Browsing by Author "Ojuawo, Olutobi B"
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Item Smear Negative Pulmonary Tuberculosis Is a Distinct Clinical Entity, Not a “Misdiagnosis Waste Basket”(Clinical Medicine International Library, 2022) Fawibe, Ademola E; Desalu, Olufemi O; Agede, Olalekan A; Ojuawo, Olutobi B; Oloyede, Taofeek; Aladesanmi, Adeniyi OBackground: PTB can mimic many chronic lung diseases resulting in misdiagnosis with serious consequences. Objectives: To appraise all SN PTB patients who were referred to us from lower health facilities after unsuccessful treatment in order to confirm the appropriate diagnosis. Methods: A cross sectional study at the pulmonary section of our hospital. Results: The median age of our patients was 46 with interquartile range of 32 to 54 years. The commonest presenting symptom was difficulty in breathing which was present in almost 90% of them (30 out of 34), cough was present in 24 with sputum production in 22 while haemoptysis was reported in 3. All the 5 patients with malignancy reported chest pain. Sixty eight percent of the patients were referred from Peripheral TB DOT centers and sputum smear tests were done in 82% of them while radiologic tests were done in less than 50% of the patients. The final diagnoses include COPD, malignancy, sarcoidosis, interstitial lung diseases and fungal infection among others. Conclusion: Many lung diseases are misdiagnosed as SN PTB because of similarity in clinical presentation, overreliance on diagnostic test with low TB detection and non adherence to local guidelines. We advocate for WHO-recommended rapid molecular test for all our suspected TB cases and prompt referral of difficult to diagnose cases.Item Urban–Rural Differences in the Epidemiology of Asthma and Allergies in Nigeria: A Population-Based Study(Dove Medical Press, 2021) Desalu, Olufemi O; Adeoti, Adekunle O; Ojuawo, Olutobi B; Aladesanmi, Adeniyi O; Oguntoye, Michael S; Afolayan, Oluwafemi J; Bojuwoye, Matthew Olumuyiwa; Fawibe, Ademola EPurpose: Urbanization is associated with the risk of developing allergic conditions. Few studies have evaluated the urban–rural disparity of allergic diseases in sub-Saharan Africa. Objective: To compare the epidemiology of adult asthma and allergies in urban and rural Nigeria. Subjects and Methods: A population-based cross-sectional study was performed among 910 subjects in Kwara State, North Central Nigeria, comprising 635 urban and 275 rural adults who were randomly selected. We used standardized questionnaires for data collection. Results: The age-adjusted prevalence of adults reporting a previous “asthma attack” or “currently taking asthma medication” within the preceding 12 months (ECRHS asthma definition) was 3.4% urban, 0.5% rural, current allergic rhinoconjunctivitis (26.2% urban, 22.2% rural), and current skin allergy (13.9% urban, 10.5% rural). The age-adjusted prevalence of “physician-diagnosed allergic conditions”: asthma (3.3% urban, 1.5% rural), allergic rhinoconjunctivitis (4.9% urban, 3.2% rural), and skin allergy (4.8% urban, 4.6% rural) were higher in urban areas than in rural areas. Urban areas recorded a higher age-adjusted 12 months prevalence of wheezing, night waking by breathlessness, night waking by chest tightness, asthma attack (p=0.042), and current use of asthma medication (p=0.031) than the rural areas. In the urban areas, 81% of those with asthma significantly had current allergic rhinoconjunctivitis, and 40.5% had current skin allergy, whereas in the rural areas, all subjects with asthma had current allergic rhinoconjunctivitis and 12.5% had current skin allergy (p=0.482). The most common trigger for asthma attack/respiratory symptoms among the urban household was exposure to environmental smoke (17.2%), and among the rural household, it was dust exposure (18.2%). Living in urban areas significantly increased the odds of having asthma [aOR: 5.6 (95% CI:1.6–19.6)] and allergic rhinoconjunctivitis [aOR: 1.7 (95% CI: 1.2–2.4)]. Conclusion: This study shows that urban residents frequently reported more allergic and respiratory symptoms and were at risk of having asthma and allergic rhinitis compared to rural residents. The findings would assist the physicians in understanding the urban–rural differences in the occurrence of allergic conditions, symptom triggers, and comorbidity, which are relevant in patient’s clinical evaluation, treatment, and disease prevention.