Browsing by Author "Igumbor, Ehimario Uche"

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    Covid-19 vaccine effectiveness studies in Nigeria: Quo vadis?
    (International Society of Global Health, 2022) Akande, Oluwatosin Wuraola; Igumbor, Ehimario Uche; Elimian, Kelly Osezele
    The “lickety-split” development of COVID-19 vaccines 326 days from when the SARS-COV-2 virus was first sequenced is indeed one of the public health successes of the 21st century. Particularly because an 18-month target was initially considered reasonable, and having achieved this success, a “moonshot” goal to ensure that a vaccine is available within 100 days after the next pandemic pathogen is recognized has been set [1].
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    Epidemiology and burden of chronic pain within the Eastern Cape Province, South Africa
    (University of the Western Cape, 2010) Igumbor, Ehimario Uche; Puoane, Thandi
    Pain is a complex biopsychosocial phenomenon that can have a profound impact on people's lives (Access Economics [AE], 2007). lts clinical relevance is well known - pain is suggestive of "actual or potential tissue damage" and plays a role in the diagnosis and clinical management of diseases and/or injury (International Association for the Study of Pain [IASP], 1986). It has both sensory and emotional aspects and is behaviourally expressed by how it is communicated by the sufferer and by its effect on the sufferer's behaviour (IASP, 1986; Linton, 2005; AE, 2007). Even though the experience of pain is associated with tissue damage or is described in terms of such damage, this association is variable so that "the size of an injury can be a poor guide as to how much an individual experiences pain" (AE, 2007). In fact, pain can exist without an objective evidence of tissue damage making pain the "ultimate subjective experience" (Odendaal, 2006). This phenomenon may relate to the fact that the interpretation of nociceptive signals as pain is influenced by a number of personal and environmental factors including past experience, integrity of the nervous system, beliefs and the situation in which tissue damage occurs (Eccleston, 2001; Turk, 2002a; Flor and Hermann, 2004; AE, 2007). As such, decisive and objective measurements are difficult to arrive at and pain is not always easily assessed by the healthcare provider. The translation of pain from acute to chronic however, means that pain and discomfort remains beyond the normal time of healing and by definition, persists either continuously or intermittently for 3 months or longer (Elliot et al., 1999). This changes the physiognomy of pain and the condition of chronic pain ensues. Chronic pain is an important but often neglected public health problem. It is disabling and associated with interference in normal activities of daily living (ADLs) such as work, home chores, family and sporting activities. Research shows that chronic pain is a key complaint that motivates many to seek health care (Crook et al., 1984, 1989; Sullivan et al., 1990; Smith et al., 1996; Mantyselka et al., 2001, 2002; Eriksen et al., 2004; AE, 2007) leading to high and ongoing consumption of treatments (AE, 2007). In fact, studies have shown that persons with chronic pain use health services up to five times more frequently than the rest of the population (Von Korff et al., 1990, 1991; Elliot et al., 1999; Eriksen et al., 2004). Side-effects of treatment are common with medication use including gastric problems such as ulcerations, nausea, constipation and mental slowing or confusion which can affect functioning. Chronic pam is also associated with mood and sleep disturbances such as depression or adjustment problems and trouble getting to sleep and/or frequent wakening during the night. For the sufferer, the effect of disuse of the aspect of the body in which pain is experienced is another manifestation of chronic pain. Muscles and joints become de-conditioned and pain sufferers may lose general body fitness (AE, 2007). Within the community, pain is a common cause of considerable suffering and disability affecting the general health and quality of life of individuals (Von Korff et al., 1990, 1992; Magni et al., 1990,1993; Walsh et al., 1992; Smith et al., 1996,2001; Verhaak et al., 1998; Elliot et al., 1999, 2002; Blyth et al., 2001; Reyes-Gibby et al., 2002; Lanteri-Minet et al., 2003). Significant amounts of working days are lost among the labour force impacting a profound economic and social toll on society (Bowsher et al., 1991; Elliot et al., 1999; Blyth et al., 2003; Igumbor et al.,2003). Simply put, "chronic pain is a human tragedy" (Odendaal, 2006). It is a serious and common problem that causes distress to patients and their caregivers, is a burden on health care professionals and health care resources and results in significant lost productivity. Chronic pain is therefore a problem of public health importance.
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    Innovative, rapid, high-throughput method for drug repurposing in a pandemic—A case study of SARS-CoV-2 and Covid-19
    (Frontiers Media, 2023) Bello, Shaibu Oricha; Yunusa, Abdulmajeed; Igumbor, Ehimario Uche
    Several efforts to repurpose drugs for COVID-19 treatment have largely either failed to identify a suitable agent or agents identified did not translate to clinical use. Reasons that have been suggested to explain the failures include use of inappropriate doses, that are not clinically achievable, in the screening experiments, and the use of inappropriate pre-clinical laboratory surrogates to predict efficacy. In this study, we used an innovative algorithm, that incorporates dissemination and implementation considerations, to identify potential drugs for COVID-19 using iterative computational and wet laboratory methods. The drugs were screened at doses that are known to be achievable in humans. Furthermore, inhibition of viral induced cytopathic effect (CPE) was used as the laboratory surrogate to predict efficacy.
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    Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016
    (Elsevier, 2018) Igumbor, Ehimario Uche; Lozano, Rafael; Fullman, Nancy
    Background: A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods: Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0–100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0–100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita.