Browsing by Author "Igumbor, Ehimario"
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Item Assessing the capacity of symptom scores to predict COVID-19 positivity in Nigeria: A national derivation and validation cohort study(BMJ Publishing Group, 2021) Elimian, Kelly Osezele; Aderinola, Olaolu; Igumbor, Ehimarios This study aimed to develop and validate a symptom prediction tool for COVID-19 test positivity in Nigeria.A cohort of 43 221 individuals within the national COVID-19 surveillance dataset from 27 February to 27 August 2020. Complete dataset was randomly split into two equal halves: derivation and validation datasets. Using the derivation dataset (n=21 477), backward multivariable logistic regression approach was used to identify symptoms positively associated with COVID-19 positivity (by real-time PCR) in children (≤17 years), adults (18–64 years) and elderly (≥65 years) patients separately.Item Descriptive epidemiology of coronavirus disease 2019 in Nigeria, 27 February-6 June, 2020(Cambridge University Press, 2020) Igumbor, Ehimario; Elimian, Kelly Osezele; Ochu, Chinwe LuciaThe objective of this study was to describe the epidemiology of COVID-19 in Nigeria with a view of generating evidence to enhance planning and response strategies. A national surveillance dataset between 27 February and 6 June, 2020 was retrospectively analysed, with confirmatory testing for COVID-19 done by real-time polymerase chain reaction (RT-PCR). The primary outcomes were cumulative incidence (CI) and case fatality (CF). A total of 40926 persons (67% of total 60839) had complete records of RT-PCR test across 35 States and the Federal Capital Territory, 12289 (30.0%) of whom were confirmed COVID-19 cases. Of those confirmed cases, 3467 (28.2%) had complete records of clinical outcome (alive or dead), 342 (9.9%) of which died. The overall CI and CF were 5.6 per 100000 population and 2.8%, respectively.Item The HIV epidemic in South Africa: Key findings from 2017 national population-based survey(MDPI, 2022) Zuma, Khangelani; Simbayi, Leickness; Igumbor, EhimarioSouth Africa has the largest number of people living with HIV worldwide. South Africa has implemented five population-based HIV prevalence surveys since 2002 aimed at understanding the dynamics and the trends of the epidemic. This paper presents key findings from the fifth HIV prevalence, incidence, and behaviour survey conducted in 2017 following policy, programme, and epidemic change since the prior survey was conducted in 2012. A cross-sectional populationbased household survey collected behavioural and biomedical data on all members of the eligible households. A total of 39,132 respondents from 11,776 households were eligible to participate, of whom 93.6% agreed to be interviewed, and 61.1% provided blood specimens. The provided blood specimens were used to determine HIV status, HIV incidence, viral load, exposure to antiretroviral treatment, and HIV drug resistance. Overall HIV incidence among persons aged 2 years and above was 0.48% which translates to an estimated 231,000 new infections in 2017.Item An intervention programme for management of overweight and obese Nigerians in Lagos State, Nigeria(University of the Western Cape, 2014) Akindele, Mukadas Oyeniran; Phillips, J.S.; Igumbor, EhimarioOver the past decades there has been a global increase in the prevalence of overweight and obesity. The increase in the prevalence of overweight and obesity leads to surging of associated co-morbidities of overweight and obesity in low/medium income countries which eventually overburdens the vulnerable health systems threatens by malnutrition and communicable diseases in low/medium income countries. The designed interventions to curb overweight/obesity in high income countries might be inappropriate to apply in low income countries, such as Nigeria, due to the different cultural norms and values regarding types of food, and physical activity. The overall aim of this study is to design an intervention that will be culturally appropriate for overweight and obesity management among Nigerians. The convergent parallel mixed method design specifically was used in this study. This involves simultaneous timing of carrying out both quantitative and qualitative strands of mixed methods during the same phase of the research process, prioritizes the methods equally, and keeps the strands autonomous during analysis and then mixes the results during overall implementation/execution. The population for the quantitative part was Nigerians residing within sixteen enumeration areas of Alimosho Local Government area of Lagos State, Nigeria. Overweight and obese Nigerians as well as traditional healers and healthcare professionals were purposely selected for the qualitative phase. Delphi study was the last phase of study which involved recruitment of healthcare professionals in the management of overweight and obesity. A sample size of 2250 was projected and approached for this while 1571 consented and participated in the study. This gave a response rate of 69.82%. About 51.2% of the sample population was male and 48.8% female. The mean age of the total sample was 35.36(SD =11.66). Using BMI, the prevalence of overweight/obesity was 42.3% using BF%, the prevalence of body fatness was 39.2% of which 62.5% were females. Data analysis shows strong positive correlation between other measures of body fatness (.694 to .872) except WHR with low but positive relationships between BF% (184), BMI (.280), WC (.495), and negative relationships with HC (-.077) and BAI (-.076). Gender, marital status and age are predictors of overweight and obesity among Nigerians. Type of diet, meal timing, reduced physical activity and genetic factor were perceived as the causes of overweight and obesity. Diet therapy, an increase in physical activity and the use of herbs were various ways perceived to assist in reducing excess body weight. Among the challenges faced by overweight and obese Nigerians were lack of time for exercise because of the nature of their jobs, lack of recreational facilities, lack of motivations and support from family members to reduce weight, lack of money and poor/lack of knowledge to reduce weight. Experts unanimously agreed that the content of a culturally appropriate intervention should be individualised and to include physical activity/exercise, diet therapy, education and self-monitoring. There was a unanimous decision that the intervention should be done for a duration of 12 weeks at health facility and should be held for between 1-2 times per week if holding at community (excluding community/ public health facility) for 12 weeks in total. In addition, experts agreed that the use of media such as television, radio, weekly newspapers and magazines should be used for preventive campaigns.Item Is there risk compensation among HIV infected youth and adults 15 years and older on antiretroviral treatment in South Africa? Findings from the 2017 national HIV prevalence, incidence, behaviour and communication survey(MDPI, 2022) Zungu, Nompumelelo; Mabaso, Musawenkosi; Igumbor, EhimarioIn this paper, risk compensation among individuals on antiretroviral therapy (ART), using the 2017 South African national survey on HIV, is explored. A multi-stage stratified cluster random sampling approach was used to realize 11,130 participants 15 years and older. Logistic regression analysis assessed the association between multiple sexual partners, condom use at last sexual encounter, consistency of condom usage and potential explanatory variables using HIV status and ART exposure as a mediator variable. HIV positive participants who were aware and on ART were less likely to have multiple sexual partners, and less likely not to use a condom at last sex compared to HIV positive participants who were aware but not on ART. The odds of reporting multiple sexual partners were significantly lower among older age groups, females, non-Black Africans, and rural settings, and higher among those with tertiary level education, and risky alcohol users.Item Tobacco control environment: cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries(BMJ Publishing Group, 2017) Chow, Clara K.; Corsi, Daniel J.; Gilmore, Anna B.; Kruger, Annamarie; Igumbor, EhimarioOBJECTIVES: This study examines in a cross-sectional study ‘the tobacco control environment’ including tobacco policy implementation and its association with quit ratio. SETTING: 545 communities from 17 high-income, upper-middle, low-middle and low-income countries (HIC, UMIC, LMIC, LIC) involved in the Environmental Profile of a Community’s Health (EPOCH) study from 2009 to 2014. PARTICIPANTS: Community audits and surveys of adults (35–70 years, n=12 953). PRIMARY AND SECONDARY OUTCOME MEASURES: Summary scores of tobacco policy implementation (cost and availability of cigarettes, tobacco advertising, antismoking signage), social unacceptability and knowledge were associated with quit ratios (former vs ever smokers) using multilevel logistic regression models. RESULTS: Average tobacco control policy score was greater in communities from HIC. Overall 56.1% (306/ 545) of communities had >2 outlets selling cigarettes and in 28.6% (154/539) there was access to cheap cigarettes (<5cents/cigarette) (3.2% (3/93) in HIC, 0% UMIC, 52.6% (90/171) LMIC and 40.4% (61/151) in LIC). Effective bans (no tobacco advertisements) were in 63.0% (341/541) of communities (81.7% HIC, 52.8% UMIC, 65.1% LMIC and 57.6% LIC). In 70.4% (379/538) of communities, >80% of participants disapproved youth smoking (95.7% HIC, 57.6% UMIC, 76.3% LMIC and 58.9% LIC). The average knowledge score was >80% in 48.4% of communities (94.6% HIC, 53.6% UMIC, 31.8% LMIC and 35.1% LIC). Summary scores of policy implementation, social unacceptability and knowledge were positively and significantly associated with quit ratio and the associations varied by gender, for example,communities in the highest quintile of the combined scores had 5.0 times the quit ratio in men (Odds ratio (OR) 5 0, 95% CI 3.4 to 7.4) and 4.1 times the quit ratio in women (OR 4.1, 95% CI 2.4 to 7.1). CONCLUSIONS: This study suggests that more focus is needed on ensuring the tobacco control policy is actually implemented, particularly in LMICs. The gender-related differences in associations of policy, social unacceptability and knowledge suggest that different strategies to promoting quitting may need to be implemented in men compared to women.Item Towards achieving the 90–90–90 HIV targets: Results from the south African 2017 national HIV survey(Springer Nature, 2020) Igumbor, Ehimario; Marinda, Edmore T.; Simbayi, Leickness ChisamuBackground: Measuring progress towards the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90–90–90 treatment targets is key to assessing progress towards turning the HIV epidemic tide. In 2017, the UNAIDS model estimated that 75% of people living with HIV (PLHIV) globally knew their HIV positive status, 79% of those who knew their status were on antiretroviral therapy (ART), and 81% of those who knew their HIV status and were on ART had a suppressed viral load. The fifth South African national HIV sero-behavioural survey collected nationally representative data that enabled the empirical estimation of these 90–90–90 targets for the country stratified by a variety of key factors. Methods: To evaluate progress towards achievement of the 90–90–90 targets for South Africa, data obtained from a national, representative, cross-sectional population-based multi-stage stratified cluster random survey conducted in 2017 were analysed. The Fifth South African National HIV Prevalence, Incidence, Behaviour and Communication Survey (SABSSM V), collected behavioural and biomarker data from individuals residing in households from 1000 randomly selected Small Area Layers (SALs), across all nine provinces of the country. Structured questionnaires were used to collect socio-demographic data, knowledge and perceptions about HIV, and related risk behaviours.