Browsing by Author "Aboyeji, A.P"
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Item Adeniran, A.S., Ocheke, A.N., Nwachukwu, D., Adewole, N., Ageda, B., Onile, TNon-obstetric causes of severe maternal complications: a secondary analysis of the Nigeria Near-Miss and Maternal Death Survey.(Royal College of Obstetricians and Gynaecologists, 2019-03-21) Adeniran, AS; Ocheke, AN; Nwachukwu, D; Adewole, N; Ageda, B; Onile, T; Umezulike, AC; Aboyeji, A.P; Oladapo, OT; Nigeria Near Miss and Maternal Death Surveillance NetworkObjective To evaluate the burden, causes and outcomes of severe non-obstetric maternal complications in Nigerian public tertiary hospitals. Design Secondary analysis of a nationwide cross-sectional study. Setting Forty-two tertiary health facilities. Population Women admitted with complications during pregnancy, childbirth or puerperium. Methods All cases of severe maternal outcome (SMO: maternal near-miss or maternal death) due to non-obstetric causes were prospectively identified over a 1-year period. Maternal near-miss was defined using organ-system dysfunction (WHO), clinical, or management-based criteria. Main outcome measures Causes and contributions of non-obstetric complications to SMO; fetal and neonatal outcomes; health service events associated with non-obstetric complications; and mortality index (% of maternal death/SMO). Results Of 100 107 women admitted with complications, 9401 (9.4%) were for non-obstetric causes; and 4.0% (375/9401) suffered severe non-obstetric complications. Of the 375 cases of severe nonobstetric complications, 48.8% (183/375) were near-misses and 51.2% (192/375) were maternal deaths. Severe anaemia unrelated to haemorrhage contributed 61.2% of near-misses and 32.8% of maternal deaths. The highest mortality indices were observed for cancer (91.7%), hepatic diseases (81.8%) and HIV/AIDS/HIV wasting syndrome (80.4%). Fatality was significantly high with extremes of age and no formal education. Regarding organ dysfunctions, neurological (77.1%) and cardiovascular (75.0%) dysfunctions had the highest mortality indices. Perinatal mortality was 65.9%. Time from diagnosis of severe non-obstetric complications to review by senior medical personnel, and to definitive intervention was <30 minutes in 30.2% and 29.8% of women with SMO, respectively. However, over 240 minutes elapsed between diagnosis and definitive intervention in more than one-third of women with SMO. Conclusion Non-obstetric complications are associated with poorer pregnancy outcomes and deserve attention similar to that accorded obstetric complications.Item Comparative analysis of caesarean delivery among out-of-pocket and Health insurance clients in Ilorin, Nigeria.(National Postgraduate Medical College of Nigeria, 2020-04-11) Adeniran, A.S; Aun, II; Fawole, A.A; Aboyeji, A.PBackground: Although out‑of‑pocket (OOP) payment for health services is common, information on the experience in maternal health services especially caesarean delivery (CD) is limited. Aim: To compare the pregnancy events and financial transactions for CD among OOP and health‑insured clients. Materials and Methods: A comparative (retrospective) study of 200 women who had CD as OOP (100 participants) or health‑insured clients (100 participants) over 30 months at Anchormed Hospital, Ilorin, using multistage sampling was conducted. The data were analysed using Chi‑square, t‑test and regression analysis; P < 0.05 was considered statistically significant. Results: Of 1246 deliveries, 410 (32.9%) had CD; of these, 186 (45.4%) were health‑insured and 224 (54.6%) were OOP payers. The health‑insured were mostly civil servants (60.0% vs. 40.0%; P = 0.009) of high social class (48.0% vs. 29.0%; P = 0.001). The payment for CD was higher among OOP (P = 0.001), whereas duration from hospital discharge to payment of hospital bill was higher for the health‑insured (P = 0.001). On regression, social class (odds ratio [OR]: 0.23, 95% confidence interval [CI]: −0.0891252–0.112799; P = 0.048), amount paid (OR: 48.52, 95% CI: −7.14–6.68; P = 0.001) and duration from discharge to payment (OR: 28.68, 95% CI: 51.7816–70.788; P = 0.001) were statistically significant among participants. The amount paid was lower (P = 0.001), whereas time interval before payment was longer (P = 0.001) for the public‑insured compared to private‑insured clients. Conclusion: OOP payers are prone to catastrophic spending on health. The waiting time before reimbursement to health‑care providers was significantly prolonged; private insurers offered earlier and higher reimbursement compared to public insurers. The referral and transportation of health‑insured clients during emergencies is suboptimal and deserve attention.Item Domestic Violence and Obstetric Outcome among Pregnant Women in Ilorin, North Central, Nigeria.(International Federation of Obstetrics and Gynaecology (FIGO), 2014) Eno, E.E; Fawole, A.A; Aboyeji, A.P; Adesina, K.T; Adeniran, ASItem Normal CD4 Count Range among Healthy Nigerian Population in Ilorin(2014) Afolabi, J.K.; Fadeyi, A; Desalu, O O.; Durotoye, I. A; Fawibe, A. E.; Adeboye, M.A.N; Olawumi, H.O; Babatunde, A.S; Ernest, S.K; Aderibigbe, S.A; Saadu, R; Salami, A.K; Aboyeji, A.PBackground: For the establishment and monitoring of the immune status, CD4 count is critical. Objectives: To determine the CD4 count range of apparently healthy Nigerians resident in Ilorin and compare with the national value. Methods: An automated blood analyzer was used to determine the full blood count and CD4 count. The percentage of CD4 count was derived by using other variables. Results: Of the 1205 participants, the reference CD4 count (percentage of CD4) range for adult was 400 to 1288 cells/mm3 (19%-48%) and for children was 582 to 3652 cells/mm3 (17%-50%). CD4 count and percentage of CD4 were significantly (P ¼ .001) higher in females than in males, and the CD4 count declined significantly with increasing age (r ¼ .174, P .0001). The percentage of CD4 count shows less variation with age (r ¼ .051, P ¼ .076). Adult residents of Ilorin had significantly lower absolute mean CD4 count (808 + 260) than that of the national reference values of 847.0 + 307.0 cells/mm3 (P ¼ .001). Conclusion: We therefore advocate the use of CD4 count range derived in this study is lower than that of the national reference values.Item Pre-and-post-operative aversion among women whose partners had caesarean delivery in a patriarchal setting.(Ghana Medical Association, 2021-12) Adeniran, AS; Ogunlaja, OO; Ogunlaja, IP; Okesina, SB; Fawole, A.A; Adesina, K.T; Aboyeji, A.PObjectives: The study evaluated pre and post-operative perception and aversion to caesarean delivery (CD) among men whose partners underwent the procedure. Design: A multicentre cross-sectional study. Setting: Two tertiary and two secondary health facilities. Participants: Men whose partners underwent CD at the study sites. Methods: Participants were recruited by purposive sampling, data collection was through interaction via an interviewer- administered questionnaire first immediately the decision for CD was made and thereafter on the third postoperative day. Men whose partners had vaginal delivery were excluded from the study and data management was with SPSS version 21.0 while p<0.05 was significant. Results: Awareness about CD was 84.0% mainly through the healthcare workers (42.1%) and the female partner (34.1%); 88.0% of participants recommended CD for medically-indicated reasons. The greatest influence on consent was the male partner (48.8%). The major pre-operative concerns were limitation of family size (34.7%) and fear of repeat CD (34.0%). Pre-operative perceptions of CD included being expensive (60.7%), fear of the procedure (48.0%), fear of complications (45.3%) and longer hospital stay (44.0%). Aversion to CD was 30.0% pre and 5.3% post-operation; predictors of aversion were history of previous surgery among male or female partner and awareness about CD. However, there were reductions in negative perception and aversion post-operation. Conclusion: The high negative perception and aversion to CD among male partners were reduced post-operation. Healthcare workers should address the concerns and negative perceptions about CD and prioritize patient-friendly experiences during surgical operations.Item Pregnancy Outcome in Cervical Incompetence: Comparison of Outcome Before and After Intervention.(Society of Obstetrics and Gynaecology of Nigeria (SOGON), 2014-04) Adeniran, A.S; Aboyeji, A.P; Okpara, E.U; Fawole, A.A; Adesina, K.TItem REFERENCE VALUES OF HAEMATOLOGICAL PARAMETERS OF HEALTHY ADULTS IN THE NORTH CENTRAL ZONE OF NIGERIA(Kenya Medical Association, 2015-08) Olawumi, H.O.; Durotoye, I A.; Afolabi, J.K; Desalu, O.O; Aderibigbe, S.A; Babatunde, A.S; Ernest, S.K; Fawibe, A.E; Salami, A.K; Saadu, R; Adeboye, MAN; Aboyeji, A.PBackground: Haematological parameters differ from one population to another due to several factors. To determine the clinical implication of the blood parameters of an individual in the state of health or disease, we need to have the knowledge of the normal reference range for that locality. Objectives: To determine the reference values of haematological parameters of apparently healthy adults in Ilorin. Design: A descriptive cross sectional study. Setting: Ilorin, North Central zone of Nigeria Subjects: Nine hundred and ten (443 males and 467 females) randomly selected normal, HIV negative individuals aged 18-65 years Results: The red blood cell count, Haemoglobin concentration, PCV and MCHC were significantly higher among males than females while the platelet count, total WBC count and absolute neutrophil count were significantly higher in females than in males. There was however no significant gender difference in the values of MCV, MCH and absolute lymphocyte count. The normal reference values obtained in this study were notably different from those that are used currently in the hospital. Conclusion: The normal reference value obtained in this study was notable different from those that are currently used in the hospital. These findings will have clinical implications regarding the adjustment of our current reference values and definitely add value to the management of patients in this part of the country.Item Spousal participation during pregnancy and delivery in Ilorin, Nigeria.(Zambia Medical Association, 2019) Adeniran, AS; Fawole, A.A; Adesina, K.T; Aboyeji, A.P; Balogun, OR; Ijaiya, M.A.Background: The potential benefits of the active involvement of men in antenatal and intrapartum events remain largely unexplored in low-resource countries despite the reported benefits from high income areas. Aim: To evaluate male partners' attitudes and experience on their level of involvement during pregnancy, labour and delivery. Methods: A cross-sectional study conducted at four health facilities in North Central Nigeria from 1st February to 30th July 2017. Participants were male partners of women who were pregnant during the study period; recruitment was after informed consent, data management was with SPSS (version 21.0); p <0.05 was significant. Results: The male partners were aged 23 to 60 years (mean 35.96±6.76), 173 (69.2%) accompanied the partner to antenatal clinic and 150(60.0%) to ultrasound scan examination. The commonest hindrance to men's antenatal participation was commuter marriage (29; 37.7%); 171(68.4%) participants supported the presence of the man at delivery while 32(40.5%) opined that men may disturb the health provider during delivery. Also, 137(54.8%) men have requested to be present at delivery previously while 46(33.6%) were obliged among those obliged, 25(54.3%) described the experience as satisfactory while 28(60.9%) intend to be present at future deliveries. In all, 212(84.8%) suggested antepartum education classes for male partners, 202(80.8%) intend to attend such classes while 143(57.2%) suggested health facility restructuring to facilitate men's participation. Conclusion: Men are increasingly desirous of active participation at antenatal and intrapartum events; increasing male partner education, male-friendly facility infrastructures and health providers' cooperation will encourage them to fulfil these roles.