Correlates of serum estradiol concentration among postmenopausal women in Ilorin, North-Central Nigeria.

OBJECTIVES: There are limited data on the associated factors of circulating endogenous estradiol among Nigerian postmenopausal women. The main objective of this study is to assess the relationship between serum estradiol levels and some menstrual, clinical, and sociodemographic factors in postmenopausal women attending a family medicine clinic in Nigeria. METHODS: This was a hospital-based cross-sectional study involving 372 postmenopausal women. Sociodemographic, menstrual, and clinical data of the participants were collected, and their serum estradiol concentrations were assayed. The collected data were analyzed using IBM SPSS version 21 statistical software. A χ2 test of association and logistic regression analysis were done to identify significant correlates of serum estradiol concentration among the participants. RESULTS: The mean ages at menarche and menopause among the participants were 15.6 and 48.1 years respectively. Approximately half of them (51.1%) were receiving chronic medical care for systemic hypertension and/or diabetes. The mean estradiol concentration of the participants in the study was 20.69 pg/mL. The participants' marital status and clinical presentation pattern (chronic vs others) were found to have statistically significant associations with their serum estradiol concentration; P = 0.048 and P = 0.001, respectively. Logistic regression analysis revealed that only the clinical presentation pattern had a significant relationship with serum estradiol concentration among the participants ( P = 0.002). CONCLUSION: Of all the studied factors, the only significant correlate of low serum estradiol concentration found in this study was chronic medical care presentation for hypertension and/or diabetes.

Family and clinical indicators of domestic violence among pregnant women in Ilorin, North-Central Nigeria.

INTRODUCTION: domestic violence affects one in four families and has significant health consequences on sufferers. When it occurs among pregnant women, it can be associated with pregnancy-related complications. There is dearth of data on the association between certain family and clinical factors of pregnant women, and domestic violence in Nigeria. This study was conducted to determine the prevalence and pattern of domestic violence and its association with certain clinical factors and family functioning of pregnant women attending the antenatal clinic at the University of Ilorin Teaching Hospital, Ilorin, North-Central Nigeria. METHODS: a total of 333 respondents were recruited for the cross-sectional study between June and August, 2017 using systematic sampling technique. Structured questionnaires were used to obtain information about domestic violence and family functioning among the study participants. Blood pressure, urinalysis and packed cell volume of respondents were obtained following standard procedures. Data were analyzed using SPSS-20 and Chi-square was used to identify significant risk factors for domestic violence among the study subjects. RESULTS: the results of this study showed that the prevalence of domestic violence among the study population was 34.5%. The most common form of violence in this study was psychological aggression (74.8%), followed by sexual coercion (47.8%), then physical assault (14.8%) and physical assault with injury (3.5%). There was a statistically significant association between domestic violence and; 1) family dysfunction p<0.001); 2) anaemia (p<0.001). CONCLUSION: pregnant women presenting with anaemia as well as those from dysfunctional families are particularly at high risk of domestic violence and as such, special attention should be drawn to these factors with a view to screen and identify victims of abuse during routine antenatal clinic visits.

Adverse events following COVID-19 vaccination in Kwara State, North-central Nigeria.

Safe and effective vaccination remains the mainstay of control of COVID-19 because there is still no universally recommended treatment. This strategy is however being threatened by vaccine hesitancy and resistance due to fear of adverse events and safety concerns. It is, therefore, necessary to study post-vaccination adverse events (AE) in various populations and geographical areas. The objective of this study was to analyze the adverse events following COVID-19 vaccination in five major immunization centers of Kwara State Nigeria. A retrospective descriptive study of the adverse events following AstraZeneca COVID-19 vaccination that were reported from five immunization centers of Kwara State, North-central Nigeria from March to July 2021 was carried out. Statistical Package for Social Science version 26 was used for analysis. Adverse event classification and severity were compared based on age, gender, and time to onset of adverse event and vaccine dose type using the Chi-square test. The incidence of COVID-19 vaccine AE was 1.6%. There was female predominance (51.6%) and a mean age of 41.6±13.7 years. Most of the AE (95.8%) were systemic and mild (81.1%) without a requirement for any therapeutic intervention. Fatal outcome was not reported in any of the AE and the time to outcome of AE was 2 days in most cases (45.3%). No significant association was found between the variables studied and the adverse event type and severity. The low incidence and mild nature of adverse events reported in this study will add to the body of knowledge regarding vaccine adverse events and may eventually impact vaccine uptake.

Pattern and Predictors of Sexual Activity among Postmenopausal Women Attending a Family Medicine Clinic in Ilorin, North-Central Nigeria.

OBJECTIVES: Sexual activity tends to decline with age and is greatly impacted in postmenopausal women. This study aimed to describe the sexual activity pattern among postmenopausal Nigerian women and also detect socio-demographic and menopause-related predictors of their sexual activity. METHODS: In this hospital-based cross-sectional study, 357 postmenopausal women between 45-60 years participated. Data was collected using the sexual activity questionnaire and a socio-demographic questionnaire developed by the authors. RESULTS: The prevalence of sexual inactivity among the participants was 60%. This was attributed mainly to the unavailability of male partners (50.5%) and negative menopause-related sociocultural beliefs (23.8%). Among sexually active participants, 83.2% of them reported having pleasurable experiences and 53.8% of them reported no associated sexual discomfort. Only being in a marital relationship was found to be a statistically significant predictor of sexual activity among the participants (regression coefficient = 3.125, degree of freedom = 1, P < 0.0001). CONCLUSIONS: We reported a high prevalence of sexual inactivity among the participants; the most important reasons given were the unavailability of their husbands and the belief that sexual intercourse was taboo during the postmenopausal period. The study also provided positive evidence for the importance of marriage for sexual activity among the participants.

ARE ANTIBIOTICS OF ANY USE IN THE MANAGEMENT OF GRANULOMA ANNULARE IN CHILDREN?

BACKGROUND: Granuloma annulare (GA) is a benign inflammatory dermatosis of unknown cause, of which generalised granuloma annulare (GGA) is a subtype that tends to be resistant to treatment. Various antibiotics have been used to treat GGA, the most recent being combination therapy with rifampicin, ofloxacin and minocycline (ROM). This study aims to explore the efficacy of antibiotics in treating GGA, and whether antibiotics may be useful in children with GGA. MATERIALS AND METHODS: A systematic review of literature published from 1947 to 2017 was undertaken in order to evaluate the use of antibiotics in treating GGA. Data on characteristics of children with GGA were extracted and eligible studies were then qualitatively analysed. RESULTS: Seven hundred and ninety (790) potential studies were identified, of which 16 were eligible for inclusion in the final analysis. Of these 16 studies, majority were case studies (n=9, 56.3%), with 2 case series (12.5%), 2 retrospective studies (12.5%) and 3 open-label prospective studies (18.8%). Main antibiotic treatments reported were either monthly combination therapy of rifampicin, ofloxacin and minocycline (ROM), or monotherapy with dapsone or doxycycline. Out of a total of 158 patients with GA, 72 patients (45.6%) were treated with antibiotics. Of the 72, 48.6% (n=35) of these patients had GGA while 4 were children; two with GA (2 with GGA), all of whom were treated with dapsone. CONCLUSION: There is paucity of evidence to support the use of antibiotics in the treatment of GGA in children. Although ROM has shown promising results in adults, more studies are needed to validate these findings in children.

High risk sexual behavior among adolescent senior secondary school students in Nigeria.

BACKGROUND: The consequences of high risk sexual practices (HRSP) are enormous among adolescent senior secondary school students. They therefore need to have sufficient knowledge of HRSP. AIM OBJECTIVES: The study gauged the level of knowledge and perceptions of high risk sexual behavior among senior secondary school students in Ilorin, Nigeria with a view to improving their understanding of the current trends in HRSP.This was a quantitative, cross-sectional, descriptive study of adolescent secondary school students in Ilorin East Local Government Area. Multi - stage sampling method involving 3 stages was used. A semi-structured interviewer administered questionnaire was used to obtain data. Informed consent of respondents was obtained. The data was analyzed using SPSS windows software package version 17. RESULTS: Majority, 305 (69.5%) of the students were between 16 - 20 years. The major source of information was from movies, 42.5%, and the internet, 24.7%. Twenty-three percent (23.1%) had poor knowledge of HRSP. Thirty-eight percent (38.1%) did not consider indiscriminate sexual intercourse as HRSP while 27.9% still believed that unprotected sexual practice is safe. Thirty-four percent (34.2%) did not know that sex with multiple partners is a HRSP while 34.4% did not know that oral -genital sex is unsafe. Over thirty-two (32.9%) perceived that engaging in sex made them mature among peers. Twenty-four (24.7%) did not perceive any danger in keeping multiple sexual partners while 15.3% would still engage in unprotected sex. CONCLUSION: The students had relatively poor knowledge and perceptions of HRSP. Quite a number did not consider indiscriminate sexual intercourse as HRSP. An appreciable number did not perceive any danger in keeping multiple sexual partners or beingengaged in unprotected sex. Counselling on the dangers of HRSP should be a component of the school health services so as to curb the complications of HRSP in our secondary schools.

Adaptation and translation of the menopause-specific Utian Quality of Life (UQOL) scale to Yoruba language using middle-aged women attending a clinic in Nigeria.

OBJECTIVE: The main objective of the study is to translate and adapt the menopause-specific Utian Quality of Life (UQOL) scale to Yoruba, an indigenous Nigerian language, using middle-aged women attending a Family Medicine clinic in Nigeria. METHODS: A total of 322 middle-aged Nigerian women at various menopausal stages were recruited for the study. Their menopausal status was categorized using the Monash Women's Health Program Menopausal Staging Algorithm into pre-, peri-, and postmenopausal groups. The UQOL Yoruba version (YUQOL), Menopause Rating Scale (MRS), and a semistructured sociodemographic questionnaire were interviewer-administered to the women. The collected data were analyzed using IBM SPSS version 21 software. RESULTS: The overall scale and the four subscales of YUQOL all had acceptable internal consistency scores; they also demonstrated good construct and criterion validities, except the YUQOL sexual subscale had poor convergent validity (average variance extracted = 0.23). CONCLUSIONS: This study has validated the YUQOL as a psychometrically sound research instrument for measuring menopause-specific QOL among women undergoing menopausal transition. Its sexual subscale would, however, need to be further tested, preferably in sexually active menopausal women to fully confirm its true psychometric property.

Are antibiotics of any use in the management of granuloma annulare in children?

Background: Granuloma annulare (GA) is a benign inflammatory dermatosis of unknown cause, of which generalised granuloma annulare (GGA) is a subtype that tends to be resistant to treatment. Various antibiotics have been used to treat GGA, the most recent being combination therapy with rifampicin, ofloxacin and minocycline (ROM). This study aims to explore the efficacy of antibiotics in treating GGA, and whether antibiotics may be useful in children with GGA. Materials and Methods: A systematic review of literature published from 1947 to 2017 was undertaken in order to evaluate the use of antibiotics in treating GGA. Data on characteristics of children with GGA were extracted and eligible studies were then qualitatively analysed. Results: Seven hundred and ninety (790) potential studies were identified, of which 16 were eligible for inclusion in the final analysis. Of these 16 studies, majority were case studies (n=9, 56.3%), with 2 case series (12.5%), 2 retrospective studies (12.5%) and 3 open-label prospective studies (18.8%). Main antibiotic treatments reported were either monthly combination therapy of rifampicin, ofloxacin and minocycline (ROM), or monotherapy with dapsone or doxycycline. Out of a total of 158 patients with GA, 72 patients (45.6%) were treated with antibiotics. Of the 72, 48.6% (n=35) of these patients had GGA while 4 were children; two with GA (2 with GGA), all of whom were treated with dapsone. Conclusion: There is paucity of evidence to support the use of antibiotics in the treatment of GGA in children. Although ROM has shown promising results in adults, more studies are needed to validate these findings in children

Prevalence and correlates of hypertension-outcome of a free medical screening in Oke-Ogun area of Oyo state, Nigeria, West Africa.

Literature abounds on prevalence of hypertension in Nigeria and urban areas of Oyo state but none in Oke-Ogun geopolitical zone, which constitutes 10 local governments of the 33 in Oyo state, despite the fact that they have high genetic and environmental predisposition to developing high blood pressure. The purpose of the study was to determine the prevalence of high blood pressure and associated risk factors among indigenes of Oke-ogun, Oyo state. A total of 10,000 respondents were recruited using proportionate sampling techniques. Hypertension was defined according to Joint National Committee-8 criteria. The fasting plasma glucose of the respondents were classified as normal (≤6 mmol/L), prediabetes (6.1-6.9 mmol/L), and diabetes (≥7 mmol/L). Body mass index was calculated as weight (kg)/height (m2) and classified as malnutrition/underweight (<16-18.49), normal (18.5-24.9), overweight (25-29.9), and obese (30-≥40). Data were analyzed using descriptive statistics, Chi-square and binary logistic regression tests at P < .05. The mean systolic and diastolic blood pressure was 138 ± 27.81 and 86.13 ± 14.39 respectively. The overall prevalence of hypertension was 38.5%. 64.1% were diabetics. 63.4% had no formal education. Majority (82.95%) earned less than N18,000 ($59) per month. 43.3% had family history of hypertension. There is high prevalence of hypertension among the people of Oke-ogun, in Oyo state. Their low socioeconomic status, low educational background, malnutrition, and genetic predisposition were identified risk factors.

Reference equations for spirometric indices from a sample of the general adult population in Nigeria.

BACKGROUND: The increasing importance of pulmonary function testing in diagnosing and managing lung diseases and assessing improvement has necessitated the need for locally derived reference equations from a sample of the general Nigerian population. METHODS: It was a cross sectional study in which we used linear regression models to obtain equations for reference values and lower limits of normal for spirometric indices in adult Nigerians from a sample of the general population aged 18-65 years (males) and 18-63 years (females). RESULTS: Seven hundred and twenty participants made up of 358 males and 362 females who satisfactorily completed the spirometric measurements using the ATS/ERS reproducibility and acceptability criteria were included in the analysis. The most important predictive variables were height and age. The values of the spirometic indices increase with increasing stature but decrease with increasing age in both sexes. The sex difference in all the indices is also apparent as all the indices, except FEV1/FVC, are higher in men than in women. Our values are higher than values obtained from previous studies in Nigeria (except FEV1/FVC) but the differences were not statistically significant. This suggests that although the values are increasing, the increase is yet to be significantly different from values obtained using the past equations. The implication of this is that there is need for periodic study to derive new equations so as to recognise when there is significant difference. There was no significant difference between values from our equations and those obtained from study among Ethiopians. Compared to report from Iran, our FVC and FEV1values (in males and females) as well as PEFR (in females) are significantly lower. Our values are also lower than values from Poland. We also observed disparities between our values and those of Afro Americans from the GLI study. CONCLUSIONS: Our findings show that it is important to always interpret ventilatory function tests in any individual by comparing it with reference values obtained from a well-defined population of healthy subjects of the same ethnic origin in similar geographic location.

The relationship between obesity and peripheral arterial disease in adult Nigerian diabetics.

AIMS AND OBJECTIVES: The aim was to identify any relationship between obesity and peripheral arterial disease (PAD) in diabetic subjects. SUBJECTS AND METHODS: Male and female diabetic subjects aged 50-89 years. Body mass index (BMI) was used to estimate total body weight and the waist-to- hip ratio (WHR) as well as waist circumference (WC) were used for abdominal fat distribution estimation. Peripheral arterial disease was defined by an ankle brachial index <0.9. RESULTS: Peripheral arterial disease (PAD) was observed in 52.5% of the subjects. BMI, WHR and WC did not correlate with PAD. CONCLUSION: None of the parameters (i.e BMI, WHR and WC) used to assess the relationship between obesity and PAD was found to correlate with PAD.

Social Determinants of Depression: Social Cohesion, Negative Life Events, and Depression Among People Living with HIV/Aids in Nigeria, West Africa.

BACKGROUND: People Living with HIV/AIDS (PLWHA) continue to face persistent and deep rooted social barriers. Incidentally, studies in social determinants of depression are very limited, necessitating this study, which examined social determinants of depression and the impact of these determinants on depression. METHODS: This was a hospital based, cross sectional descriptive study of three hundred adult HIV/AIDS patients, attending the HIV clinic of Kwara State Specialist Hospital, Sobi, Ilorin, Nigeria. Depressive symptoms were measured by the PHQ-9 rating scale. Three variables of social determinants of depression: socio-economic status (years of school and self-reported economic status of family), social cohesion, and negative life events were examined. RESULTS: The self-reported economic status of the family varied from good 35(11.7%), average 162(54%), and poor among 103(34.3%) of the respondents. Social cohesion was low in 199(66.3%), fair in 65(21.7%) and high among 36(12%) of the respondents. There was significant association between social cohesion, negative life events, and depression. CONCLUSION AND GLOBAL HEALTH IMPLICATIONS: Income was the most significant socio-economic determinant. Majority had very low social cohesion and more negative life events, while those with below average years of schooling were more depressed. These are statistically significant. Social determinants of depression should be given a lot of emphasis, when addressing the issue of depression, if we are to meaningfully tackle this increasing scourge in our society.

Assessment of stigma and discrimination experienced by people living with HIV and AIDS receiving care/treatment in University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria.

The research was designed to assess the stigma and discrimination faced by People living with HIV and AIDS (PLWHA) that are receiving treatment in UITH, Ilorin. The study was a descriptive cross-sectional survey conducted on three hundred (300) people living with HIV and AIDS receiving care at the antiretroviral therapy (ART) clinics within University of Ilorin Teaching Hospital (which was the only ART site in Kwara State as at then). A quantitative method through the use of interviewer administered questionnaire was used for data collection. This study was a cross-sectional descriptive study design. All the patients who came to the clinic and met the selection criteria were recruited until the desired sample size was reached. Data were analyzed by EPI-INFO 2005 software package. The mean age of the respondents was 39 years (SD = 9.32), and their age ranged between 19 and 65 years. About two thirds (64.7%) of the respondents were females, 62.7% were married, and 62.9% were from monogamous family settings. Slightly less than half (47.3%) of the respondents were not informed before they were tested for HIV, majority (63.3%) were not counseled before the test, but only 11% did not receive posttest counseling. One quarter of the respondents had experienced stigmatization/discrimination. Various forms of stigmatization/discrimination experienced by the respondents include blame for being responsible for their HIV status, various name callings, telling them that they are no more useful to anybody, violation of confidentiality, social isolation, restriction of their participation in family/religious activities, rejection by their spouses/families, dismissal from place of work, isolating them from other patients, and denying them care at health centers. It is therefore recommended that government at all levels should develop and implement programs to educate health care providers about HIV and AIDS, ethics, and treatment and care; educate the general population on HIV and AIDS, put in place policies that will reduce/stop HIV-related stigma and discrimination at all levels of the society, educate PLWHA on their right to live and work without discrimination, and also ensure full community participation in HIV control programs.

The prevalence of peripheral arterial disease in diabetic subjects in south-west Nigeria

Background: Peripheral arterial disease (PAD) is rarely sought for and generally underdiagnosed even in diabetics in developing countries like Nigeria. PAD is easily detected and diagnosed by the ankle-brachial index; a simple and reliable test. Objectives: To determine the prevalence of PAD in diabetic subjects aged 50-89 years and the value of ankle-brachial index measurement in the detection of PAD. Method: A cross-sectional descriptive study of 219 diabetic subjects aged 50-89 years was carried out. The participants were administered a pre-tested questionnaire and measurement of ankle-brachial index (ABI) was done. The ankle-brachial index 0.90 was considered equivalent to peripheral arterial disease. Results: The overall prevalence of PAD was 52.5. The prevalence of symptomatic PAD was 28.7whilst that of asymptomatic PAD was 71.3. There were a number of associations with PAD which included; age (p 0.05); sex (p 0.05); and marital status (p 0.05). The use of the ankle-brachial index in the detection of PAD was clearly more reliable than the clinical methods like history of intermittent claudication and absence or presence of pedal pulses. Conclusion: The prevalence of PAD is relatively high in diabetic subjects in the southwestern region of Nigeria. Notable is the fact that a higher proportion was asymptomatic. Also the use of ABI is of great value in the detection of PAD as evidenced by a clearly more objective assessment of PAD compared to both intermittent claudication and absent pedal pulses

The prevalence of abdominal obesity and hypertension amongst adults in Ogbomoso, Nigeria

Background: In many developing countries obesity and obesity-related morbidity are now becoming a problem of increasing importance. Obesity is associated with a number of disease conditions, including hypertension, type 2 diabetes mellitus, cardiovascular diseases, cancer, gallstones, respiratory system problems and sleep apnoea. Objectives: The aim of this study was to determine the prevalence of hypertension and obesity, as classified according to waist circumference (WC), and further to determine whether there was any association between abdominal obesity and hypertension amongst adults attending the Baptist Medical Centre, Ogbomoso, Nigeria. Method: A cross-sectional descriptive study of 400 adults aged 18 years or older was conducted. Blood pressure and WC measurements were taken and participants completed a standardised questionnaire. Results: A group of 400 participants were randomly selected (221 women; 179 men), with a mean age of 48.7 ± 16.6 years. The overall prevalence of obesity as indicated by WC was 33.8%(men = 8.9%; women = 53.8%). Women were significantly more sedentary than men (50.8% for men vs 62.4% for women, p<0.05). Most of the obese participants' families also preferred high-energy foods (85.2%, p>0.05). Overall prevalence of hypertension amongst the study population was 50.5%, but without a significant difference between men and women (52.0% for men vs 49.3% for women, p>0.05). The prevalence of hypertension amongst the obese subset, however, was 60.0%. Conclusion: Prevalence of abdominal obesity was found to be particularly significant amongst women in this setting and was associated with hypertension, physical inactivity and the consumption of high-energy diets

A retrospective evaluation of pretreatment and follow-up monitoring of HIV-infected adult patients in a resource-poor setting.

The rapid scale-up of antiretroviral therapy (ART) is associated with the challenges of ensuring that HIV care delivered to clients is of the highest quality. This study was designed to evaluate the pretreatment and 12 month follow-up monitoring of clinical and laboratory profiles of HIV-infected patients at the adult HIV clinic of the University of Ilorin Teaching Hospital, in Nigeria. It was a retrospective analysis of records of 440 adult patients who were on follow-up visits for 1 or more years. Two hundred two (45.9%) were male and 238 (54.1%) were female. Weight was documented at baseline in 314 (71.4%) and at month 12 of follow-up in 258 (58.6%). Baseline World Health Organization (WHO) clinical stage was documented in 269 (61.1%). Baseline CD4 count, full blood count (FBC), creatinine (Cr), liver function tests (LFT), fasting blood sugar (FBS), and fasting serum lipids (FSL) were documented in 243 (55.6%), 260 (59.1%), 143 (32.5%), 136 (30.9%), 268 (60.9%), and 161 (36.6%), respectively. At 12th month of follow-up visit, the CD4 count, FBC, Cr, LFT, FBS, and FSL were documented in 121 (27.5%), 94 (21.4%), 59 (13.4%), 77 (17.5%), 179 (40.7%), and 95 (21.6%), respectively. This report shows that the pretreatment and the 12th-month follow-up monitoring of HIV-infected adult patients in our center was less than optimal. We recommend periodic self-assessment by care providers to monitor compliance with standards.