing targeted interventions in high-pressure academic environments.</p><p><strong>Aim: </strong>This study assessed the prevalence of dietary diversity, food insecurity, and associated socio-demographic factors among medical students at the University of Ibadan, Nigeria.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted in 2019 among 208 medical students in their 300-500 academic levels. Participants were selected using a purposive sampling technique. Data were collected using the 10-item US Adult Food Security Scale Module for food security assessment and dietary diversity tools (Minimum Dietary Diversity for Women [MDD-W] and Individual Dietary Diversity Score [IDDS]). Statistical analysis was performed using SPSS version 20, including descriptive statistics, chi-square test was used to determine associations between categorical variables, while multivariate logistic regression was employed to identify food insecurity predictors among students. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>The mean age of participants was 21.7 ± 2.7 years, with 53.8% being male. Over one-third (34.5%) reported a monthly allowance of ₦10,100-₦20,000, while 42.3% had daily food expenditures of ₦800-₦1000. Low dietary diversity was prevalent, particularly among female students (90.0%) compared to males (38.6%). Cereals (98.8%) and legumes (32.5%) were the most consumed food groups, whereas fruits (27.5%) and vegetables (11.3%) were under-consumed. The overall prevalence of food insecurity was 64.9%, with significant predictors including female gender (OR=2.51, 95% CI: 1.16-5.43) and a monthly allowance below ₦10,000 (OR=25.4, 95% CI: 2.08-309.2).</p><p><strong>Conclusion: </strong>This study highlights a high prevalence of food insecurity and low dietary diversity among medical students at the University of Ibadan, with financial constraints and gender disparities being key determinants. These findings underscore the urgent need for institutional interventions, such as subsidized meal programs and nutrition education initiatives, to mitigate this public health concern and support students' well-being and academic success.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"42 3","pages":"215-224"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Complementary and Alternative Medicine Use on Fasting Blood Glucose Among Adult Type 2 Diabetics Attending General Outpatient Clinic in North Central Nigeria: Any Benefits?","authors":"N L P De-Kaa, B O Ornguga, N A Akwaras, L T Swende, D A Daniel, M N Ocheifa, V N Shaahu, T J Igbudu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Management of diabetes mellitus can be quite challenging especially if glucose control is poor necessitating the use of multiple health facilities. Failure of good control is usually multifactorial, leading to an evolving trend in the use of complementary and alternative medicine (CAM) by patients to improve outcome. In view of increasing use of CAM as adjunct or as an alternative treatment, more assessment on CAM use is needed.</p><p><strong>Objectives: </strong>To assess the effect of CAM use on fasting blood glucose on type 2 DM patients attending the General Outpatient Clinic.</p><p><strong>Methods: </strong>Two hundred and forty-four adult type 2 diabetics selected using systematic sampling were recruited into the study. A semi- structured interviewer-administered questionnaire was used to obtain information on sociodemographic characteristics and CAM use. Data obtained was analyzed with the Statistical Package for Social Sciences (SPSS Version 23). Statistical analyses were significant at p< 0.05 and a 95% confidence interval.</p><p><strong>Results: </strong>The mean age ± standard deviation was 56.97 ±10.69 years. Overall CAM use was 40.1%. The highest proportion of CAM use was among those aged between 30 - 40 years (52.9%). Most of the CAM users (71.4%) had uncontrolled fasting blood glucose. Moringa was the most used CAM 61(34.4%). Those who did not use CAM (OR=1.95, CI= 1.12 - 3.37, p<0.05) were 1.95 times more likely to have controlled FBG, and was statistically significant.</p><p><strong>Conclusion: </strong>Many of the diabetic patients used CAM and most of those who practiced concurrent use of CAM and orthodox medicine had poor glycaemic control. Developing a patient-centred approach to CAM use through health education, community engagement, workshops for CAM providers and strengthening health system will reduce reliance on CAM.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"42 3","pages":"231-239"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Disease Risk Related Knowledge, Perception, Behaviours, and Utilization of Routine Screening Services among a Nigerian Adult Population: A Cross-Sectional Analytic Study.","authors":"P Oyibo, E O Eke, N S Awunor, K O Obohwemu, E M Umuerri, O Eyawo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) risk preventive interventions should be informed by and targeted at addressing health literacy needs of individuals and communities. This study assessed the CVD risk knowledge, perception, behaviours, and utilization of routine risk screening services among a Nigerian adult population.</p><p><strong>Methods: </strong>A cross-sectional analytic study design was employed to assess the CVD risk knowledge, perception, behaviours, and utilization of risk screening services among a random multistage sample of 900 adults. Data were collected using an interviewer-administered semi-structured questionnaire adapted from the WHO STEPS questionnaire. Descriptive and inferential analyses of data collected were carried out using the IBM SPSS version 28 software.</p><p><strong>Results: </strong>The mean age of the study participants was 45.0 (SD = 18.7) years, with 66.8% reporting three concurrent risk behaviours, and 34.2% reporting utilization of at least one CVD risk screening service in the preceding year. Overall good CVD risk knowledge, and perception among the study participants was 77.2% and 19.6% respectively. Education, urban settlement, family history of CVD, good overall CVD risk knowledge and perception were predictors of the utilization of CVD risk screening services.</p><p><strong>Conclusion: </strong>A significant proportion of the study participants reported multiple CVD risk behaviours, had poor risk perception and utilization of risk screening services despite having a good overall CVD risk knowledge. There is need for concerted efforts by the relevant stakeholder in the State Ministry of Health to target the adult population in the study setting with health promotion information on CVD risk prevention and the benefits of early risk detection.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"42 3","pages":"178-189"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, Attitude and Perception of Medical Students at the University College Hospital, Ibadan towards Female Genital Mutilation.","authors":"O O Lawal, G O Obajimi, R A Abdus-Salam, P C Ugochukwu, M T Ibagbe, O P Atere, D E Aigbonoga, O O Bello, I O Morhason-Bello","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Female genital mutilation (FGM) is prevalent in many parts of Africa, Asia and the Middle East. Healthcare providers are key players in its medicalization; hence, effort must be put in place to discourage this harmful practice right from inception of medical training.</p><p><strong>Method: </strong>A descriptive cross-sectional study conducted amongst clinical medical students at the University College Hospital, Ibadan, between February and March 2022. Purposive sampling was utilized to recruit 380 participants. A self-administered questionnaire was used to collect data which was analyzed using IBM SPSS version 26. Descriptive statistics were generated, and Chi-square was used to test the association between categorical variables. Logistic regression analysis was performed, and p-value was set at 0.05.</p><p><strong>Result: </strong>Three hundred and eighty questionnaires were administered, however, only 355 (93.4%) were completed and suitable for analysis. The mean age of the respondents was 22.9 (± 2.0) years. There were more males (58.9%) than females (41.1%) with majority being of Yoruba (73.2%) extraction. Sixty-eight (19.2%), 170 (47.9%), and 152 (42.8%) respondents had good knowledge about classification, complication, and medicalization of FGM respectively. A significant association (p<0.05) was noted between religion, gender and years of training with knowledge about FGM. The majority of the respondents' attitude towards FGM was that of objection (91.3%) and outright abolishment (90.4%).</p><p><strong>Conclusion: </strong>Prevention of FGM should be a collaborative effort by healthcare practitioners through the incorporation of programmes to equip trainees on the strategies to eliminate FGM. Medicalization of FGM should be discouraged through targeted mass education and enforcement of penalties.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"42 3","pages":"208-214"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General and Emergency Presentations of Children with Congenital Heart Defect and Factors Affecting it as Seen in A Tertiary Health Institution in Enugu.","authors":"I O Arodiwe, I A Nwafor, F A Ujunwa, B O Edelu, J M Chinawa, T A Oguonu, N Ezemba, J C Eze","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and objectives: </strong>The pattern of emergency presentations in children with congenital heart disease (CHD) is changing. The aim of our study was to identify the pattern and its associated factors.</p><p><strong>Methods: </strong>It is a retrospective study of medical records of 252 children with CHD admitted as emergency cases from June 2018 - May 2023. Inclusion criteria were children with presentations from the CHD and those with no direct presentations were excluded. Data collected included age, gender, pre-existing diagnosis, main complaint and patient condition at discharge. The children were divided into two groups; cyanotic and acyanotic groups. Data was analyzed using SPSS version 25. Fishers exact -test was used for continuous variables and the χ2 test for nominal variables, p < 0.05 was taken to be statistically significant.</p><p><strong>Results: </strong>The participants were 252; 131 (51.8%) were males The age range was 1 month -18 years, with a mean of 9.3 ± 9.1 years. There were more children in acyanotic group, 167 (66.3%). The main presentations in acyanotic group were symptoms of heart failure 71 (43.1%) and lower respiratory tract infection 51 (31.1%) while in cyanotic group the presentations were failure to thrive 29 (34.1 %) and cyanosis 23 (27%). The main causes of heart failure were uncorrected lesions and pulmonary hypertension. There was no significant difference in mortality between both groups. All required cardiac surgery, however only 13 (5%) had the intervention.</p><p><strong>Conclusion: </strong>Children with CHD presented with varied manifestations which are type and age-specific. Improved knowledge of the common presentations in emergencies will help management.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"42 3","pages":"202-207"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}