opeyemi akinajo - Academia.edu (original) (raw)

Papers by opeyemi akinajo

Curēus, Mar 13, 2024

Background Male infertility is one of the major reproductive health concerns, causing a lot of di... more Background Male infertility is one of the major reproductive health concerns, causing a lot of distress for couples globally. Others have looked into its connection to vitamin D deficiency, but their findings are conflicting. Aim This study aimed to determine the relationship between male infertility and vitamin D deficiency among Nigerians. Method This analytical cross-sectional study was conducted among 132 men. A purposive sampling technique was employed to recruit 66 participants in the study (men with infertility) and control groups (men with proven fertility). Descriptive statistics were conducted, while the association between vitamin D level and sperm parameters was assessed using bivariate and regression modeling. A two-tailed test of the hypothesis was assumed, and the level of statistical significance was set at a P-value < 0.05. Results None of the participants had a serum vitamin D deficiency. However, the overall serum vitamin D insufficiency rate was 15%. The median vitamin D level for the total study population (both fertile and infertile) was 37.52 ng/ml (IQR: 32.1-51.69). This study demonstrated no association between serum vitamin D levels and male infertility, as well as no association between serum vitamin D levels and the quality of semen parameters. Conclusion There was no significant association between vitamin D levels, male infertility, and seminal fluid parameters. However, larger multi-center studies are recommended to provide further insights into this conclusion.

Reproductive health, Feb 13, 2024

Background Anaemia in pregnancy causes a significant burden of maternal morbidity and mortality i... more Background Anaemia in pregnancy causes a significant burden of maternal morbidity and mortality in sub-Saharan Africa, with prevalence ranging from 25 to 45% in Nigeria. The main treatment, daily oral iron, is associated with suboptimal adherence and effectiveness. Among pregnant women with iron deficiency, which is a leading cause of anaemia (IDA), intravenous (IV) iron is an alternative treatment in moderate or severe cases. This qualitative study explored the acceptability of IV iron in the states of Kano and Lagos in Nigeria. Methods We purposively sampled various stakeholders, including pregnant women, domestic decision-makers, and healthcare providers (HCPs) during the pre-intervention phase of a hybrid clinical trial (IVON trial) in 10 healthcare facilities across three levels of the health system. Semi-structured topic guides guided 12 focus group discussions (140 participants) and 29 key informant interviews. We used the theoretical framework of acceptability to conduct qualitative content analysis. Results We identified three main themes and eight sub-themes that reflected the prospective acceptability of IV iron therapy. Generally, all stakeholders had a positive affective attitude towards IV iron based on its comparative advantages to oral iron. The HCPs noted the effectiveness of IV iron in its ability to evoke an immediate response and capacity to reduce anaemia-related complications. It was perceived as a suitable alternative to blood transfusion for specific individuals based on ethicality. However, to pregnant women and the HCPs, IV iron could present a higher opportunity cost than oral iron for the users and providers as it necessitates additional time to receive and administer it. To all stakeholder groups, leveraging the existing infrastructure to facilitate IV iron treatment will stimulate coherence and self-efficacy while strengthening the existing trust between pregnant women and HCPs can avert misconceptions. Finally, even though high out-of-pocket costs might make IV iron out of reach for poor women, the HCPs felt it can potentially prevent higher treatment fees from complications of IDA.

Nigerian Journal of Clinical Practice, 2022

Hellenic Journal of Obstetrics and Gynecology

Background: Dipstick urinalysis is a handy and cost effective method for the early detection of a... more Background: Dipstick urinalysis is a handy and cost effective method for the early detection of asymptomatic bacteriuria. Asymptomatic bacteriuria occurs in 2-10% of pregnancies and has been associated with low birth weight and preterm delivery in pregnant women if untreated. Objective: To determine the incidence of asymptomatic bacteriuria in pregnancy, the distribution of infecting organisms and the antibiotic sensitivity pattern in pregnant Nigerian women attending the antenatal clinic of the Lagos University Teaching Hospital, Idi- Araba, Lagos. Methodology: This was a prospective study. The study population were 201 consecutive asymptomatic pregnant women, who attended the antenatal clinic of LUTH for booking between 1st July and 31st December, 2021. Two consecutive urine samples were collected and analysed for microscopy, culture and sensitivity and urinalysis. The outcomes of interest were prevalence of asymptomatic bacteriuria at LUTH, bacterial isolates, and their antibioti...

Implementation Science Communications

Background Pregnancy-related anaemia is a public health challenge across Africa. Over 50% of preg... more Background Pregnancy-related anaemia is a public health challenge across Africa. Over 50% of pregnant women in Africa get diagnosed with this condition, and up to 75% of these are caused by iron deficiency. The condition is a significant contributor to the high maternal deaths across the continent and, in particular, Nigeria, which accounts for about 34% of global maternal deaths. Whereas oral iron is the mainstay treatment for pregnancy-related anaemia in Nigeria, this treatment is not very effective given the slow absorption of the medication, and its gastrointestinal adverse effects which lead to poor compliance by women. Intravenous iron is an alternative therapy which can rapidly replenish iron stores, but fears of anaphylactic reactions, as well as several misconceptions, have inhibited its routine use. Newer and safer intravenous iron formulations, such as ferric carboxymaltose, present an opportunity to overcome some concerns relating to adherence. Routine use of this formul...

Nigerian Journal of Clinical Practice

The Journal of Maternal-Fetal & Neonatal Medicine, 2020

COVID-19 is a pandemic that is currently ravaging the world. Infection rate is steadily increasin... more COVID-19 is a pandemic that is currently ravaging the world. Infection rate is steadily increasing in Sub-Saharan Africa. Pregnant women and their infants may suffer severe illnesses due to their lower immunity. This guideline prepares and equips clinicians working in the maternal and newborn sections in the sub-region to manage COVID-19 during pregnancy and childbirth.

Case Reports in Obstetrics and Gynecology, 2016

Lassa fever (LF), an acute viral haemorrhagic fever, is an endemic zoonotic viral infection in We... more Lassa fever (LF), an acute viral haemorrhagic fever, is an endemic zoonotic viral infection in West Africa countries with up to 15% case fatality rate. Though a rodent-borne infection, it can also be transmitted from person to person during the care of sick relations or more commonly in health care settings as a nosocomial infection. Vertical transmission from mother to child has been documented. We report 2 cases of LF among pregnant women which were managed at the University College Hospital, Ibadan, between September and October 2014. Both patients were in their early 20s with only one surviving the disease. Both had supportive therapy but none had antiviral therapy. This report emphasized the importance of early presentation, high index of suspicion, prompt diagnosis, and early commencement of supportive therapy in the management of patients suspected with LF especially in the era of other viral haemorrhagic infections.

Prevalence of and risk factors for iron defciency among pregnant women with moderate or severe anaemia in Nigeria: a cross-sectional study, 2023

Background Anaemia during pregnancy causes adverse outcomes to the woman and the foetus, includin... more Background Anaemia during pregnancy causes adverse outcomes to the woman and the foetus, including anaemic heart failure, prematurity, and intrauterine growth restriction. Iron deficiency anaemia (IDA) is the leading cause of anaemia and oral iron supplementation during pregnancy is widely recommended. However, little focus is directed to dietary intake. This study estimates the contribution of IDA among pregnant women and examines its risk factors (including dietary) in those with moderate or severe IDA in Lagos and Kano states, Nigeria. Methods In this cross-sectional study, 11,582 women were screened for anaemia at 20-32 weeks gestation. The 872 who had moderate or severe anaemia (haemoglobin concentration < 10 g/dL) were included in this study. Iron deficiency was defined as serum ferritin level < 30 ng/mL. We described the sociodemographic and obstetric characteristics of the sample and their self-report of consumption of common food items. We conducted bivariate and multivariable logistic regression analysis to identify risk factors associated with IDA. Results Iron deficiency was observed among 41% (95%CI: 38-45) of women with moderate or severe anaemia and the prevalence increased with gestational age. The odds for IDA reduces from aOR: 0.36 (95%CI: 0.13-0.98) among pregnant women who consume green leafy vegetables every 2-3 weeks, to 0.26 (95%CI: 0.09-0.73) among daily consumers, compared to those who do not eat it. Daily consumption of edible kaolin clay was associated with increased odds of having IDA compared to nonconsumption, aOR 9.13 (95%CI: 3.27-25.48). Consumption of soybeans three to four times a week was associated with higher odds of IDA compared to non-consumption, aOR: 1.78 (95%CI: 1.12-2.82). Conclusion About 4 in 10 women with moderate or severe anaemia during pregnancy had IDA. Our study provides evidence for the protective effect of green leafy vegetables against IDA while self-reported consumption of edible kaolin clay and soybeans appeared to increase the odds of having IDA during pregnancy. Health education on diet

West African journal of medicine, 2019

BACKGROUND Congenital Anomalies are a major contributor to perinatal deaths worldwide. The World ... more BACKGROUND Congenital Anomalies are a major contributor to perinatal deaths worldwide. The World Health Organization (WHO) estimates that 303,000 newborns die within the first 4 weeks of life worldwide as a result of it. The exact cause is often difficult to determine and as such efforts are geared towards prevention AIM AND OBJECTIVE: This study was done to determine the common presentations as well as epidemiological features of pregnant women with anomalous fetus and at the Lagos University Teaching Hospital. This may help to develop strategies for patient counseling and management. METHOD This study is a retrospective, cross sectional hospital based study conducted at the department of Obstetrics and Gyneacology of the Lagos University Teaching Hospita,l Idi-Araba during the period Jan 2012-Dec 2016. Relevant information regarding maternal age, parity, gestational age and pregnancy outcomes was documented from the delivery records of the mothers. RESULTS One hundred (100) babies...

Tropical Journal of Obstetrics and Gynaecology, 2019

Background: Efavirenz is now a first-line non-nucleoside reverse transcriptase inhibitor used as ... more Background: Efavirenz is now a first-line non-nucleoside reverse transcriptase inhibitor used as highly active antiretroviral therapy (HAART) though its use is fraught with maternal side effects, usually of the central nervous system (CNS) and fetal complications.

Background Anaemia during pregnancy could cause adverse outcomes to the woman and the foetus, inc... more Background Anaemia during pregnancy could cause adverse outcomes to the woman and the foetus, including anaemic heart failure, prematurity, and intrauterine growth retardation. Iron deficiency is the leading cause of anaemia and oral iron supplementation during pregnancy is widely recommended. However, little focus is directed to dietary intake. This study estimates the contribution of iron deficiency among anaemic pregnant women and examines risk factors including dietary risk factors for iron deficiency anaemia (IDA) in pregnant women with moderate or severe anaemia in Lagos and Kano states, Nigeria.Methods In this cross-sectional study, 11,582 women were screened for anaemia at 20–32 weeks gestation. The 872 who had moderate or severe anaemia (haemoglobin concentration < 10g/dL) were included in this study. Iron deficiency was defined as serum ferritin level < 30ng/mL. We described the sociodemographic and obstetric characteristics of the sample and their self-report of con...

Trials, Sep 8, 2022

Background: Anaemia in pregnancy is highly prevalent in African countries. High-dose oral iron is... more Background: Anaemia in pregnancy is highly prevalent in African countries. High-dose oral iron is the current recommended treatment for pregnancy-related iron deficiency anaemia (IDA) in Nigeria and other African countries. This oral regimen is often poorly tolerated and has several side effects. Parenteral iron preparations are now available for the treatment of IDA in pregnancy but not widely used in Africa. The IVON trial is investigating the comparative effectiveness and safety of intravenous ferric carboxymaltose versus oral ferrous sulphate standard-of-care for pregnancy-related IDA in Nigeria. We will also measure the implementation outcomes of acceptability, feasibility, fidelity, and cost-effectiveness for intravenous ferric carboxymaltose. Methods: This is an open-label randomised controlled trial with a hybrid type 1 effectiveness-implementation design, conducted at 10 health facilities in Kano (Northern) and Lagos (Southern) states in Nigeria. A total of 1056 pregnant women at 20-32 weeks' gestational age with moderate or severe anaemia (Hb < 10g/dl) will be randomised 1:1 into two groups. The interventional treatment is one 1000-mg dose of intravenous ferric carboxymaltose at enrolment; the control treatment is thrice daily oral ferrous sulphate (195 mg elemental iron daily), from enrolment till 6 weeks postpartum. Primary outcome measures are (1) the prevalence of maternal anaemia at 36 weeks and (2) infant preterm birth (<37 weeks' gestation) and will be analysed by intention-to-treat. Maternal full blood count and iron panel will be assayed at 4 weeks post-enrolment, 36 weeks' gestation, delivery, and 6 weeks postpartum. Implementation outcomes of acceptability, feasibility, fidelity, and cost will be assessed with structured questionnaires, key informant interviews, and focus group discussions.

Journal of Obstetrics and Gynaecology

South Sudan Medical Journal, 2020

Nigerian Hospital Practice, 2020

Background: Caesarean delivery (CD) is a procedure which poses a major public health concern to O... more Background: Caesarean delivery (CD) is a procedure which poses a major public health concern to Obstetricians. The outcome of emergency and elective caesarean delivery largely depend on the maternal and or fetal conditions. The study compared maternal and fetal outcomes in both elective and emergency caesarean delivery at the University College Hospital, Ibadan, Nigeria. Methods: This was a six-year retrospective study of pregnant women who underwent caesarean delivery at the University College Hospital. Information was extracted from their medical records using a proforma. Comparison of maternal and fetal outcomes of elective and emergency caesarean deliveries was done. Data were analyzed using SPSS version 20. Results: A total of 6,854 women had caesarean delivery (CD), mean age was 28.85 ± 5.62 years and ranged from 15-48 years. A higher proportion (85.5%) had emergency CD in which majority were unbooked (80.4%) with the commonest indication as prolong obstructed labour while rep...

The Lancet, 2021

Surgical site infection (SSI) is the most common postoperative complication worldwide. WHO guidel... more Surgical site infection (SSI) is the most common postoperative complication worldwide. WHO guidelines to prevent SSI recommend alcoholic chlorhexidine skin preparation and fascial closure using triclosan-coated sutures, but called for assessment of both interventions in low-resource settings. This study aimed to test both interventions in low-income and middle-income countries. FALCON was a 2 × 2 factorial, randomised controlled trial stratified by whether surgery was clean-contaminated, or contaminated or dirty, including patients undergoing abdominal surgery with a skin incision of 5 cm or greater. This trial was undertaken in 54 hospitals in seven countries (Benin, Ghana, India, Mexico, Nigeria, Rwanda, and South Africa). Patients were computer randomised 1:1:1:1 to: (1) 2% alcoholic chlorhexidine and non-coated suture, (2) 2% alcoholic chlorhexidine and triclosan-coated suture, (3) 10% aqueous povidone-iodine and non-coated suture, or (4) 10% aqueous povidone-iodine and triclosan-coated suture. Patients and outcome assessors were masked to intervention allocation. The primary outcome was SSI, reported by trained outcome assessors, and presented using adjusted relative risks and 95% CIs. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, NCT03700749. Between Dec 10, 2018, and Sept 7, 2020, 5788 patients (3091 in clean-contaminated stratum, 2697 in contaminated or dirty stratum) were randomised (1446 to alcoholic chlorhexidine and non-coated suture, 1446 to alcoholic chlorhexidine and triclosan-coated suture, 1447 to aqueous povidone-iodine and non-coated suture, and 1449 to aqueous povidone-iodine and triclosan-coated suture). 14·0% (810/5788) of patients were children and 66·9% (3873/5788) had emergency surgery. The overall SSI rate was 22·0% (1163/5284; clean-contaminated stratum 15·5% [454/2923], contaminated or dirty stratum 30·0% [709/2361]). For both strata, there was no evidence of a difference in the risk of SSI with alcoholic chlorhexidine versus povidone-iodine (clean-contaminated stratum 15·3% [223/1455] vs 15·7% [231/1468], relative risk 0·97 [95% CI 0·82-1·14]; contaminated or dirty stratum 28·3% [338/1194] vs 31·8% [371/1167], relative risk 0·91 [95% CI 0·81-1·02]), or with triclosan-coated sutures versus non-coated sutures (clean-contaminated stratum 14·7% [215/1459] vs 16·3% [239/1464], relative risk 0·90 [95% CI 0·77-1·06]; contaminated or dirty stratum 29·4% [347/1181] vs 30·7% [362/1180], relative risk 0·98 [95% CI 0·87-1·10]). With both strata combined, there were no differences using alcoholic chlorhexidine or triclosan-coated sutures. This trial did not show benefit from 2% alcoholic chlorhexidine skin preparation compared with povidone-iodine, or with triclosan-coated sutures compared with non-coated sutures, in preventing SSI in clean-contaminated or contaminated or dirty surgical wounds. Both interventions are more expensive than alternatives, and these findings do not support recommendations for routine use. National Institute for Health Research (NIHR) Global Health Research Unit Grant, BD.

BackgroundAnaemia in pregnancy is highly prevalent in African countries. High-dose oral iron is t... more BackgroundAnaemia in pregnancy is highly prevalent in African countries. High-dose oral iron is the current recommended treatment for pregnancy-related iron deficiency anaemia (IDA) in Nigeria and other African countries. This oral regimen is often poorly tolerated and has several side effects. Parenteral iron preparations are now available for treatment of IDA in pregnancy but not widely used in Africa.The IVON trial is investigating the comparative effectiveness and safety of intravenous ferric carboxymaltose versus oral ferrous sulphate standard-of-care for pregnancy-related IDA in Nigeria. We will also measure the implementation outcomes of acceptability, feasibility, fidelity, and cost-effectiveness for intravenous ferric carboxymaltose.Methods This is an open-label randomized controlled trial with a hybrid type 1 effectiveness-implementation design, conducted at 10 health facilities in Kano (Northern) and Lagos (Southern) states in Nigeria. A total of 1,056 pregnant women at 2...

The Journal of medical research, 2018

Ectopic pregnancy (EP) is a public health issue all over the world and remains a major gynaecolog... more Ectopic pregnancy (EP) is a public health issue all over the world and remains a major gynaecological problem in contemporary gynaecological practice. We assessed the risk factors for EP among women presenting at a tertiary health facility, University College Hospital (UCH), Ibadan, Nigeria. A10 year’s retrospective study of EP cases managed in UCH. Information was collected using a proforma and data analysed using SPSS 20. A total of 337 women had ectopic pregnancy. Mean age was 29.8 +/-5.6 years and majority (82.2%) were married. Identified risk factors were previous abdominal/pelvic surgery (ies), ectopic pregnancy and abortions while common clinical features include abdominal pain, vaginal bleeding and amenorrhoea. Majority (76.6%) were ruptured while ampulla of the fallopian tube was the commonest site. EP is still a dare emergency in our environment with most women presenting after it has ruptured. However, the risk factors and presentation has not changed.

Background: Caesarean section (C/S) rate and pattern of indications can be a reflection of matern... more Background: Caesarean section (C/S) rate and pattern of indications can be a reflection of maternal health status and quality of medical practice. This study aimed at determining current C/S rate at Lagos University Teaching Hospital (LUTH) and to assess trend, pattern and outcome of C/S in the last ten years. Study design: A cross sectional study of all cases of C/S ≥28 weeks gestational age performed at LUTH from January 1, 2008 to December 31, 2017. Information which included maternal age, parity, gestational age at delivery, booking status, type of C/S and indications was retrieved from Labour Ward register using an electronic database. Data analysis was done with IBM SPSS version 23. Results: A total of 12,811 deliveries that met the inclusion criteria during the study period were reviewed. Overall C/S rate was found to be 51.3% and there has been an increase over the years (p = 0.000). Commonest indications were previous C/S, HIV infection, hypertensive disorders, fetal distre...