Approximation of the Cox survival regression model by MCMC Bayesian Hierarchical Poisson modelling of factors associated with childhood mortality in Nigeria.

The need for more pragmatic approaches to achieve sustainable development goal on childhood mortality reduction necessitated this study. Simultaneous study of the influence of where the children live and the censoring nature of children survival data is scarce. We identified the compositional and contextual factors associated with under-five (U5M) and infant (INM) mortality in Nigeria from 5 MCMC Bayesian hierarchical Poisson regression models as approximations of the Cox survival regression model. The 2018 DHS data of 33,924 under-five children were used. Life table techniques and the Mlwin 3.05 module for the analysis of hierarchical data were implemented in Stata Version 16. The overall INM rate (INMR) was 70 per 1000 livebirths compared with U5M rate (U5MR) of 131 per 1000 livebirth. The INMR was lowest in Ogun (17 per 1000 live births) and highest in Kaduna (106), Gombe (112) and Kebbi (116) while the lowest U5MR was found in Ogun (29) and highest in Jigawa (212) and Kebbi (248). The risks of INM and U5M were highest among children with none/low maternal education, multiple births, low birthweight, short birth interval, poorer households, when spouses decide on healthcare access, having a big problem getting to a healthcare facility, high community illiteracy level, and from states with a high proportion of the rural population in the fully adjusted model. Compared with the null model, 81% vs 13% and 59% vs 35% of the total variation in INM and U5M were explained by the state- and neighbourhood-level factors respectively. Infant- and under-five mortality in Nigeria is influenced by compositional and contextual factors. The Bayesian hierarchical Poisson regression model used in estimating the factors associated with childhood deaths in Nigeria fitted the survival data.

Drug use among senior secondary school students in rural Nigeria.

Several studies in Asia, USA and the United Kingdom have shown widespread drug use among adolescents and young adults, thus drawing global attention to this problem. There is however a paucity of data on drug use among youths in rural Nigeria. The target population for this study were adolescents and youths from three out of the 6 senior secondary schools in Igboora, Nigeria, selected by simple random sampling. A cross-sectional study, using interviewer-assisted questionnaire to determine the prevalence of and identify factors associated with drug use. Two hundred and seventy three (69.3%) respodents were currently using one or more drugs of which 123 (45.1%) were single drug users while 150 (54.9%) were multiple drug users. Fourteen different psychoactive substances were reportedly used of which Alabukun, a popular, locally manufactured analgesic (a mixture of acetyl salicylic acid and caffeine) was the most commonly reported drug currently used and ever used. Alcohol was the next commonly reported currently used drug while Kolanut was the next commonly ever-used drug. Tobacco ranked low on the list with only 1.5% current users, while 4.4% reported having ever-used this drug. Following logistic regression analysis, having peers (close friends) and primary caretakers who use drugs, significantly increased the chances of the students using drugs (P < 0.001, P < 0.001). Males compared with females were also significantly more likely to use drugs (P = 0.024). Significant relationship exists between drug use and poor role modeling. Introducing peer counseling, community awareness and working with adults who have adolescents at home would go a long way towards reducing psychoactive drug use at community and household level, particularly among in-school youths.