Olayemi Olaomi - Academia.edu (original) (raw)

Papers by Olayemi Olaomi

Research paper thumbnail of Spatial and temporal analysis of road traffic crashes and ambulance responses in Lagos state, Nigeria

BMC Public Health

Background Sub-Saharan African countries, Nigeria inclusive, are constrained by grossly limited a... more Background Sub-Saharan African countries, Nigeria inclusive, are constrained by grossly limited access to quality pre-hospital trauma care services (PTCS). Findings from pragmatic approaches that explore spatial and temporal trends of past road crashes can inform novel interventions. To improve access to PTCS and reduce burden of road traffic injuries we explored geospatial trends of past emergency responses to road traffic crashes (RTCs) by Lagos State Ambulance Service (LASAMBUS), assessed efficiency of responses, and outcomes of interventions by local government areas (LGAs) of crash. Methods Using descriptive cross-sectional design and REDcap we explored pre-hospital care data of 1220 crash victims documented on LASAMBUS intervention forms from December 2017 to May 2018. We analyzed trends in days and times of calls, demographics of victims, locations of crashes and causes of delayed emergency responses. Assisted with STATA 16 and ArcGIS pro we conducted descriptive statistics a...

Research paper thumbnail of Geospatial analysis of mortality risk from road traffic crashes in Federal Capital Territory, Nigeria

Traffic safety research, Jun 30, 2023

The objective of the study was to present a novel analytical approach using Nigerian trauma regis... more The objective of the study was to present a novel analytical approach using Nigerian trauma registry data to determine risks and hotspots of road traffic crash-related mortality for patients treated at National Trauma Centre, Abuja. Patient characteristics were compared between those who died at the hospital (n = 118) and those who survived (n = 2018). Multiple logistic regression and cluster analyses were used to identify risks of mortality and hotspots of high mortality and injury rates. The patient's status as pedestrian (p < .0001), and whether the crash occurred on an expressway or transition zone between expressways and local roads (p = 0.0045) were significantly associated with mortality. Cluster analysis further isolated significant hotspots of mortality rate (Moran's I = 0.31), pedestrian injury rate (Moran's I = 0.34), and expressway/transition zone injury rate (Moran's I = 0.18). For patients who survived to hospitalization at National Hospital Abuja, pedestrians involved in a crash and those whose crashes occurred on expressways/transition zones were at higher risk of mortality. High mortality and pedestrian and expressway/transition zone injury rates isolated to five contiguous administrative wards in Abuja. These analysis methods can be applied to determine risks and hotspots of crashes, injuries, and mortality in various settings.

Research paper thumbnail of Road safety in low- and middle-income countries: Role of police strike

Journal of Global Health, Nov 8, 2022

In low-and middle-income countries, police play a critical role as first responders to improve th... more In low-and middle-income countries, police play a critical role as first responders to improve the survival of road traffic injury victims, however, a police strike has the potential to reverse this outcome by causing excess road mortality through reduced access to efficient post-crash care.

Research paper thumbnail of Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study

Anaesthesia, 2021

SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this stu... more SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS‐CoV‐2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre‐operative SARS‐CoV‐2 infection were compared with those without previous SARS‐CoV‐2 infection. The primary outcome measure was 30‐day postoperative mortality. Logistic regression models were used to calculate adjusted 30‐day mortality rates stratified by time from diagnosis of SARS‐CoV‐2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre‐operative SARS‐CoV‐2 diagnosis. Adjusted 30‐day mortality in patients without SARS‐CoV‐2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre‐operative SARS‐CoV‐2 diagnosis, mortality was increased in patients having surgery wi...

Research paper thumbnail of SARS‐CoV‐2 infection and venous thromboembolism after surgery: an international prospective cohort study

Anaesthesia, 2021

SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critica... more SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri‐operative or prior SARS‐CoV‐2 were at further increased risk of venous thromboembolism. We conducted a planned sub‐study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS‐CoV‐2 diagnosis was defined as peri‐operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre‐operative anti‐coagulation for baseline comorbidities was no...

Research paper thumbnail of Implementation and early outcomes from an anal cancer screen and treat program in Nigeria

Papillomavirus Research, 2018

These factors were categorized: on a personal level, within the relationship, with regard to feel... more These factors were categorized: on a personal level, within the relationship, with regard to feelings and action. The most dramatic result was showed that one out of six reported having ended his relationship and one was too afraid to start a new relationship. Conclusions: This small study shows the impact of psychological factors on sexual functioning after electrocautery treatment. We advise that sexuality is discussed during HRA visits to allow healthcare providers to resolve misconceptions and provide sexual counseling or refer them to sexual counselor experts.

Research paper thumbnail of An open study of the safety and efficacy of ranitidine Bismuth citrate in the treatment of patients with Helicobacter Pylori-associated duodenal ulcer

Nigerian quarterly journal of hospital medicine, Feb 9, 2004

Research paper thumbnail of Assessment of Knowledge, Skills, and Preparedness of General-Duty Police on Prehospital Care of Road Traffic Accident Victims in Abuja, Nigeria

Disaster Medicine and Public Health Preparedness

Objectives: Prompt prehospital care (PHC) is essential for improving outcomes of road traffic acc... more Objectives: Prompt prehospital care (PHC) is essential for improving outcomes of road traffic accident victims. Previous studies in Nigeria show that little or no PHC is delivered to trauma victims by first responders. This study was conducted to assess police officers’ experience with FA/BLS, to identify gaps in their FA/BLS knowledge and skills, and assess police stations’ FA/BLS equipment capacity for PHC of road traffic accident victims. Methods: This cross-sectional study was conducted among 428 GD police in Abuja between November and December 2018. Respondents were selected using stratified random sampling with proportional allocation method. Data were collected using self-administered electronic semi-structured questionnaires. Data analysis was done using STATA v 14.0 (StataCorp, College Station, TX). Chi-square and multivariate logistic regression were used to assess associations. Results: We analyzed data from 419 respondents. Almost all (90.2%) of the police were aware of ...

Research paper thumbnail of A matched case–control study of bean intake and breast cancer risk in urbanized Nigerian women

Cancer Causes & Control

Research paper thumbnail of A Matched Case-Control Study of Beans Intake And Breast Cancer Risk in Urbanized Nigerian Women

Purpose. Beans intake has been associated with reduced risk of breast cancer (BRCA), however; onl... more Purpose. Beans intake has been associated with reduced risk of breast cancer (BRCA), however; only few studies considered molecular subtypes status and none in African women. Therefore, the purpose of this study was to examine the associations between dietary intake of beans and BRCA including its subtypes in Nigerian women.Methods. Overall, 472 newly diagnosed patients with primary invasive BRCA were age-matched (±5 years) with 472 controls from the Nigerian Integrative Epidemiology of Breast Cancer (NIBBLE) Study from 01/2014-07/2016. We collected dietary intake of beans using a food frequency questionnaire (FFQ). Beans intake was categorized into three levels of never (never in the past year), low (≤1 portion/week) and high intake (>1 portions/week). We used conditional and unconditional logistic regression models to estimate the Odds Ratio (OR) of beans intake and the risk of overall BRCA and by its molecular subtypes.Results. The mean (SD) age of cases was 44.4(10.0) and of ...

Research paper thumbnail of Intimate partner violence in a young pregnant woman at National Hospital Abuja, Nigeria

International Journal of Gynecology & Obstetrics, 2020

Intimate partner violence (IPV) during pregnancy is a serious public health issue globally. World... more Intimate partner violence (IPV) during pregnancy is a serious public health issue globally. Worldwide, 40-70% of female murder is committed by intimate partners.[1] In Sub-Saharan Africa, nearly 40% of women have reported experiences of abuse by their intimate partners.[2] The prevalence of domestic violence during pregnancy in Nigeria ranges between 2.3-44.6%, with lifetime prevalence rates ranging between 33.1-63.2%.[3] IPV among pregnant women is of great concern because of deleterious impacts on the pregnancy such as antepartum hemorrhage, intrauterine growth retardation, trauma, perinatal death, abortion/miscarriage, low birth weight, preterm delivery, as well as risk of homicide.[4].

Research paper thumbnail of Police experiences of bystander assistance in pre-hospital care of road traffic accident victims in Abuja, Nigeria: a cross-sectional study

The Lancet Global Health, 2021

Abstract Background Globally, most deaths from road traffic accidents (RTA) occur before the inju... more Abstract Background Globally, most deaths from road traffic accidents (RTA) occur before the injured person reaches hospital. This mortality burden is disproportionately higher in Africa, with Nigeria having a mortality burden from RTA, at 21·4 per 100 000 people, that is six-times higher than that in high-income countries such as Norway (3·1 per 100 000 people). Bystander first aid is associated with improved survival of trauma victims and Norway has a high rate of bystander first aid to RTA victims (89%); however, data on bystander first aid for RTA victims are lacking in Nigeria. The objectives of this study were to: (1) determine the bystander assistance rate to RTA victims; (2) assess the prevalence of bystander first aid to RTA victims; and (3) evaluate bystander non-helping behaviours to RTA victims. Methods This was a cross-sectional study that used observer-report data collected from police officers at 31 police stations in Abuja, Nigeria. A stratified randomised sample of 428 police officers were interviewed using a structured electronic pre-tested questionnaire for data collection. The questionnaires were self-administered. We collected data on sociodemographic characteristics of police officers and they were asked to report information on bystander assistance, first aid, and non-helping behaviours during their last pre-hospital care encounters with RTA victims in Abuja. To calculate the bystander assistance rate and the prevalence of first aid, we defined bystander assistance as any activities such as calling the police or ambulance service and first aid to save the lives of RTA victims. First aid was defined as basic care such as chest compression or wound dressing given to stabilise RTA victims either at the scene of injury or during transportation to the hospital. Descriptive statistics were summarised using STATA v. 14.0. Findings Between Nov 21, 2018, and Dec 8, 2018, we included data from 281 police officers who had ever provided pre-hospital care to RTA victims in Abuja. The bystander assistance rate to RTA victims was 93·2% (n=262). Provision of first aid and calling the police or ambulance service were the most common form of bystander assistance (31·3% [n=82] and 28·2% [74], respectively). Other bystander assistance included provision of safety for RTA victims or first-aiders (20·2% [53]), and search and rescue for life and property near the accident scene (19·8%% [52]). The rate of bystander first aid to RTA victims was 29·2% (82). Of the bystander non-helping behaviours reported (6·8% [19]), gazing or just looking accounted for the most (68% [13]), followed by stealing victims' property (21% [4]). Interpretation The rate of bystander first aid to RTA victims in Nigeria is significantly lower than those in high-income countries such as Norway and is likely to contribute to increased RTA mortality. Our findings highlight the need to increase community access to first aid trainings and behaviour-change interventions to improve RTA victims' health outcomes. Funding NIH and Fogarty International Center Training Grant for Partnerships to Develop Injury Research Capacities in Sub Saharan Africa (5D43TW010463-03) by Office of Global Health, University of Texas Southwestern Medical Center, USA.

Research paper thumbnail of Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomized, double-blind, placebo-controlled trial

The Journal of Emergency Medicine, 2020

Background Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patient... more Background Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0•9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0•9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124.

Research paper thumbnail of Delays in breast cancer presentation and diagnosis in Nigeria

Journal of Clinical Oncology, 2016

e13092Background: Breast cancer (BC) is the most common cancer among Nigerian women. In this stud... more e13092Background: Breast cancer (BC) is the most common cancer among Nigerian women. In this study we investigated delays in BC presentation and their determinants. Methods: This is an on-going multi-centre case-control study at six hospitals in Nigeria (five in Abuja, and one in Enugu). From Jan 2014, we enrolled eligible women aged > 18years who presented with breast symptoms for suspected BC. We collected information regarding women’s experiences with their breast problem, including dates of initial symptoms and visits to all providers and factors that might have contributed to delays in presentation and diagnosis. Results: A total of 403 patients have been recruited so far: 206 cases of confirmed BC (mean age: 44.8 (SD = 12.1) years), and 197 with benign breast disease (BBD) (39.0 (9.6) years). Stage at diagnosis was known for 90% of BC patients, with ~50% having been diagnosed at an early stage (2.6% and 52.7% in stages I and II, respectively versus 27% and 17.7 in stages III and IV, repectively). Th...

Research paper thumbnail of Tranexamic acid in trauma: we need stronger global health policy

BMJ (Clinical research ed.), Jan 23, 2013

Research paper thumbnail of Leisure time physical activity is associated with a reduced risk of preterm delivery

American Journal of Obstetrics and Gynecology, 2008

Aims: Physical activity has consistently been shown to improve cardiovascular health and high-den... more Aims: Physical activity has consistently been shown to improve cardiovascular health and high-density lipoproteincholesterol levels. However, only small and heterogeneous studies have investigated the effect of exercise on highdensity lipoprotein functions. Our aim is to evaluate, in the largest observational study to date, the association between leisure time physical activity and a range of high-density lipoprotein functional traits. Methods: The study sample consisted of 296 Spanish adults at high cardiovascular risk. Usual leisure time physical activity and eight measures of high-density lipoprotein functionality were averaged over two measurements, one year apart. Multivariable linear regression models were used to explore the association between leisure time physical activity (exposure) and each high-density lipoprotein functional trait (outcome), adjusted for cardiovascular risk factors. Results: Higher levels of leisure time physical activity were positively and linearly associated with average levels over one year of plasma high-density lipoprotein-cholesterol and apolipoprotein A-I, paraoxonase-1 antioxidant activity, highdensity lipoprotein capacity to esterify cholesterol and cholesterol efflux capacity in individuals free of type 2 diabetes only. The increased cholesterol esterification index with increasing leisure time physical activity reached a plateau at around 300 metabolic equivalents.min/day. In individuals with diabetes, the relationship with cholesteryl ester transfer protein followed a U-shape, with a decreased cholesteryl ester transfer protein activity from 0 to 300 metabolic equivalents.min/day, but increasing from there onwards. Increasing levels of leisure time physical activity were associated with poorer high-density lipoprotein vasodilatory capacity. Conclusions: In a high cardiovascular risk population, leisure time physical activity was associated not only with greater circulating levels of high-density lipoprotein-cholesterol, but also with better markers of high-density lipoprotein functionality, namely cholesterol efflux capacity, the capacity of high-density lipoprotein to esterify cholesterol and

Research paper thumbnail of Thoracic trauma in national hospital Abuja, Nigeria: The epidemiology, injury severity and initial management options

African Journal of Emergency Medicine

Research paper thumbnail of Colonoscopy: Early Experience in National Hospital Abuja Nigeria

International Journal of Gastroenterology, 2020

Colonoscopy has become one of the most important modalities in the assessment of the lower gastro... more Colonoscopy has become one of the most important modalities in the assessment of the lower gastrointestinal lesions. This study focused on our early experience with colonoscopy documenting the indications and outcome in the first five years of Colonoscopy in National Hospital, Abuja, Nigeria. This was a retrospective analysis of demographic data, indications for colonoscopy, agents used for bowel preparation, type of anaesthesia used, endoscopic findings, and extent of colon intubation from the endoscopy unit register of National Hospital, Abuja between July 2007 and June 2012. Patients whose data were incomplete or procedure abounded were excluded. Two hundred and eleven patients had colonoscopy during the 5 year period. Only 153 patients fulfilled the inclusion criteria and their data analysed. Males were 107 (69.9%) and 46 (30.1%) were females given a male/female ratio of 2.3:1 Age range was 2years to 90years with a Mean of 48.02. The commonest indications were bleeding per rectum (33.3%), haemorrhoids (24.8%) and suspicion of malignancy of the lower gastrointestinal tracts (24.3%). The most common findings on colonoscopy in our study were haemorrhoids (47.7%) and malignancies (24.2%) of various parts of the large bowel. 12.4% of the patients had normal study. Our Ceacal intubation rate was 75.8%. Majority of the lesions were found in the Anorectal region (69.9%) with only 17.7% in the rest of the Colon 24.2% of our findings were malignancies of lower intestinal tract. 97.3% of the malignancies were Adenocarcinoma. 83.8% of the malignancies were located in the left colon. Assessment of lower gastrointestinal symptom is incomplete without colonoscopy. Colonoscopy gives a good yield in well selected patients, it is safe and has low complication rate.

Research paper thumbnail of Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries

The Lancet

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as ind... more Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. Methods First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assessment (surgical preparedness index; SPI). Second, we measured surgical preparedness across a global network of hospitals in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) to explore the distribution of the SPI at national, subnational, and hospital levels. Finally, using COVID-19 as an example of an external system shock, we compared hospitals&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; SPI to their planned surgical volume ratio (SVR; ie, operations for which the decision for surgery was made before hospital admission), calculated as the ratio of the observed surgical volume over a 1-month assessment period between June 6 and Aug 5, 2021, against the expected surgical volume based on hospital administrative data from the same period in 2019 (ie, a pre-pandemic baseline). A linear mixed-effects regression model was used to determine the effect of increasing SPI score. Findings In the first phase, from a longlist of 103 candidate indicators, 23 were prioritised as core indicators of elective surgical system preparedness by 69 clinicians (23 [33%] women; 46 [67%] men; 41 from HICs, 22 from MICs, and six from LICs) from 32 countries. The multidomain SPI included 11 indicators on facilities and consumables, two on staffing, two on prioritisation, and eight on systems. Hospitals were scored from 23 (least prepared) to 115 points (most prepared). In the second phase, surgical preparedness was measured in 1632 hospitals by 4714 clinicians from 119 countries. 745 (45•6%) of 1632 hospitals were in MICs or LICs. The mean SPI score was 84•5 (95% CI 84•1-84•9), which varied between HIC (88•5 [89•0-88•0]), MIC (81•8 [82•5-81•1]), and LIC (66•8 [64•9-68•7]) settings. In the third phase, 1217 (74•6%) hospitals did not maintain their expected SVR during the COVID-19 pandemic, of which 625 (51•4%) were from HIC, 538 (44•2%) from MIC, and 54 (4•4%) from LIC settings. In the mixed-effects model, a 10-point increase in SPI corresponded to a 3•6% (95% CI 3•0-4•1; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0•0001) increase in SVR. This was consistent in HIC (4•8% [4•1-5•5]; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0•0001), MIC (2•8 [2•0-3•7]; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0•0001), and LIC (3•8 [1•3-6•7%]; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0•0001) settings. Interpretation The SPI contains 23 indicators that are globally applicable, relevant across different system stressors, vary at a subnational level, and are collectable by front-line teams. In the case study of COVID-19, a higher SPI was associated with an increased planned surgical volume ratio independent of country income status, COVID-19 burden, and hospital type. Hospitals should perform annual self-assessment of their surgical preparedness to identify areas that can be improved, create resilience in local surgical systems, and upscale capacity to address elective surgery backlogs.

Research paper thumbnail of Pattern of trauma in elderly patients seen at the trauma centre of national hospital Abuja, Nigeria

African Journal of Emergency Medicine, 2021

The global population is aging, creating challenges for health systems. The mean age of patients ... more The global population is aging, creating challenges for health systems. The mean age of patients with major trauma has increased over time, posing some challenges for trauma system designs. Elderly trauma patients are said to have higher mortality rates and longer hospital and intensive care unit stays. This study is aimed at assessing the pattern of injuries in elderly population in a dedicated trauma centre of a developing economy. Methods: This is a retrospective study of all patients aged 60 years and above seen in the trauma centre of a West African tertiary hospital over a three year period from January 2017 to December 2019. Relevant parameters including Sociodemographic data, injury pattern and injury scores were derived from the trauma registry. Data analysis was done using statistical package for social sciences (SPSS) version 24. Results were presented using tables and a figure. Results: A total of 183 patients aged 60 years and above were enrolled out of 4549 general trauma patients, representing 4% of the trauma patient population seen. Male to female ratio was 2.3 with the mean age of 65 ± 6.3. The most frequent mechanisms of injury were motor vehicular crash (MVC) (48.4%), followed by falls (16.5%). More proportion of females (21.8%) were significantly found to suffer falls compared to their males (14.2%) counterparts (p < 0.05). Traumatic brain injury was the commonest diagnosis accounting for 24.3% of cases. The predominant revised trauma scores (RTS) and injury severity scores (ISS) were 12 and 1-15 respectively, with overall mortality of 6.1%. Conclusion: The proportion of elderly trauma patients studied in this centre is low. MVC is still the leading mechanism of injury in our elderly trauma population. The mortality rate is however low in this study, in line with the low trauma and severity scores. Preventive measures for MVC should be strongly encouraged to reduce the incidence of elderly trauma patients in this part of the world. African relevance • The African population is gradually aging but the aged population is still low. • The article shows that we may not always extrapolate the practice of other climes to our African settings. • This article will help trauma team and emergency physicians prepare relevant guidelines targeted at elderly in Africa. • This article will also serve as a baseline data for subsequent study on elderly or geriatric emergencies and trauma in Africa.

Research paper thumbnail of Spatial and temporal analysis of road traffic crashes and ambulance responses in Lagos state, Nigeria

BMC Public Health

Background Sub-Saharan African countries, Nigeria inclusive, are constrained by grossly limited a... more Background Sub-Saharan African countries, Nigeria inclusive, are constrained by grossly limited access to quality pre-hospital trauma care services (PTCS). Findings from pragmatic approaches that explore spatial and temporal trends of past road crashes can inform novel interventions. To improve access to PTCS and reduce burden of road traffic injuries we explored geospatial trends of past emergency responses to road traffic crashes (RTCs) by Lagos State Ambulance Service (LASAMBUS), assessed efficiency of responses, and outcomes of interventions by local government areas (LGAs) of crash. Methods Using descriptive cross-sectional design and REDcap we explored pre-hospital care data of 1220 crash victims documented on LASAMBUS intervention forms from December 2017 to May 2018. We analyzed trends in days and times of calls, demographics of victims, locations of crashes and causes of delayed emergency responses. Assisted with STATA 16 and ArcGIS pro we conducted descriptive statistics a...

Research paper thumbnail of Geospatial analysis of mortality risk from road traffic crashes in Federal Capital Territory, Nigeria

Traffic safety research, Jun 30, 2023

The objective of the study was to present a novel analytical approach using Nigerian trauma regis... more The objective of the study was to present a novel analytical approach using Nigerian trauma registry data to determine risks and hotspots of road traffic crash-related mortality for patients treated at National Trauma Centre, Abuja. Patient characteristics were compared between those who died at the hospital (n = 118) and those who survived (n = 2018). Multiple logistic regression and cluster analyses were used to identify risks of mortality and hotspots of high mortality and injury rates. The patient's status as pedestrian (p < .0001), and whether the crash occurred on an expressway or transition zone between expressways and local roads (p = 0.0045) were significantly associated with mortality. Cluster analysis further isolated significant hotspots of mortality rate (Moran's I = 0.31), pedestrian injury rate (Moran's I = 0.34), and expressway/transition zone injury rate (Moran's I = 0.18). For patients who survived to hospitalization at National Hospital Abuja, pedestrians involved in a crash and those whose crashes occurred on expressways/transition zones were at higher risk of mortality. High mortality and pedestrian and expressway/transition zone injury rates isolated to five contiguous administrative wards in Abuja. These analysis methods can be applied to determine risks and hotspots of crashes, injuries, and mortality in various settings.

Research paper thumbnail of Road safety in low- and middle-income countries: Role of police strike

Journal of Global Health, Nov 8, 2022

In low-and middle-income countries, police play a critical role as first responders to improve th... more In low-and middle-income countries, police play a critical role as first responders to improve the survival of road traffic injury victims, however, a police strike has the potential to reverse this outcome by causing excess road mortality through reduced access to efficient post-crash care.

Research paper thumbnail of Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study

Anaesthesia, 2021

SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this stu... more SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS‐CoV‐2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre‐operative SARS‐CoV‐2 infection were compared with those without previous SARS‐CoV‐2 infection. The primary outcome measure was 30‐day postoperative mortality. Logistic regression models were used to calculate adjusted 30‐day mortality rates stratified by time from diagnosis of SARS‐CoV‐2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre‐operative SARS‐CoV‐2 diagnosis. Adjusted 30‐day mortality in patients without SARS‐CoV‐2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre‐operative SARS‐CoV‐2 diagnosis, mortality was increased in patients having surgery wi...

Research paper thumbnail of SARS‐CoV‐2 infection and venous thromboembolism after surgery: an international prospective cohort study

Anaesthesia, 2021

SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critica... more SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri‐operative or prior SARS‐CoV‐2 were at further increased risk of venous thromboembolism. We conducted a planned sub‐study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS‐CoV‐2 diagnosis was defined as peri‐operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre‐operative anti‐coagulation for baseline comorbidities was no...

Research paper thumbnail of Implementation and early outcomes from an anal cancer screen and treat program in Nigeria

Papillomavirus Research, 2018

These factors were categorized: on a personal level, within the relationship, with regard to feel... more These factors were categorized: on a personal level, within the relationship, with regard to feelings and action. The most dramatic result was showed that one out of six reported having ended his relationship and one was too afraid to start a new relationship. Conclusions: This small study shows the impact of psychological factors on sexual functioning after electrocautery treatment. We advise that sexuality is discussed during HRA visits to allow healthcare providers to resolve misconceptions and provide sexual counseling or refer them to sexual counselor experts.

Research paper thumbnail of An open study of the safety and efficacy of ranitidine Bismuth citrate in the treatment of patients with Helicobacter Pylori-associated duodenal ulcer

Nigerian quarterly journal of hospital medicine, Feb 9, 2004

Research paper thumbnail of Assessment of Knowledge, Skills, and Preparedness of General-Duty Police on Prehospital Care of Road Traffic Accident Victims in Abuja, Nigeria

Disaster Medicine and Public Health Preparedness

Objectives: Prompt prehospital care (PHC) is essential for improving outcomes of road traffic acc... more Objectives: Prompt prehospital care (PHC) is essential for improving outcomes of road traffic accident victims. Previous studies in Nigeria show that little or no PHC is delivered to trauma victims by first responders. This study was conducted to assess police officers’ experience with FA/BLS, to identify gaps in their FA/BLS knowledge and skills, and assess police stations’ FA/BLS equipment capacity for PHC of road traffic accident victims. Methods: This cross-sectional study was conducted among 428 GD police in Abuja between November and December 2018. Respondents were selected using stratified random sampling with proportional allocation method. Data were collected using self-administered electronic semi-structured questionnaires. Data analysis was done using STATA v 14.0 (StataCorp, College Station, TX). Chi-square and multivariate logistic regression were used to assess associations. Results: We analyzed data from 419 respondents. Almost all (90.2%) of the police were aware of ...

Research paper thumbnail of A matched case–control study of bean intake and breast cancer risk in urbanized Nigerian women

Cancer Causes & Control

Research paper thumbnail of A Matched Case-Control Study of Beans Intake And Breast Cancer Risk in Urbanized Nigerian Women

Purpose. Beans intake has been associated with reduced risk of breast cancer (BRCA), however; onl... more Purpose. Beans intake has been associated with reduced risk of breast cancer (BRCA), however; only few studies considered molecular subtypes status and none in African women. Therefore, the purpose of this study was to examine the associations between dietary intake of beans and BRCA including its subtypes in Nigerian women.Methods. Overall, 472 newly diagnosed patients with primary invasive BRCA were age-matched (±5 years) with 472 controls from the Nigerian Integrative Epidemiology of Breast Cancer (NIBBLE) Study from 01/2014-07/2016. We collected dietary intake of beans using a food frequency questionnaire (FFQ). Beans intake was categorized into three levels of never (never in the past year), low (≤1 portion/week) and high intake (>1 portions/week). We used conditional and unconditional logistic regression models to estimate the Odds Ratio (OR) of beans intake and the risk of overall BRCA and by its molecular subtypes.Results. The mean (SD) age of cases was 44.4(10.0) and of ...

Research paper thumbnail of Intimate partner violence in a young pregnant woman at National Hospital Abuja, Nigeria

International Journal of Gynecology & Obstetrics, 2020

Intimate partner violence (IPV) during pregnancy is a serious public health issue globally. World... more Intimate partner violence (IPV) during pregnancy is a serious public health issue globally. Worldwide, 40-70% of female murder is committed by intimate partners.[1] In Sub-Saharan Africa, nearly 40% of women have reported experiences of abuse by their intimate partners.[2] The prevalence of domestic violence during pregnancy in Nigeria ranges between 2.3-44.6%, with lifetime prevalence rates ranging between 33.1-63.2%.[3] IPV among pregnant women is of great concern because of deleterious impacts on the pregnancy such as antepartum hemorrhage, intrauterine growth retardation, trauma, perinatal death, abortion/miscarriage, low birth weight, preterm delivery, as well as risk of homicide.[4].

Research paper thumbnail of Police experiences of bystander assistance in pre-hospital care of road traffic accident victims in Abuja, Nigeria: a cross-sectional study

The Lancet Global Health, 2021

Abstract Background Globally, most deaths from road traffic accidents (RTA) occur before the inju... more Abstract Background Globally, most deaths from road traffic accidents (RTA) occur before the injured person reaches hospital. This mortality burden is disproportionately higher in Africa, with Nigeria having a mortality burden from RTA, at 21·4 per 100 000 people, that is six-times higher than that in high-income countries such as Norway (3·1 per 100 000 people). Bystander first aid is associated with improved survival of trauma victims and Norway has a high rate of bystander first aid to RTA victims (89%); however, data on bystander first aid for RTA victims are lacking in Nigeria. The objectives of this study were to: (1) determine the bystander assistance rate to RTA victims; (2) assess the prevalence of bystander first aid to RTA victims; and (3) evaluate bystander non-helping behaviours to RTA victims. Methods This was a cross-sectional study that used observer-report data collected from police officers at 31 police stations in Abuja, Nigeria. A stratified randomised sample of 428 police officers were interviewed using a structured electronic pre-tested questionnaire for data collection. The questionnaires were self-administered. We collected data on sociodemographic characteristics of police officers and they were asked to report information on bystander assistance, first aid, and non-helping behaviours during their last pre-hospital care encounters with RTA victims in Abuja. To calculate the bystander assistance rate and the prevalence of first aid, we defined bystander assistance as any activities such as calling the police or ambulance service and first aid to save the lives of RTA victims. First aid was defined as basic care such as chest compression or wound dressing given to stabilise RTA victims either at the scene of injury or during transportation to the hospital. Descriptive statistics were summarised using STATA v. 14.0. Findings Between Nov 21, 2018, and Dec 8, 2018, we included data from 281 police officers who had ever provided pre-hospital care to RTA victims in Abuja. The bystander assistance rate to RTA victims was 93·2% (n=262). Provision of first aid and calling the police or ambulance service were the most common form of bystander assistance (31·3% [n=82] and 28·2% [74], respectively). Other bystander assistance included provision of safety for RTA victims or first-aiders (20·2% [53]), and search and rescue for life and property near the accident scene (19·8%% [52]). The rate of bystander first aid to RTA victims was 29·2% (82). Of the bystander non-helping behaviours reported (6·8% [19]), gazing or just looking accounted for the most (68% [13]), followed by stealing victims' property (21% [4]). Interpretation The rate of bystander first aid to RTA victims in Nigeria is significantly lower than those in high-income countries such as Norway and is likely to contribute to increased RTA mortality. Our findings highlight the need to increase community access to first aid trainings and behaviour-change interventions to improve RTA victims' health outcomes. Funding NIH and Fogarty International Center Training Grant for Partnerships to Develop Injury Research Capacities in Sub Saharan Africa (5D43TW010463-03) by Office of Global Health, University of Texas Southwestern Medical Center, USA.

Research paper thumbnail of Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomized, double-blind, placebo-controlled trial

The Journal of Emergency Medicine, 2020

Background Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patient... more Background Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0•9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0•9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124.

Research paper thumbnail of Delays in breast cancer presentation and diagnosis in Nigeria

Journal of Clinical Oncology, 2016

e13092Background: Breast cancer (BC) is the most common cancer among Nigerian women. In this stud... more e13092Background: Breast cancer (BC) is the most common cancer among Nigerian women. In this study we investigated delays in BC presentation and their determinants. Methods: This is an on-going multi-centre case-control study at six hospitals in Nigeria (five in Abuja, and one in Enugu). From Jan 2014, we enrolled eligible women aged > 18years who presented with breast symptoms for suspected BC. We collected information regarding women’s experiences with their breast problem, including dates of initial symptoms and visits to all providers and factors that might have contributed to delays in presentation and diagnosis. Results: A total of 403 patients have been recruited so far: 206 cases of confirmed BC (mean age: 44.8 (SD = 12.1) years), and 197 with benign breast disease (BBD) (39.0 (9.6) years). Stage at diagnosis was known for 90% of BC patients, with ~50% having been diagnosed at an early stage (2.6% and 52.7% in stages I and II, respectively versus 27% and 17.7 in stages III and IV, repectively). Th...

Research paper thumbnail of Tranexamic acid in trauma: we need stronger global health policy

BMJ (Clinical research ed.), Jan 23, 2013

Research paper thumbnail of Leisure time physical activity is associated with a reduced risk of preterm delivery

American Journal of Obstetrics and Gynecology, 2008

Aims: Physical activity has consistently been shown to improve cardiovascular health and high-den... more Aims: Physical activity has consistently been shown to improve cardiovascular health and high-density lipoproteincholesterol levels. However, only small and heterogeneous studies have investigated the effect of exercise on highdensity lipoprotein functions. Our aim is to evaluate, in the largest observational study to date, the association between leisure time physical activity and a range of high-density lipoprotein functional traits. Methods: The study sample consisted of 296 Spanish adults at high cardiovascular risk. Usual leisure time physical activity and eight measures of high-density lipoprotein functionality were averaged over two measurements, one year apart. Multivariable linear regression models were used to explore the association between leisure time physical activity (exposure) and each high-density lipoprotein functional trait (outcome), adjusted for cardiovascular risk factors. Results: Higher levels of leisure time physical activity were positively and linearly associated with average levels over one year of plasma high-density lipoprotein-cholesterol and apolipoprotein A-I, paraoxonase-1 antioxidant activity, highdensity lipoprotein capacity to esterify cholesterol and cholesterol efflux capacity in individuals free of type 2 diabetes only. The increased cholesterol esterification index with increasing leisure time physical activity reached a plateau at around 300 metabolic equivalents.min/day. In individuals with diabetes, the relationship with cholesteryl ester transfer protein followed a U-shape, with a decreased cholesteryl ester transfer protein activity from 0 to 300 metabolic equivalents.min/day, but increasing from there onwards. Increasing levels of leisure time physical activity were associated with poorer high-density lipoprotein vasodilatory capacity. Conclusions: In a high cardiovascular risk population, leisure time physical activity was associated not only with greater circulating levels of high-density lipoprotein-cholesterol, but also with better markers of high-density lipoprotein functionality, namely cholesterol efflux capacity, the capacity of high-density lipoprotein to esterify cholesterol and

Research paper thumbnail of Thoracic trauma in national hospital Abuja, Nigeria: The epidemiology, injury severity and initial management options

African Journal of Emergency Medicine

Research paper thumbnail of Colonoscopy: Early Experience in National Hospital Abuja Nigeria

International Journal of Gastroenterology, 2020

Colonoscopy has become one of the most important modalities in the assessment of the lower gastro... more Colonoscopy has become one of the most important modalities in the assessment of the lower gastrointestinal lesions. This study focused on our early experience with colonoscopy documenting the indications and outcome in the first five years of Colonoscopy in National Hospital, Abuja, Nigeria. This was a retrospective analysis of demographic data, indications for colonoscopy, agents used for bowel preparation, type of anaesthesia used, endoscopic findings, and extent of colon intubation from the endoscopy unit register of National Hospital, Abuja between July 2007 and June 2012. Patients whose data were incomplete or procedure abounded were excluded. Two hundred and eleven patients had colonoscopy during the 5 year period. Only 153 patients fulfilled the inclusion criteria and their data analysed. Males were 107 (69.9%) and 46 (30.1%) were females given a male/female ratio of 2.3:1 Age range was 2years to 90years with a Mean of 48.02. The commonest indications were bleeding per rectum (33.3%), haemorrhoids (24.8%) and suspicion of malignancy of the lower gastrointestinal tracts (24.3%). The most common findings on colonoscopy in our study were haemorrhoids (47.7%) and malignancies (24.2%) of various parts of the large bowel. 12.4% of the patients had normal study. Our Ceacal intubation rate was 75.8%. Majority of the lesions were found in the Anorectal region (69.9%) with only 17.7% in the rest of the Colon 24.2% of our findings were malignancies of lower intestinal tract. 97.3% of the malignancies were Adenocarcinoma. 83.8% of the malignancies were located in the left colon. Assessment of lower gastrointestinal symptom is incomplete without colonoscopy. Colonoscopy gives a good yield in well selected patients, it is safe and has low complication rate.

Research paper thumbnail of Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries

The Lancet

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as ind... more Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. Methods First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assessment (surgical preparedness index; SPI). Second, we measured surgical preparedness across a global network of hospitals in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) to explore the distribution of the SPI at national, subnational, and hospital levels. Finally, using COVID-19 as an example of an external system shock, we compared hospitals&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; SPI to their planned surgical volume ratio (SVR; ie, operations for which the decision for surgery was made before hospital admission), calculated as the ratio of the observed surgical volume over a 1-month assessment period between June 6 and Aug 5, 2021, against the expected surgical volume based on hospital administrative data from the same period in 2019 (ie, a pre-pandemic baseline). A linear mixed-effects regression model was used to determine the effect of increasing SPI score. Findings In the first phase, from a longlist of 103 candidate indicators, 23 were prioritised as core indicators of elective surgical system preparedness by 69 clinicians (23 [33%] women; 46 [67%] men; 41 from HICs, 22 from MICs, and six from LICs) from 32 countries. The multidomain SPI included 11 indicators on facilities and consumables, two on staffing, two on prioritisation, and eight on systems. Hospitals were scored from 23 (least prepared) to 115 points (most prepared). In the second phase, surgical preparedness was measured in 1632 hospitals by 4714 clinicians from 119 countries. 745 (45•6%) of 1632 hospitals were in MICs or LICs. The mean SPI score was 84•5 (95% CI 84•1-84•9), which varied between HIC (88•5 [89•0-88•0]), MIC (81•8 [82•5-81•1]), and LIC (66•8 [64•9-68•7]) settings. In the third phase, 1217 (74•6%) hospitals did not maintain their expected SVR during the COVID-19 pandemic, of which 625 (51•4%) were from HIC, 538 (44•2%) from MIC, and 54 (4•4%) from LIC settings. In the mixed-effects model, a 10-point increase in SPI corresponded to a 3•6% (95% CI 3•0-4•1; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0•0001) increase in SVR. This was consistent in HIC (4•8% [4•1-5•5]; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0•0001), MIC (2•8 [2•0-3•7]; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0•0001), and LIC (3•8 [1•3-6•7%]; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0•0001) settings. Interpretation The SPI contains 23 indicators that are globally applicable, relevant across different system stressors, vary at a subnational level, and are collectable by front-line teams. In the case study of COVID-19, a higher SPI was associated with an increased planned surgical volume ratio independent of country income status, COVID-19 burden, and hospital type. Hospitals should perform annual self-assessment of their surgical preparedness to identify areas that can be improved, create resilience in local surgical systems, and upscale capacity to address elective surgery backlogs.

Research paper thumbnail of Pattern of trauma in elderly patients seen at the trauma centre of national hospital Abuja, Nigeria

African Journal of Emergency Medicine, 2021

The global population is aging, creating challenges for health systems. The mean age of patients ... more The global population is aging, creating challenges for health systems. The mean age of patients with major trauma has increased over time, posing some challenges for trauma system designs. Elderly trauma patients are said to have higher mortality rates and longer hospital and intensive care unit stays. This study is aimed at assessing the pattern of injuries in elderly population in a dedicated trauma centre of a developing economy. Methods: This is a retrospective study of all patients aged 60 years and above seen in the trauma centre of a West African tertiary hospital over a three year period from January 2017 to December 2019. Relevant parameters including Sociodemographic data, injury pattern and injury scores were derived from the trauma registry. Data analysis was done using statistical package for social sciences (SPSS) version 24. Results were presented using tables and a figure. Results: A total of 183 patients aged 60 years and above were enrolled out of 4549 general trauma patients, representing 4% of the trauma patient population seen. Male to female ratio was 2.3 with the mean age of 65 ± 6.3. The most frequent mechanisms of injury were motor vehicular crash (MVC) (48.4%), followed by falls (16.5%). More proportion of females (21.8%) were significantly found to suffer falls compared to their males (14.2%) counterparts (p < 0.05). Traumatic brain injury was the commonest diagnosis accounting for 24.3% of cases. The predominant revised trauma scores (RTS) and injury severity scores (ISS) were 12 and 1-15 respectively, with overall mortality of 6.1%. Conclusion: The proportion of elderly trauma patients studied in this centre is low. MVC is still the leading mechanism of injury in our elderly trauma population. The mortality rate is however low in this study, in line with the low trauma and severity scores. Preventive measures for MVC should be strongly encouraged to reduce the incidence of elderly trauma patients in this part of the world. African relevance • The African population is gradually aging but the aged population is still low. • The article shows that we may not always extrapolate the practice of other climes to our African settings. • This article will help trauma team and emergency physicians prepare relevant guidelines targeted at elderly in Africa. • This article will also serve as a baseline data for subsequent study on elderly or geriatric emergencies and trauma in Africa.