Comparison of statistical models used for assessing factors associated with infant mortality in Nigeria

Background: Infant mortality is a public health concern especially in developing countries, particularly Nigeria. Different models had been used independently to identify factors associated with infant mortality. Some of the used models sometimes violate the underlying assumption for the models. This study was designed to compare the models that have been previously used and identify the appropriate model using standard model selection criteria to analyse risk factors for infant mortality in Nigeria.Methods: The study utilised 2008 Nigeria Demographic and Health Survey (NDHS) data with a sample size of 7107. The NDHS was a stratified two-stage cluster design where a questionnaire was used to collect data on the birth history of women aged 15-49 years. The models employed for this study were: Logit, Probit and Clog-log. The model selection criteria were Akaike Information Criterion (AIC), Residual Deviance and Vuong test. The model with the smallest criteria was considered to be the best fit.Results: The results showed that Infant Mortality in Nigeria can be appropriately modelled by Clog-log model. The models and corresponding AIC values were: Logit (6171.1), Probit (6212.6) and Clog-log (6126.6). The residual deviance included: Logit (6135.1), Probit (6176.6) and Clog-log (6090.6). Clog-log had the smallest AIC and residual deviance values; hence, it was of the best fit. Home delivery and delivery by professionals had negative significant associations with infant mortality while women's education (primary/no education) and birth order had positive significant association, (p < 0.05). Conclusion: The best model for infant mortality evaluation in Nigeria was Clog-log. Generally, improved women's education would significantly reduce Infant Mortality in Nigeria

Trends in the clinical Pattern, diagnosis and management of rhinosinusitis in a sub-urban tertiary health centre

Background: Rhinosinusitis (RSS) is a common form of upper airway disease encountered by Otolaryngologists. Objectives: To describe the trends in the clinical presentation, diagnosis and management of RSS in a tertiary hospital.Methods:Retrospective analysis of clinical information retrieved from the hospital records of patients with RSS managed in the ENT department of OOUTH Sagamu over an 18-month period was done.Results: Out of 1814 patients, 143 had RRS with the prevalence rate of 7.9%. The male-to-female ratio was 1.1:1, the age ranged from 7 to 79 (median = 32.4) years. The presenting symptoms included mucoid nasal discharge (68.7%), nasal congestion (61.5%) and excessive sneezing (46.8%). Most (71.3%) of the patients presented after 3weeks of the onset of symptoms and the median duration was 3.2 months. The leading physical findings included engorged nasal turbinates (78.3%), ooedematous nasal mucosa (72.0%), mucopurulent anterior rhinorrhoea (28.6%) and pale nasal mucosa (25.9%). The investigations done included plain X-Rays of the sinuses (86.0%), full blood count (67.1%) and computerized tomographic (CT) scan of the sinuses (8.4%). Plain X-Ray abnormalities were most common in the maxillary sinuses (45.5%) while 30.1% had multi-sinusitis. The trend of diagnosis ranged from infective RSS in 51.7% to allergic RSS in 38.5%. About a quarter had different forms of non-endoscopic surgical intervention. Recorded complications included nasal polyps in 11.9%. Conclusion: The trend of RSS observed relative affectation of adults and mostly chronic infective types, and sometimes allergic types.Radiological assessment was by plain X-Rays in most cases, management was either medical or non-endoscopic surgical methods, frequently complicated by polyps