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Objective: This study aimed to identify individual and contextual factors that are associated with under- and over-nutrition among school-aged children and adolescents in two Nigerian states. Design: Community-based cross-sectional study. Setting: The study was carried out in rural and urban communities of Osun and Gombe States in Nigeria. Participants: A total of 1200 school-aged children and adolescents. Results: Multi-level analysis showed that the full models accounted for about 82 % and 39 % of the odds of thinness or overweight/obese across the communities, respectively. Household size (adjusted OR (aOR) 1·10; P = 0·001; 95 % CI (1·04, 1·16)) increased the odds, while the upper wealth index (aOR 0·43; P = 0·016; 95 % CI (0·22, 0·86)) decreased the odds of thinness. Age (aOR 0·86; P < 0·001; 95 % CI (1·26, 8·70)), exclusive breastfeeding (aOR 0·46; P = 0·010; 95 % CI (0·25, 0·83)), physical activity (aOR 0·55; P = 0·001; 95 % CI (0·39, 0·78)) and the upper wealth index (aOR 0·47; P = 0·018; 95 % CI (0·25, 0·88)) were inversely related with overweight/obesity, while residing in Osun State (aOR 3·32; P = 0·015; 95 % CI (1·26, 1·70)), female gender (aOR 1·73; P = 0·015; 95 % CI (1·11, 2·69)) and screen time > 2 h/d (aOR 2·33; P = 0·005; 95 % CI (1·29, 4·19)) were positively associated with overweight/obesity. Conclusions: The study shows that selected community and individual-level factors are strongly associated with thinness and overweight/obesity among school-aged children and adolescents. [ABSTRACT FROM AUTHOR]

Introduction: insured-persons have complained about poor quality of services rendered by health care providers, which has consequently affected their satisfaction with care received. The objectives of this study aimed to identify the determinants of satisfaction and compare the level of clients' satisfaction with quality of care received in both public and private health care facilities, in Oyo-State, Nigeria. Methods: this was a cross sectional study, comparative in design. A total number of 300 clients were recruited from selected public and private health facilities in Oyo-state, using a multistage sampling technique. Data were analyzed using IBM SPSS version 24, and the level of significance was set at p-value < 0.05. Results: the mean age of the respondents in private and public health facilities was 39.9 ± 10.0 years and 42.4 ± 10.1 years respectively. About 74% and 41.3% of the enrolees in the public and private health facilities respectively were dissatisfied with waiting time before receiving care with a statically significant difference of p=0.002. Majority of the respondents (82.7%) in the public health facilities and only 42.7% of those using private health care facilities were satisfied with the quality of drugs given to them at their respective pharmacies. This finding was statistically significantly different with p=0.001. Overall level of satisfaction with quality of care was 60% and 40% among enrolees using public and private health facilities respectively. There was a statistically significance difference (p=0.028) between the overall level of satisfaction and the type of health facility used by the clients. The determinants of clients' satisfaction with quality of care in both private and public health facilities in this study were mainly socio-demographic characteristics; age (p=0.007), level of education (p=0.046) and occupation (p=0.004), the waiting time experience and the type of facility where services were accessed. Conclusion: clients attending public health facilities were more satisfied with care received under NHIS, compared with those using private health facilities. Efforts should be made to reduce waiting time and improve quality of drugs in the public and private facilities respectively. [ABSTRACT FROM AUTHOR]

Background: Owing to progressive urbanization and the associated changes in lifestyle, childhood overweight/obesity is becoming a challenging problem in many emerging countries while malnutrition is far from being over. This study, which was carried out in the school setting, therefore, aimed to compare the pattern and determinants of the weight status of school-age children from rural and urban communities of Osun State, Nigeria. Methodology: A total of 300 respondents each was selected from a rural and an urban community using multi-stage sampling technique. Information from respondents was obtained using pretested semi-structured questionnaires and their weights and heights were measured and used to calculate their body mass index (BMI). Data collection was done from September to December, 2013. The BMI was used to classify them into those underweight, normal and overweight/obese using the IOTF criteria. Data analysis was done with Statistical Package for Social Sciences (SPSS) version 16. Results: The children differed significantly in their nutrition history and activity patterns according to their residence. With the IOTF criteria, the prevalence rates of underweight and overweight/obesity in the children from rural communities were 36.7% and 0.0% respectively; and 17.3% and 9.7% in the children from urban communities, respectively. Conclusion: Underweight is still a major problem among school-age children in Osun State, especially for those living in rural communities. There is also a rising trend of overweight/obesity in the urban communities in the State. A comprehensive school health program for the primary schools with emphasis on good nutrition is hereby recommended. [ABSTRACT FROM AUTHOR]

Introduction. Young people are at the centre of the global HIV/AIDS epidemic. This study therefore aimed to evaluate the effectiveness of peer education in improving HIV knowledge, attitude, and preventive practices among in-school adolescents in Osun State, Nigeria. Methods. This was an intervention study that was carried out among in-school adolescents attending mixed secondary schools in Osun State, Nigeria. The study was in three stages: before intervention, intervention, and after intervention. The impact of peer education was evaluated twelve weeks after intervention. Data were collected using pretested semistructured questionnaires and data analysis was done with SPSS version 16. Results. At the preintervention stage, the study and control groups were similar in their sociodemographic characteristics, HIV knowledge, attitude, and preventive practices, including high risk behaviours for HIV/AIDS transmission. After the peer education intervention, those with good knowledge and positive attitudes towards HIV/AIDS increased significantly from 50.0% to 86.7% and from49.0% to 85.6%, respectively (P< 0.05). Conclusion. The study showed that peer education is effective in improving knowledge, attitude, and some preventive practices towards HIV/AIDS among in-school adolescents. Educational programmes about HIV/AIDS should therefore be designed to target this age group putting into consideration their unique characteristics. [ABSTRACT FROM AUTHOR]

Background: Little evidence exists on the relationship between diet-related factors and child/adolescent malnutrition in Nigeria. This study aimed to assess the associations between household food insecurity (HFI), dietary diversity (DD), and dietary patterns (DP) with the double burden of malnutrition (DBM) among 6–19-year-olds in two Nigerian States. Methods: This community-based cross-sectional study was carried out among 1200 respondents (6–19 years in age) in the Gombe and Osun States of Nigeria. HFI was assessed using the HFI access scale. DD was assessed using a 24-h dietary recall. DP were determined by principal component analysis using a 30-day food frequency questionnaire. DP scores were categorized into quartiles (Q) for statistical analysis. Diet-related predictors of DBM were assessed using logistic regression. Results: HFI was experienced by 568 (47.3%) respondents. The median DD score was 7.0 (maximum of 14). Two DPs were identified, diversified DP (DDP) and traditional DP (TDP). TDP was significantly associated with both thinness (Q4:OR: 2.91; 95% CI: 1.52–5.55; Ptrend: 0.002) and overweight/obesity (Q4:OR: 2.50; 95% CI: 1.43–4.35; Ptrend: 0.007), while DDP was inversely related with thinness (Q4:OR: 0.36; 95% CI: 0.21–0.61; Ptrend: 0.008) as compared to Q1. Conclusions: TDP increased the odds for DBM, while the DDP reduced the odds. [ABSTRACT FROM AUTHOR]

Background: Some cases of sudden death (SD) have been attributed to communicable diseases (CD) in middle- and low-income countries of the world even in this 21st century. CDs produce clinical symptoms and signs over several days before culminating in death. They are also amenable to treatment with antimicrobials if affected persons present early. We sought to find out the incidence of CD-related SD at the Ladoke Akintola University of Technology Teaching Hospital (Osogbo, Osun State, Nigeria) - a tertiary health facility in southwest Nigeria - and the prevailing associated factors. Methods: We conducted a retrospective study of CD-related SD in adult patients aged 18 years and older that occurred from January 2003 to December 2011. The Statistical Package for the Social Sciences version 16 was used for analysis of the generated data. Percentages and frequencies were calculated. Results: There were 17 (39.6%) CD-related SDs out of the 48 cases of SD studied. CD-related SD also accounted for 2.4% of all adult medical admissions. The mean age of the patients was 37.6 ± 11.6 years, age range of 25-62 years, mode of 25 years, and median 34 years. The male-to-female ratio was 1.8:1. Typhoid sepsis was responsible for SD in 47.1% of patients, pulmonary tuberculosis in 17.7% of patients, and lobar pneumonia in 17.7% of patients. The most affected age group was the 20-29-year-old group (41.2%), while the unskilled occupational group was the most affected occupational group with 35.3% of them having SD. Most of the patients with acute bacterial infection died of multiple organ failure. Conclusion: There is an urgent need to step up public health strategies to curtail infections in this environment, encourage better use of the existing health facilities by the people, and the government should strive hard to make health a top priority. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to determine the etiology and epidemiologic characteristics of sudden death at Ladoke Akintola University of Technology (LAUTECH) Teaching Hospital, South West Nigeria. Methods: This was a retrospective descriptive study of all cases of natural unexpected death, either occurring out of hospital or less than 24 hours after admission to LAUTECH Teaching Hospital, over a nine-year period from January 2003 to December 2011. Data were generated from information in the case notes and autopsy reports for these cases. Results: Sudden death accounted for 29 (4.0%) of 718 adult medical deaths and 1.0% of all adult medical admissions. Out-of-hospital deaths occurred in 72.4% of cases. The mean age of the patients was 46.8 ± 11.5 (range 25-74) years. The male to female ratio was 6.25:1. Cardiovascular disease were the most common cause of death (51.7%), followed by respiratory disease (20.7%), pulmonary thromboembolism (10.4%), central nervous system disease (13.8%), gastrointestinal disorders (13.8%), severe chemical/drug poisoning (13.8%), and combined cardiovascular and central nervous system disease (13.8%). Hypertension-related causes were responsible for 14/29 (48.3%) of the sudden deaths. Hypertensive heart disease accounted for 86.7% of the cardiovascular deaths, hypertensive heart failure accounted for 73.3%, whilst all heart failure cases accounted for 80.0%. Left ventricular hypertrophy was present in 69.2% of the patients with hypertensive heart disease. Moderate to severe atheromatous changes occurred in the aorta in 38.5% of patients aged ⩾50 years. No case of myocardial infarction was found. Conclusion: Hypertensive heart disease and hypertension-related disorders are the most common causes of sudden death in South West Nigeria, so effective public health strategies should be channeled towards prevention, detection, and treatment of hypertension. [ABSTRACT FROM AUTHOR]

Background: Changes in the timing of puberty have been an area of research interest in developed countries because of its associated health and psychosocial problems. Adolescents in Africa are no exception as they are reaching adulthood today much earlier than before. This changing trend may have a major influence on adolescents' sexual behaviour. Aim: This study determined the timing of puberty and demographic predictors among the adolescents in southwest Nigeria. Materials and Methods: The study was a cross-sectional study. Using Modified Sexual Maturity Scale (MSMS) of pubertal assessment, data were collected from 1000 respondents from rural and urban areas of Osun state, Nigeria. Data were collected using pre-tested Assisted Self Completion Questionnaires (ASCQ). The rate of pubertal development was based on age group and current pubertal stage. Data were analysed using SPSS version 16. Chi-square and logistic regression analyses were done to identify significant demographic predictors. Statistical significance was at 5% level. Results: The overall mean age of the respondents was 14.22±2.47 years. The mean age for males was 14.19±2.38 years and 14.25±2.57 years for females. A total of 52.9% of the respondents were males and 47.1% were females. Higher proportions of the females, 41.6% were already in late puberty stages compared to their male counterparts where 21.9% were at this stage. With regards to this rate of pubertal development, more males, 14.2% significantly had late rate of pubertal development than the females 5.1%. The significant demographic predictors was socio-economic class in females only. Conclusion: From this study, the timing of puberty was early for females and socio-economic class is an important demographic predictor for pubertal development. This study was however limited because intrinsic factors such as genetic makeup and nutritional status which could affect the finding were not be excluded. [ABSTRACT FROM AUTHOR]

Introduction: The perception of mothers about causes of underweight and overweight among children or adolescents and associated cultural beliefs may influence nutritional status. However, data from qualitative studies on this subject and regarding age 6-19 are scarce in Nigeria., Objective: This study aimed to explore mothers' perceptions and cultural beliefs about underweight and overweight children and adolescents in selected communities in a northern and a southern Nigerian state., Design: This was a qualitative study using focus group discussions (FGD). Eight FGD sessions were held. The interviews were transcribed verbatim, and the transcripts were coded and analysed using NVivo V.11, and direct quotations representing the themes generated from the perspectives were cited as appropriate., Setting: The study was carried out in eight randomly selected rural and urban communities in Gombe and Osun states of Nigeria., Participants: Seventy-six mothers of children and adolescents aged 6-19 years., Results: The mothers identified concepts, causes and community experience of underweight and overweight children and adolescents, however, some gaps and misconceptions were observed. These included perspectives that suggest a limited understanding of the concepts of mild and moderate malnutrition and stunting and citing of 'witches and wizards' as causes of malnutrition. The mothers observed that being underweight was more prevalent in rural communities of Osun and Gombe states, while overweight was more prevalent in urban communities in Osun state. The majority of the women reported no known food taboo or restrictions, and no cultural beliefs relating to the nutrition of children and adolescents., Conclusion: Gaps and misconceptions exist in the perceptions of mothers on underweight and overweight children and adolescents. Food taboos, food restrictions and other cultural beliefs were not reported by majority of the mothers. Educational programmes for mothers on child/adolescent nutrition should target identified gaps and misconceptions., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: High maternal mortality is a major problem in Nigeria. Birth Preparedness and Complication Readiness will ensure that women can have professional delivery thus reducing obstetric complications. This study assessed the birth preparedness and complication readiness among pregnant women in Osogbo metropolis, a south western community in Nigeria., Methods: A community based descriptive cross sectional survey was used. A total of 180 women were selected using multistage sampling technique. Pretested semi-structured interviewer administered questionnaires were used to elicit information about previous obstetric history, knowledge of the danger signs of pregnancy and level of birth preparedness. Composite score and mean were computed. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 17. P-value was set at < 0.05., Results: The mean age was 26.11 ± 3.63 years. A total of 51.1% were carrying their 2 nd or 3 rd pregnancies. A total of 70.8% were aware of danger signs in pregnancy and the commonest danger sign mentioned was bleeding per vagina. In all, 82.1% were well prepared for birth. Being in the younger age group (p = 0.026), being more educated (p < 0.0001) and being aware of danger signs in pregnancy (p < 0.0001) was more significantly associated with being well prepared., Conclusion: The respondents were well prepared for birth with the younger women, educated ones and those knowledgeable of danger signs being better prepared. Continuous education about the Birth Preparedness and Complication Readiness should be sustained in order to maintain and improve women's preparedness.