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    Demand and referral pattern for orthodontic care at University College Hospital, Ibadan, Nigeria
    (2004) Onyeaso CO
    Objective: To assess the demand and pattern of referral for orthodontic services at University College Hospital, Ibadan, Nigeria. Design: A 21-month prospective clinic-based study of consecutive orthodontic patients. Setting and sample population: The orthodontic clinic of University College Hospital, Ibadan, Nigeria. One hundred and seventy-eight (178) consecutive patients, consisting of 79 (44.4%) males and 99 (55.6%) females with mean age of 16.21 ± 7.81 years were studied. Results: 80% of subjects were 20 years of age or younger, while less than 2% were over 40 years of age. More females sought orthodontic care than males. Over 43% of the patients needed removable orthodontic appliances while close to 17% required treatment with fixed appliances. Extractions of retained primary teeth and other grossly malpositioned teeth accounted for 9.6% while 24.7% needed observation of occlusal developments before any treatment decisions could be made. Dentists were noted to be the main referrers of these patients, accounting for over 49% of the referrals, followed by 25.4% who were self referred, and 18.3% who attended under parental influence. Conclusion: More girls than boys demanded orthodontic care and dentists were the major referrers of orthodontic patients.
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    Orthodontic treatment complexity and need at the University College Hospital, Ibadan, Nigeria, according to the Index of Complexity, Outcome and Need (ICON): A pilot study
    (2006) Ochi Onyeaso C; Idaboh G
    Although occlusal indices have been useful in research, audit, practice management, and quality assurance in clinical orthodontics, complexity of orthodontic cases had not been easy to assess for a long time in clinical practice. This pilot study aimed at assessing the orthodontic treatment need and complexity in a referral orthodontic centre in Nigeria. A retrospective analysis of 56 pre-treatment study models randomly selected from the orthodontic model collection of the University College Hospital, Ibadan, Nigeria was carried out without any bias for age or gender. The index of Complexity, Outcome and Need (ICON) was used as the outcome measure. Descriptive statistics were employed in the data analysis. Forty-seven (83.9%) of the sample needed treatment. Thirty-four (60.7%) cases were classified as difficult or very difficult. Only 1 (1.8%) and 13(23.2%) belonged to the easy and mild categories, respectively. The overall mean ICON score was 67.4±19.6SD (range 25–104). Considerable proportions of these referred orthodontic cases in Nigeria needed treatment and had treatment complexity comparable to the Caucasians.
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    Maternal Tetanus at the University College Hospital in Ibadan Nigeria: A 15-Year Retrospective Analysis
    (2008) Roberts OA; Morhason-Bello IO; Adedokun BO; Adekunle AO
    Objective To determine the characteristics of women with maternal tetanus, pattern of presentation and outcome of management. Methods A total of 19 women were managed with maternal tetanus between 1990 and 2005 from the University College Hospital in Ibadan Nigeria. A retrospective study was performed. The medical records of all women managed as a case of maternal tetanus were retrieved from the central record department of the hospital. The pattern of presentation, characteristics of women, the duration of hospital admission, tetanus toxoid immunization, and outcome of care were measured. Results The records of 18 women managed were analyzed. The mean age at presentation was 25.2 ± 5.3 years. The patients were mostly single, nulliparous and had primary school education. The maternal tetanus cases seen mainly complicated induced abortion while 5 and 2 other cases were due to childbirth complication and leg wound respectively. The portal of entry of the remaining 3 cases could not be ascertained. None of the patient managed had complete immunization schedule. The average duration of admission was 11.2 ± 6.7 d. Five women had intensive care with 3 of them requiring ventilatory support. The case fatality rate was 66.7%. The only factor that significantly improved survival was presence of generalized spasm at presentation (P=0.006) Conclusion The occurrence of maternal tetanus is a reflection of low quality of health care delivery and lack or inefficient routine immunization coverage in any community.
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    Biosocial Profiles and Pattern of Complaints of New Intrauterine Device Acceptors at the University College Hospital, Ibadan, Nigeria
    (2009) Okunlola MA; Morhason-Bello IO; Roberts AA; Tokzaka AA; Adekunle AO
    Objective To determine the pattern of biosocial characteristics of the new IUD acceptors and describe their concerns. Methods This was a retrospective review of records of new IUD acceptors at the University College Hospital, Ibadan, Nigeria from January to December 2007. Results The age range of subjects was 19 to 49 years with a mean of 33.5 ± 2.4 years. The commonest source (46.0%) of clientele referral was through the health care providers — doctors and nurse/midwife. Other referral patterns were from friends/ relative (23.5%), media — TV and radio (17.0%), outreach programmes (7.3%), self referral (5.2%) and others — the source was not indicated (1.2%). Of the total participants, only 239 (56.1%) reported for follow-up visits. Majority had at least one visit; about a third had two, while others had three or four and above visits. About 43.2% of those at follow-up visits had complaints. The commonest (37.5%) complaint was menstrual irregularity. Other complaints were cramping abdominal pain (22.2%), vaginal discharge (19.6%), amenorrhoea (10.3%), penile discomfort during sexual intercourse (4.3%), expulsion of IUD (3.8%) and 2.2% of missing IUD. Conclusion This audit shows that new IUD acceptors are largely referred by health care providers and are mainly offered the TCu380A version. Community outreach programmes as alternative strategy is likely to boost the uptake of this particular method in Nigeria.
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    Perception and Practice of Emergency Contraception among Female Undergraduates of the University of Ibadan, Nigeria
    (2009) Bello FA; Olayemi O; Fawole AO; Ogunbode OO; Sobukunola T; Adesina OA; Aimakhu C; Okunlola MA
    Objective To assess perception and level of proper utilization of emergency contraception (EC) among female undergraduates. Methods Cross-sectional questionnaire study was performed on 383 female undergraduates in Nigeria in June 2006. Data analysis was with χ-square test and logistic regressions (P<0.05). Results One hundred and five (48.2%) had been sexually exposed. Only 32 (30.5%) used regular contraception. Seventy-three (24.3%) female undergraduates were aware of EC. Only 29 (7.6%) had used EC before. Most would not use emergency contraceptive drugs in future due to lack of awareness (64.8%), and fear for future fertility and of drugs being injurious to health. Use of EC was associated with awareness of correct interval for use (OR=9.1; 95%CI: 2.1-39.9). Conclusion There is poor knowledge about EC and poor use, while significant need remains. Most knowledge was acquired from peers and inaccurate. Peer educators are important and professionals' knowledge needs improvement.
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    Neonatal Mortality in an Urban Population in Ibadan, Nigeria
    (2011) Adetola AO; Tongo OO; Orimadegun AE; Osinusi K
    Background Neonatal mortality remains a major contributor to death among children younger than 5 years in developing countries. This study was undertaken to determine the neonatal mortality rate (NMR), causes of death, and associated risk factors among hospital live births in a suburban population in Nigeria. Patients and Methods A total of 1058 consecutive live newborns at Adeoyo Maternity Hospital, Ibadan, were enrolled at birth and followed up in their homes for 28 days. The causes of death were extracted from hospital records, and verbal autopsy was used to determine the causes of death outside the hospital. Results The NMR was 32.1 per 1000 live births. The leading causes of death were severe perinatal asphyxia (79.4%), low birth weight (LBW: 55.9%), and infections (41.2%). The associated risk factors were lack of antenatal care [relative risk (RR)=45.18; 95% confidence interval (CI)=7.80, 261.60]; prolonged rupture of membranes (RR=4.47; 95% CI=1.95, 10.25); maternal peripartal fever (RR=5.42; 95% CI=2.35, 12.52); prematurity (RR=7.53; 95% CI=4.91, 11.55); and LBW (RR=5.50; 95% CI=3.88, 7.80). Conclusion NMR is high among hospital live births in Ibadan. There is a need for programs encouraging the use of antenatal care, improving skills on neonatal resuscitation and care of LBW infants; as well as implementation of community-based newborn survival strategies.
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    Evaluation of directly observed treatment short courses at a secondary health institution in Ibadan, Oyo State, Southwestern Nigeria
    (2013) Adegoke OA; Orokotan OA
    Objective To evaluate the success rate of tuberculosis intervention programme at a specialist hospital in Ibadan, Nigeria through a retrospective study as well as carry out physicochemical evaluation of anti-tuberculous agents as a way of eliminating drug-related failure. Methods The retrospective study involved the use of quarterly tuberculosis central register at the Government Chest Hospital, Ibadan between 1st quarter (2003) to 4th quarter (2009). Relevant data were extracted from these register with the aid of data collection forms. The basic physicochemical analyses of the drugs given to the patients were also carried out using the International Pharmacopoeia methods. Results All the drugs examined for their physicochemical properties passed the International Pharmacopeia recommended tests. A total number of 1 260 patients enrolled at the hospital were assessed through case notes. This comprises of 59.4% males of which 69.23% new cases were also males. There was a significant (P0.05). Failure rates in all categories were higher in males than females (P>0.05). Conclusions More enlightenment and counseling is still required to meet up with the target for TB control.
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    Pattern of childhood cancer in University College Hospital, Ibadan
    (2014) Babatunde TO; Akang EE; Ogun GO; Brown BJ
    Background Cancer is an important cause of morbidity and mortality among children under 15 years old worldwide. Aim: To describe the pattern of childhood cancer in Ibadan. Methods Histologically and cytologically confirmed cases of cancer in children aged <15 years diagnosed at the University College Hospital (UCH), Ibadan, between January 1991 and December 2010 were recruited. The cases were categorised using the International Classification of Childhood Cancer, third edition (ICCC-3). Results There were 625 cases, comprising 360 (57.6%) males with a modal age of 3 years. The most common neoplasms were lymphomas (22.4%). Other common neoplasms were retinoblastomas (21%), soft tissue sarcomas (14.9%), leukaemias (10.2%) and CNS tumours (6.9%). Lymphomas, bone tumours, malignant hepatic tumours and other malignant epithelial neoplasms had the highest mean and modal ages, while retinoblastomas, neuroblastomas, germ cell tumours and renal tumours had the lowest mean and modal ages. Conclusion There has been a decline in the frequency of childhood cancer cases at UCH, Ibadan, in the last 20 years. This may be due to establishment of additional specialist centres in the subregion. Retinoblastoma is now the most common individual childhood cancer at Ibadan, due to a persistent decline in the frequency of Burkitt lymphoma.
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    A novel plasmid carrying blaCTX-M-15 identified in commensal Escherichia coli from healthy pregnant women in Ibadan, Nigeria
    (2015) Fortini D; Fashae K; Villa L; Feudi C; García-Fernández A; Carattoli A
    The aim of this study was to investigate the molecular characteristics of commensal Escherichia coli producing extended-spectrum β-lactamases and showing fluoroquinolone resistance circulating in a healthy population in Ibadan, Nigeria. In total, 101 faecal samples from healthy pregnant women on the day of admission to hospital were collected and plated on eosin–methylene blue agar supplemented with cefotaxime. Genotyping demonstrated the presence of the blaCTX-M-15 gene in all of the cefotaxime-resistant isolates (n=32), and there was circulation of prevalent clones. The aac(6′)-Ib-cr, qnrS1, qepA1 and qnrB1 genes were identified in several strains. A novel plasmid supporting the spread of the blaCTX-M-15, blaTEM-1 and qnrS1 genes was identified in these isolates by complete DNA sequencing.
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    Detection and circulation of hepatitis B virus immune escape mutants among asymptomatic community dwellers in Ibadan, southwestern Nigeria
    (2015) Faleye TO; Adewumi OM; Ifeorah IM; Akere A; Bakarey AS; Omoruyi EC; Oketunde K; Awonusi OB; Ajayi MR; Adeniji JA
    Background In 2012, the first Nigerian Hepatitis B Virus (HBV) immune escape mutant (IEM) case was detected in a pregnant woman in southwestern Nigeria. Consequently, this study was designed to investigate the presence and possible circulation of IEMs amongst asymptomatic community dwellers in southwestern Nigeria. Methods Blood specimens collected from 438 asymptomatic community dwellers were screened for HBsAg using ELISA technique. Subsequently, the S-gene was amplified in HBsAg positive samples by a nested PCR protocol, and amplicons sequenced. Isolates were then subtyped by amino acid residues at positions 122, 127, 134 and 160, and genotyped by phylogenetic analysis. Results Of the 31 (7.08%) samples positive for HBsAg, the ∼408bp Sgene fragment was successfully amplified and sequenced in 27. Samples obtained from 4 patients could not be amplified due to low titres. Sequence data from only 15 of the isolates could be analysed further as eight of the remaining 12 had multiple peaks while the rest three showed no similarity to any HBV gene when subjected to BLAST analysis. Thirteen of the 15 isolates were identified as genotype E. Eleven of which were subtyped as ayw4 while the remaining two could not be subtyped due to sR122Q/P substitutions. The last two isolates that could not be genotyped and subtyped had other mutations in the “a” determinant associated with IEMs. Conclusions This study confirmed presence and circulation of HBV IEM in Nigeria, the country's inclusion in the genotype E crescent, and the value of phylogenetic analysis in HBV identification.
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    Awake craniotomy for intracranial lesions: An audit of the anaesthetists’ initial experience at the University College Hospital, Ibadan
    (2016) Idowu OK; Adeleye AO; Amanor-Boadu SD
    Background Awake craniotomy (AC) is an attractive ‘minimally invasive’ anaesthetic technique for intracranial surgical procedures. There is dearth of information on the feasibility of this technique from developing countries. Material and methods This is a prospective descriptive study on all the patients who had AC for intracranial surgery over a 2-year period in a developing country. The data regarding their demographics, preoperative, intraoperative and postoperative anaesthetic events and any intraoperative complications were recorded. Results There were 18 patients, 11 (61.1%) males, mean age of 47.5years (SD=14.71). Propofol and Fentanyl were the sole agents providing conscious sedation during these surgical cases, while 0.25% Plain Bupivacaine and 1% Lidocaine with Adrenaline (1:200,000) were used for operative site anaesthesia. Most of the tumours, 7 (38.9%), were found in the parietal region of the brain; 9 (50.1%) patients had between 5 and 10mm midline shift on brain MRI/CT Scan; metastatic tumours, 8 (44.4%), were the commonest lesions, and 13 (72.2%) had GCS of 15/15 prior to surgery. Hypertension and tachycardia, 3 cases (16.7%) in each, were the commonest intraoperative complications. All the patients successfully underwent the AC and none was admitted into the Intensive Care Unit postoperatively. At a mean follow-up of six months 10 (55.6%) patients were alive, 6 (33.3%) dead, and 2 (11.0%) of unknown status. Conclusions This audit showed AC to be a well-tolerated procedure with low rate of complications in our practice, an encouraging prospect for the feasibility of AC for intracranial surgical procedures in developing countries.
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    Zoo animals' disease pattern in a university zoological garden, Ibadan, Nigeria
    (2016) Emikpe BO; Morenikeji OA; Jarikre TA
    Objective To investigate wildlife diseases in Nigeria spanning across 20 years, highlighting various conditions diagnosed in zoo/wild animals using conventional and ancillary pathological techniques. Methods The animals were closely examined for signs of illness by the attending veterinarian and clinical samples were taken as appropriate. Carcasses were submitted for detailed necropsy by the experienced pathologists and diagnostic samples were taken for cytological, microbial isolation, parasitic identification and histopathology. Results Between 1991 and 2014 about 262 carcasses of zoo animals were presented for postmortem comprising ruminants (12.2%), primates (16.8%), carnivores (11.5%), reptiles (20.6%), Equidae (4.2%), rodents (5%) and aviary (29.7%). Pasteurellosis and other forms of respiratory diseases were common in ruminants; pneumonia, trichuriasis and dndocarditis were common in primates; tuberculosis and helminthiasis (ancylostomiasis) were common in carnivores; enteritis and impaction were common in reptiles; cholera, salmonellosis and Newcastle diseases were common in aviary. Conclusions It is important to know the causes of death in zoo animals and wildlife for purposes of preservation and conservation.
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    Barriers to radiotherapy access at the University College Hospital in Ibadan, Nigeria
    (2017) Anakwenze CP; Ntekim A; Trock B; Uwadiae IB; Page BR
    Introduction Nigeria has the biggest gap between radiotherapy availability and need, with one machine per 19.4 million people, compared to one machine per 250,000 people in high-income countries. This study aims to identify its patient-level barriers to radiotherapy access. Material and methods This was a cross sectional study consisting of patient questionnaires (n=50) conducted in January 2016 to assess patient demographics, types of cancers seen, barriers to receiving radiotherapy, health beliefs and practices, and factors leading to treatment delay. Results Eighty percent of patients could not afford radiotherapy without financial assistance and only 6% of the patients had federal insurance, which did not cover radiotherapy services. Of the patients who had completed radiotherapy treatment, 91.3% had experienced treatment delay or often cancellation due to healthcare worker strike, power failure, machine breakdown, or prolonged wait time. The timeliness of a patient’s radiotherapy care correlated with their employment status and distance from radiotherapy center (p<0.05). Conclusions Barriers to care at a radiotherapy center in a low- and middle-income country (LMIC) have previously not been well characterized. These findings can be used to inform efforts to expand the availability of radiotherapy and improve current treatment capacity in Nigeria and in other LMICs.
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    Field evaluation and confirmation of acute peste des petits ruminant outbreak in a flock of West African dwarf goats in Ibadan, Nigeria
    (2017) Balogun FA; Fasanmi OG; Oladipo TA; Popoola MA; Olona JF; Adeoye YD
    This study utilised epidemiological, haematological, pathological findings and serological detection of specific antibodies to evaluate and confirm a peste des petit ruminants (PPR) outbreak in a herd of West African dwarf (WAD) goats in Ibadan, Nigeria. The morbidity and mortality rates post exposure (PE) were 96% and 60% respectively. Laboratory analyses revealed significant differences (P<0.05) in mean values of the haematological and serum biochemical indices between the PE and control groups. The PE group experienced a significant (P<0.05) increase in white blood cell (WBC), lymphocyte and monocytes after 10days PE; the drop in glucose and high levels of alkaline phosphatase (ALP) and aspartate amino transferase (AST) indicated liver damage, while increased serum creatinine, blood urea nitrogen (BUN) and uric acid arose from kidney impairment. The electrolyte imbalance (potassium, sodium and chloride ions) resulting from the symptomatic diarrhea affected the functionality of the Na+–K+ pump mechanisms, hence pathologic damage to the liver, kidneys, skin, gastrointestinal, respiratory and cardiovascular systems. The competitive enzyme linked immuno-sorbent assay (c-ELISA) detected varying antibody levels in the PPR infected WAD goats; the percent inhibition was highest (P<0.001) in survivors (70.00±1.73), then in contact group (60.00±2.00), and least in infected (23.33±1.53), which were sero-negative. This study confirmed a PPR outbreak in a WAD goat flock in Ibadan, Nigeria.
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    Knowledge, attitude and practice with respect to soil contamination by Soil-Transmitted Helminths in Ibadan, Southwestern Nigeria
    (2018) Oyebamiji DA; Ebisike AN; Egede JO; Hassan AA
    Ancylostoma duodenale, Necator americanus, Ascaris lumbricoides and Trichuris trichiura, the four major Soil-transmitted helminths (STHs) and also Strongyloides stercoralis infect humans worldwide. Most studies on Soil-transmitted helminths (STHs) carried out in Ibadan were faecal examination based while relatively few soil examination based studies were carried out mostly around school premises using limited number of sampling locations. This study was therefore designed to assess the level of soil contamination with STH and associated risk factors in the eleven local government areas of Ibadan. A total of 1980 soil samples were purposively collected monthly, between January and December 2017, from toilet areas, refuse dump sites, house vicinities, playgrounds, roadsides/walk ways, and examined for the presence of parasite eggs or larvae using automated analysis of light microscopy images by computer. Well-structured questionnaires were administered to 620 consenting participants to obtain information on the Knowledge of STH infections, Attitudes and Practices towards the infections. Data were analyzed using SPSS version 21, Chi-square and ANOVA were used in the analysis at p < 0.05. Out of soil samples examined, 1087 (54.9%) had at least one species of parasite. The prevalence of hookworm was 74.5% followed by 50.2% and 37.2% for Strongyloides species larvae and adult respectively, and 25.1% for Ascaris species. The highest prevalence was observed in the refuse dump (74.2%) followed by toilet area (36.5%) while the lowest was at house vicinities (1.6%). Fifty-seven percent of the respondents use pit latrine while 20.6% still practice open defecation. A high transmission risk was observed as large percentage (66.8%) of the respondents showed inadequate knowledge of how to avoid STH infections. Moreover, 64.0% and 25.2% reported that they often walk barefooted and suck fingers respectively. The high prevalence of parasitic contamination of soil observed in the present study and the high proportion of respondent with inadequate knowledge of how to prevent transmission of STH pose a high risk of re-infections in the study area even after treatment. Therefore there is a need for proper education on parasite transmission in the area.