Adebola Orimadegun | University of Ibadan Nigeria (original) (raw)

Papers by Adebola Orimadegun

Research paper thumbnail of Efficacy of Dual Parenteral Artemisinin-Based Combination Therapy for Cerebral Malaria in a Tripple Blinded Randomized Control Trial in Nigerian Children: DUAL PACT TRIAL

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Research paper thumbnail of Genetic analysis of Plasmodium malariae and Plasmodium ovale from asymptomatic adolescents in South-East Nigeria

日本寄生虫学会大会プログラム・抄録集, 2017

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Research paper thumbnail of Trends of infant vaccination timeliness and completion in selected urban slum communities in Ibadan, Southwestern Nigeria: A four-year review

PLOS ONE, May 23, 2023

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Research paper thumbnail of Efficacy and safety of dual intravenous artesunate plus quinine compared to intravenous artesunate for cerebral malaria in a triple blinded parallel multisite randomized controlled trial in Nigerian children: DUAL PAQ TRIAL Protocol

Trials, Oct 20, 2021

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Research paper thumbnail of Measles in Ibadan: a continuous scourge

PubMed, Dec 1, 2005

Measles remains one of the leading causes of childhood mortality in the world, despite the availa... more Measles remains one of the leading causes of childhood mortality in the world, despite the availability of a safe, effective, relatively inexpensive vaccine. It is also one of the leading causes of childhood blindness in the developing world. We reviewed the records of cases of measles admitted into Oni Memorial Children's Hospital, Ibadan over a 5-year period, January 2000 to December 2004; to evaluate any changes in the pattern of the disease. A total of 666 cases of measles were admitted comprising of 347 males and 319 females, giving a male to female ratio of 1.1:1. The yearly incidence of measles remained fairly the same from January 2000 to December 2002. There was a marked increase in yearly incidence in the year 2003. The majority of the affected children (74.1%) were 2 years and below. One hundred and thirty-six (20.4%) cases developed measles before the age of 9 months, the recommended age for measles vaccination in Nigeria. The peak incidence occurred in the months February and March. The commonest complication was bronchopneumonia, seen in 45.2% of cases. Other complications include protein-energy malnutrition, tuberculosis, croup, keratopathy, otitis media, heart failure and tension pneumothorax. Fifty-six patients died giving a case fatality rate of 8.4%. Factors associated with increased mortality were young age (<2years) and malnutrition. Measles remains a major threat to the health of the Nigerian child. A significant number of children developed measles before receiving the required vaccination at the recommended age of 9 months. There is a need to review the current immunisation policy, strengthen immunisation practices and improve the living standards in order to make the eradication of measles a reality.

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Research paper thumbnail of Ultrasonographic Hepatosplenic Parenchymal and Blood Flow Changes in Children with Acute Falciparum Malaria

PubMed, May 29, 2021

Background: Malaria, a major cause of morbidity and mortality in Nigerian children, is associated... more Background: Malaria, a major cause of morbidity and mortality in Nigerian children, is associated with biochemical, haematological, blood flow and clinical multiorgan changes, including changes in the spleen and the liver. Objectives: To investigate hepatosplenic pathologies in a Nigerian children cohort with acute P. falciparum malaria. Methods: A prospective case-control study of 260 children (65 uncomplicated malaria (UCM),65 complicated malaria (CM) cases and 130 controls) aged six months to six years. All subjects had laboratory tests and hepatosplenic parenchymal and blood-flow ultrasonographic evaluation. Results: Mean splenic length was 8.13cm (95% CI: 7.84cm, 8.41cm) and 7.42cm (95% CI: 7.13cm, 7.71cm) in CM and UCM (p=0.001) respectively, liver span was significantly different in controls and CM (p<0.001); controls and UCM (p=0.014). Portal vein flow velocity was 32.5cm/s, 25.4cm/s and 26.5cm/s in controls, UCM and CM (p=<0.001 and 0.004 respectively) while splenic flow velocity was 30.7cm/s and 25.8cm/s in controls and CM (p=0.022). Splenic artery peak systolic velocity (PSV) =73.78cm/s, 66.52cm/s and 59.35cm/s (p = 0.008) among controls, UCM and CM respectively. There was significant correlation between malaria parasite (MP) density and splenic length (r =0.239, p = 0.007), splenic artery pulsatility index (PI) (r = 0.300, p = 0.001), splenic artery resistivity index (RI) (r = 0.260, p = 0.003) and liver span. Conclusion: In children with acute malaria, the splenic vessels and portal vein blood flow velocities were reduced. High malaria parasite density evokes direct relationship with spleen and liver span, splenic artery RI and PI and portalvein diameter.

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Research paper thumbnail of Development and validation of the Ibadan Simplified Developmental Screening chart

Frontiers in Pediatrics, Jan 11, 2023

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Research paper thumbnail of High prevalence of Plasmodium malariae and Plasmodium ovale in co-infections with Plasmodium falciparum in asymptomatic malaria parasite carriers in Southwest Nigeria

medRxiv (Cold Spring Harbor Laboratory), Jan 15, 2021

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Research paper thumbnail of Protocol and Researcher's Relationship with Institutional Review Board

PubMed, Dec 1, 2020

The document of ethical approval is an important official requirement for research involving huma... more The document of ethical approval is an important official requirement for research involving human participants worldwide. It is the process whereby an investigator submits the full research proposal and related documents including detailed informed consent process to an independent Institutional Review Board (IRB) for scrutiny. The process of seeking review and approval is necessary to ensure adequate measure are in place to safeguard and protect research participants as entrenched in the principles of The Declaration of Helsinki and The Belmont Report. It is the responsibility of every clinical researcher to obtain ethical approval, therefore, their obligation to understand the process of review and establish relationship with local IRB in order to enhance smooth review and approval. This article, therefore, explains clinical research and distinguishes between research and clinical care, clarifies briefly what constitutes a study protocol and describes the researchers' relationship with IRB.

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Research paper thumbnail of Predictors of hypoxaemia during steady-state among children with Sickle Cell Anaemia in North-Western Nigeria

PubMed, Sep 1, 2015

Abstract Background: Haemoglobin desaturation, which presents as hypoxaemia, is a known phenomeno... more Abstract Background: Haemoglobin desaturation, which presents as hypoxaemia, is a known phenomenon in the cycle of red blood cells sickling in sickle cell anaemia (SCA). Thus, early and accurate recognition of hypoxaemia is important in order to ameliorate its adverse effects on vital organs. This study was carried out to investigate clinical and laboratory features that predict hypoxaemia in children with SCA during steady-state. Methods: We prospectively measured percutaneous haemoglobin saturation of 208 children with SCA in room air during steady-state at a secondary health facility in the north-west of Nigeria. Demographic, clinical and laboratory features and anthropometry were recorded. Hypoxaemia was defined as haemoglobin saturation < 90%. Chi square test and logistic regression were used to assess the associations of selected factors with hypoxaemia. Results: Participants comprised 132 males and 76 females and their age ranged from 9 to 168 months. Prevalence of hypoxaemia was 17.3%. Though hypoxaemia was significantly associated with age, time of first symptom to presentation, body mass index (BMI), weight-for-height z-score < 2.0, tachycardia, chest retraction and palpable spleen, age (OR = 0.78; 95% CI = 0.62, 0.96), time of first symptom to presentation (OR = 1.28; 95% = 1.03, 1.59), BMI (OR = 0.87; 95% = 0.76, 0.92) and palpable spleen (OR = 2.87; 95% CI = 1.43, 16.65) remained independent predictors in the logistic regression model. Conclusion: Careful consideration should be given to time of first symptom to presentation, body mass index and palpable spleen when evaluating children with sickle cell anaemia for hypoxaemia in resource limited settings.

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Research paper thumbnail of Sex-specific prevalence and trends in acute respiratory infection episodes among children less than 5 years in Nigeria

Nigerian Journal of Clinical Practice, 2019

Background: Biological sex is an important factor that influences childhood morbidity and mortali... more Background: Biological sex is an important factor that influences childhood morbidity and mortality but its role in acute respiratory infections (ARI) in children is not well understood. We investigated the trends in sex-specific prevalence of childhood ARI episodes and associated factors in Nigerian children from 1990 to 2013. Methods: This secondary analysis used data from the Nigerian Demographic Health Surveys (NDHS) collected in 1990, 1999, 2003, 2008 and 2013. Variables extracted include: two ARI-related questions, household characteristics, children's anthropometry and vaccination status. We defined ARI as maternal report of cough accompanied by short, rapid breathing. Univariate and bivariate analyses were carried out to estimate prevalence of suspected ARI and compared between male and female children. Results: We found an initial increase followed by a decreasing trend in prevalence of ARI-related symptoms among under-5 children; from 6.7% in 1990 to 11.6% in 1999 then to 3.8% in 2013 without consistent sex differences regardless of other factors except malnutrition. In the 2003 survey, more male than female children had ARI among underweight [OR = 1.22 (95% CI: 1.04, 1.43)] and stunted [OR = 1.23 (95% CI: 1.07, 1.43)] children. Similarly, the 2008 survey showed that more male (5.8%) than female (5.4%) children in the wasted category had ARI [OR = 1.13 (95% CI: 1.07, 2.01)]. The highest prevalence of suspected ARI was consistently recorded in the North-East region. Conclusion: The Nigeria Demographic Health Surveys demonstrated no consistent sex differences in burden and trends of childhood pneumonia-like episodes over a 24-year period. Malnutrition has some influence on the burden of ARI-related symptoms.

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Research paper thumbnail of High prevalence of Plasmodium malariae and Plasmodium ovale in co-infections with Plasmodium falciparum in asymptomatic malaria parasite carriers in southwestern Nigeria

International Journal for Parasitology, 2022

Asymptomatic malaria parasite carriers do not seek anti-malarial treatment and may constitute a s... more Asymptomatic malaria parasite carriers do not seek anti-malarial treatment and may constitute a silent infectious reservoir. In order to assess the level of asymptomatic and symptomatic carriage amongst adolescents in a highly endemic area, and to identify the risk factors associated with such carriage, we conducted a cross-sectional survey of 1032 adolescents (ages 10-19 years) from eight schools located in Ibadan, southwestern Nigeria in 2016. Blood films and blood spot filter paper samples were prepared for microscopy and DNA analysis. The prevalence of asymptomatic malaria was determined using microscopy, rapid diagnostic tests (RDTs) and PCR for 658 randomly selected samples. Of these, we found that 80% of asymptomatic schoolchildren were positive for malaria parasites by PCR, compared with 47% and 9%, determined by RDT and microscopy, respectively. Malaria parasite species typing was performed using PCR targeting the mitochondrial CoxIII gene, and revealed high rates of carriage of Plasmodium malariae (53%) and Plasmodium ovale (24%). Most asymptomatic infections were co-infections of two or more species (62%), with Plasmodium falciparum + P. malariae the most common (35%), followed by P. falciparum + P. malariae + P. ovale (21%) and P. falciparum + P. ovale (6%). Single infections of P. falciparum, P. malariae and P. ovale accounted for 24%, 10% and 4% of all asymptomatic infections, respectively. To compare the species composition of asymptomatic and symptomatic infections, further sample collection was carried out in 2017 at one of the previously sampled schools, and at a nearby hospital. Whilst the species composition of the asymptomatic infections was similar to that observed in 2016, the symptomatic infections were markedly different, with single infections of P. falciparum observed in 91% of patients, P. falciparum + P. malariae in 5% and P. falciparum + P. ovale in 4%.

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Research paper thumbnail of Prevalence and socio-demographic factors associated with non-protective immunity against tetanus among high school adolescents girls in Nigeria

Italian Journal of Pediatrics, Mar 17, 2014

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Research paper thumbnail of Obesity Affects Health-Related Quality of Life in Schools Functioning Among Adolescents in Southwest of Nigeria

Nigerian Journal of Clinical Practice

Background: The relationship between body mass index (BMI) and health-related quality of life (HR... more Background: The relationship between body mass index (BMI) and health-related quality of life (HRQoL) in adolescence is important but there is a dearth of this information among developing countries such as Nigeria. To assess the relationship between BMI and HRQoL among healthy schooling adolescents in Southwestern Nigeria. Aims: We assessed the relationship between BMI and HRQoL among healthy schooling adolescents in southwestern Nigeria. Methods: In a cross-sectional study design, 650 adolescents were selected and interviewed about their quality of life in the preceding 1 month using a validated instrument with contents adapted from the Pediatric Quality of Life Inventory (PedsQLTM) questionnaire. The BMI was calculated and plotted on the Center for Disease Control and Prevention percentile chart to categorize as underweight, normal, overweight, or obese. Comparisons were made using Student's t-test, ANOVA, and linear regression model at P = 0.05. Results: Participants mean BMI and overall HRQoL score was 19.0 ± 3.0 kg/m2 and 73.7 ± 11.7, respectively. The prevalence of underweight, overweight, and obesity was 6.9%, 2.3%, and 0.6%, respectively. Females (72.3 ± 12.2) had a significantly lower overall mean HRQoL score than males (75.0 ± 11.1), P = 0.048. Post-hoc ANOVA showed that obese adolescents had significantly lower mean HRQoL in school functioning domain (55.0 ± 20.8) than underweight (83.5 ± 14.), and normal BMI (81.3 ± 16.3) participants (P < 0.05). Conclusion: Obesity reduces HRQoL in the school functioning domain among adolescents in Ibadan, Nigeria. Our finding buttresses the need to monitor body mass and size in high schools for enhancing quality of life.

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Research paper thumbnail of SD-Bioline malaria rapid diagnostic test performance and time to become negative after treatment of malaria infection in Southwest Nigerian Children

Annals of African Medicine

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Research paper thumbnail of Infant Care Practices at Home in the First Weeks of Life in Ibadan, South-West Nigeria

West African journal of medicine, Dec 29, 2022

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Research paper thumbnail of Comparison of point-of-care glucometers and laboratory based glucose oxidase test in determining blood glucose levels

Nigerian Journal of Paediatrics

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Research paper thumbnail of Persistence of Plasmodium Falciparum HRP2 Antigen After Effective Antimalarial Therapy

Annals of Ibadan postgraduate medicine, Jun 1, 2021

Introduction: Histidine Rich Protein 2 based (HRP2-based) malaria rapid diagnostic tests (mRDTs) ... more Introduction: Histidine Rich Protein 2 based (HRP2-based) malaria rapid diagnostic tests (mRDTs) have been shown to perform as well as routine light microscopy, however, they are limited by some factors including persistence of HRP2 antigenemia. In this paper we report the evaluation of an HRP2-based mRDT in a prospective study that enrolled children and followed them up for 28 days. Methods: Children aged below five years, with acute episode of fever/pyrexia, were enrolled. The enrolled participants had expert malaria microscopy and RDT done at enrolment (Day 0), and on days 1, 2, 3, 7, 14, 21, and 28. The malaria RDT test was considered positive when the antigen and control lines were visible in their respective windows, negative when only the control band was visible and invalid when the control band was not visible. Faint test lines were considered positive. The RDT results were compared to those of expert microscopy. Results: Two hundred and twenty-six children aged 29.2 ± 15.5 months were enrolled. The proportion of children positive by expert malaria microscopy and RDT was 100% and 95.6% respectively. During the 28 day follow up of the children the proportions positive by microscopy and RDT on days 3, 7, 14, and 28 were 1% and 94.6%, 0% and 93.5%, 0% and 91%, and 16.5% and 80.6% respectively. Gender and age dependent analysis of proportion of positive children were similar. Proportion of children with persistence of HRP2 antigen appeared to be lower in those with parasite density below 200/µL, however, this observation requires further evaluation in larger studies. Conclusion: the study revealed a high proportion of persistence of HRP2 antigen in the children 28 days after effective antimalarial therapy. Histidine rich protein 2 based malaria rapid diagnostic tests are not recommended for monitoring of antimalarial therapies.

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Research paper thumbnail of Electrocardiographic features in children with severe falciparum malaria at the University College Hospital, Ibadan

Research Journal of Health Sciences

Introduction: The high burden of Malaria morbidity and mortality in children is due to its potent... more Introduction: The high burden of Malaria morbidity and mortality in children is due to its potential to cause multi-organ dysfunction. There is however limited information on the specific electrocardiographic features in falciparum malaria in paediatric age group.Aim: To investigate the electrocardiographic (ECG) features in children with (complicated) severe falciparum malaria (SM) and acute uncomplicated malaria (AUM) at the University College Hospital, Ibadan.Methods: This was a comparative cross-sectional study conducted among 398 children with symptomatic and confirmed Plasmodium falciparum malaria and apparently healthy controls. The frequencies of ECG features were described and compared among these children.Results: The prevalence of ECG abnormality was 79.7% and 63.2% in Severe Malaria SM and Acute uncomplicated malaria AUM patients, respectively. Sinus tachycardia was significantly more frequent in SM than AUM and control groups (p <0.001). The risk of an ECG abnormalit...

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Research paper thumbnail of Non-Malaria Causes of Fever among under-5 Children with Negative Results for Malaria Rapid Diagnostic Test in South-Western Nigeria

Journal of Tropical Pediatrics

Background Although the global malaria burden is decreasing, there are still concerns about overd... more Background Although the global malaria burden is decreasing, there are still concerns about overdiagnosis of malaria and the danger of misdiagnosis of non-malaria causes of fever. Clinicians continue to face the challenge of differentiating between these causes despite the introduction of malaria rapid diagnostic tests (mRDTs). Aim To determine the prevalence and causes of non-malaria-caused fever in children in South-Western Nigeria. Methods Secondary analysis of data obtained to evaluate the effect of restricting antimalarial treatment to positive mRDT children in rural and urban areas of southwest Nigeria. Clinical examinations, laboratory tests for malaria parasites (including thick blood film and mRDT) and bacterial identification were performed on children aged 3–59 months (n = 511). The non-malaria group comprised febrile children who had both negative mRDT and microscopy results, while the malaria group included those who were positive for either mRDT or microscopy. We compa...

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Research paper thumbnail of Efficacy of Dual Parenteral Artemisinin-Based Combination Therapy for Cerebral Malaria in a Tripple Blinded Randomized Control Trial in Nigerian Children: DUAL PACT TRIAL

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Research paper thumbnail of Genetic analysis of Plasmodium malariae and Plasmodium ovale from asymptomatic adolescents in South-East Nigeria

日本寄生虫学会大会プログラム・抄録集, 2017

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Research paper thumbnail of Trends of infant vaccination timeliness and completion in selected urban slum communities in Ibadan, Southwestern Nigeria: A four-year review

PLOS ONE, May 23, 2023

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Research paper thumbnail of Efficacy and safety of dual intravenous artesunate plus quinine compared to intravenous artesunate for cerebral malaria in a triple blinded parallel multisite randomized controlled trial in Nigerian children: DUAL PAQ TRIAL Protocol

Trials, Oct 20, 2021

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Research paper thumbnail of Measles in Ibadan: a continuous scourge

PubMed, Dec 1, 2005

Measles remains one of the leading causes of childhood mortality in the world, despite the availa... more Measles remains one of the leading causes of childhood mortality in the world, despite the availability of a safe, effective, relatively inexpensive vaccine. It is also one of the leading causes of childhood blindness in the developing world. We reviewed the records of cases of measles admitted into Oni Memorial Children's Hospital, Ibadan over a 5-year period, January 2000 to December 2004; to evaluate any changes in the pattern of the disease. A total of 666 cases of measles were admitted comprising of 347 males and 319 females, giving a male to female ratio of 1.1:1. The yearly incidence of measles remained fairly the same from January 2000 to December 2002. There was a marked increase in yearly incidence in the year 2003. The majority of the affected children (74.1%) were 2 years and below. One hundred and thirty-six (20.4%) cases developed measles before the age of 9 months, the recommended age for measles vaccination in Nigeria. The peak incidence occurred in the months February and March. The commonest complication was bronchopneumonia, seen in 45.2% of cases. Other complications include protein-energy malnutrition, tuberculosis, croup, keratopathy, otitis media, heart failure and tension pneumothorax. Fifty-six patients died giving a case fatality rate of 8.4%. Factors associated with increased mortality were young age (<2years) and malnutrition. Measles remains a major threat to the health of the Nigerian child. A significant number of children developed measles before receiving the required vaccination at the recommended age of 9 months. There is a need to review the current immunisation policy, strengthen immunisation practices and improve the living standards in order to make the eradication of measles a reality.

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Research paper thumbnail of Ultrasonographic Hepatosplenic Parenchymal and Blood Flow Changes in Children with Acute Falciparum Malaria

PubMed, May 29, 2021

Background: Malaria, a major cause of morbidity and mortality in Nigerian children, is associated... more Background: Malaria, a major cause of morbidity and mortality in Nigerian children, is associated with biochemical, haematological, blood flow and clinical multiorgan changes, including changes in the spleen and the liver. Objectives: To investigate hepatosplenic pathologies in a Nigerian children cohort with acute P. falciparum malaria. Methods: A prospective case-control study of 260 children (65 uncomplicated malaria (UCM),65 complicated malaria (CM) cases and 130 controls) aged six months to six years. All subjects had laboratory tests and hepatosplenic parenchymal and blood-flow ultrasonographic evaluation. Results: Mean splenic length was 8.13cm (95% CI: 7.84cm, 8.41cm) and 7.42cm (95% CI: 7.13cm, 7.71cm) in CM and UCM (p=0.001) respectively, liver span was significantly different in controls and CM (p<0.001); controls and UCM (p=0.014). Portal vein flow velocity was 32.5cm/s, 25.4cm/s and 26.5cm/s in controls, UCM and CM (p=<0.001 and 0.004 respectively) while splenic flow velocity was 30.7cm/s and 25.8cm/s in controls and CM (p=0.022). Splenic artery peak systolic velocity (PSV) =73.78cm/s, 66.52cm/s and 59.35cm/s (p = 0.008) among controls, UCM and CM respectively. There was significant correlation between malaria parasite (MP) density and splenic length (r =0.239, p = 0.007), splenic artery pulsatility index (PI) (r = 0.300, p = 0.001), splenic artery resistivity index (RI) (r = 0.260, p = 0.003) and liver span. Conclusion: In children with acute malaria, the splenic vessels and portal vein blood flow velocities were reduced. High malaria parasite density evokes direct relationship with spleen and liver span, splenic artery RI and PI and portalvein diameter.

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Research paper thumbnail of Development and validation of the Ibadan Simplified Developmental Screening chart

Frontiers in Pediatrics, Jan 11, 2023

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Research paper thumbnail of High prevalence of Plasmodium malariae and Plasmodium ovale in co-infections with Plasmodium falciparum in asymptomatic malaria parasite carriers in Southwest Nigeria

medRxiv (Cold Spring Harbor Laboratory), Jan 15, 2021

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Research paper thumbnail of Protocol and Researcher's Relationship with Institutional Review Board

PubMed, Dec 1, 2020

The document of ethical approval is an important official requirement for research involving huma... more The document of ethical approval is an important official requirement for research involving human participants worldwide. It is the process whereby an investigator submits the full research proposal and related documents including detailed informed consent process to an independent Institutional Review Board (IRB) for scrutiny. The process of seeking review and approval is necessary to ensure adequate measure are in place to safeguard and protect research participants as entrenched in the principles of The Declaration of Helsinki and The Belmont Report. It is the responsibility of every clinical researcher to obtain ethical approval, therefore, their obligation to understand the process of review and establish relationship with local IRB in order to enhance smooth review and approval. This article, therefore, explains clinical research and distinguishes between research and clinical care, clarifies briefly what constitutes a study protocol and describes the researchers' relationship with IRB.

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Research paper thumbnail of Predictors of hypoxaemia during steady-state among children with Sickle Cell Anaemia in North-Western Nigeria

PubMed, Sep 1, 2015

Abstract Background: Haemoglobin desaturation, which presents as hypoxaemia, is a known phenomeno... more Abstract Background: Haemoglobin desaturation, which presents as hypoxaemia, is a known phenomenon in the cycle of red blood cells sickling in sickle cell anaemia (SCA). Thus, early and accurate recognition of hypoxaemia is important in order to ameliorate its adverse effects on vital organs. This study was carried out to investigate clinical and laboratory features that predict hypoxaemia in children with SCA during steady-state. Methods: We prospectively measured percutaneous haemoglobin saturation of 208 children with SCA in room air during steady-state at a secondary health facility in the north-west of Nigeria. Demographic, clinical and laboratory features and anthropometry were recorded. Hypoxaemia was defined as haemoglobin saturation < 90%. Chi square test and logistic regression were used to assess the associations of selected factors with hypoxaemia. Results: Participants comprised 132 males and 76 females and their age ranged from 9 to 168 months. Prevalence of hypoxaemia was 17.3%. Though hypoxaemia was significantly associated with age, time of first symptom to presentation, body mass index (BMI), weight-for-height z-score < 2.0, tachycardia, chest retraction and palpable spleen, age (OR = 0.78; 95% CI = 0.62, 0.96), time of first symptom to presentation (OR = 1.28; 95% = 1.03, 1.59), BMI (OR = 0.87; 95% = 0.76, 0.92) and palpable spleen (OR = 2.87; 95% CI = 1.43, 16.65) remained independent predictors in the logistic regression model. Conclusion: Careful consideration should be given to time of first symptom to presentation, body mass index and palpable spleen when evaluating children with sickle cell anaemia for hypoxaemia in resource limited settings.

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Research paper thumbnail of Sex-specific prevalence and trends in acute respiratory infection episodes among children less than 5 years in Nigeria

Nigerian Journal of Clinical Practice, 2019

Background: Biological sex is an important factor that influences childhood morbidity and mortali... more Background: Biological sex is an important factor that influences childhood morbidity and mortality but its role in acute respiratory infections (ARI) in children is not well understood. We investigated the trends in sex-specific prevalence of childhood ARI episodes and associated factors in Nigerian children from 1990 to 2013. Methods: This secondary analysis used data from the Nigerian Demographic Health Surveys (NDHS) collected in 1990, 1999, 2003, 2008 and 2013. Variables extracted include: two ARI-related questions, household characteristics, children's anthropometry and vaccination status. We defined ARI as maternal report of cough accompanied by short, rapid breathing. Univariate and bivariate analyses were carried out to estimate prevalence of suspected ARI and compared between male and female children. Results: We found an initial increase followed by a decreasing trend in prevalence of ARI-related symptoms among under-5 children; from 6.7% in 1990 to 11.6% in 1999 then to 3.8% in 2013 without consistent sex differences regardless of other factors except malnutrition. In the 2003 survey, more male than female children had ARI among underweight [OR = 1.22 (95% CI: 1.04, 1.43)] and stunted [OR = 1.23 (95% CI: 1.07, 1.43)] children. Similarly, the 2008 survey showed that more male (5.8%) than female (5.4%) children in the wasted category had ARI [OR = 1.13 (95% CI: 1.07, 2.01)]. The highest prevalence of suspected ARI was consistently recorded in the North-East region. Conclusion: The Nigeria Demographic Health Surveys demonstrated no consistent sex differences in burden and trends of childhood pneumonia-like episodes over a 24-year period. Malnutrition has some influence on the burden of ARI-related symptoms.

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Research paper thumbnail of High prevalence of Plasmodium malariae and Plasmodium ovale in co-infections with Plasmodium falciparum in asymptomatic malaria parasite carriers in southwestern Nigeria

International Journal for Parasitology, 2022

Asymptomatic malaria parasite carriers do not seek anti-malarial treatment and may constitute a s... more Asymptomatic malaria parasite carriers do not seek anti-malarial treatment and may constitute a silent infectious reservoir. In order to assess the level of asymptomatic and symptomatic carriage amongst adolescents in a highly endemic area, and to identify the risk factors associated with such carriage, we conducted a cross-sectional survey of 1032 adolescents (ages 10-19 years) from eight schools located in Ibadan, southwestern Nigeria in 2016. Blood films and blood spot filter paper samples were prepared for microscopy and DNA analysis. The prevalence of asymptomatic malaria was determined using microscopy, rapid diagnostic tests (RDTs) and PCR for 658 randomly selected samples. Of these, we found that 80% of asymptomatic schoolchildren were positive for malaria parasites by PCR, compared with 47% and 9%, determined by RDT and microscopy, respectively. Malaria parasite species typing was performed using PCR targeting the mitochondrial CoxIII gene, and revealed high rates of carriage of Plasmodium malariae (53%) and Plasmodium ovale (24%). Most asymptomatic infections were co-infections of two or more species (62%), with Plasmodium falciparum + P. malariae the most common (35%), followed by P. falciparum + P. malariae + P. ovale (21%) and P. falciparum + P. ovale (6%). Single infections of P. falciparum, P. malariae and P. ovale accounted for 24%, 10% and 4% of all asymptomatic infections, respectively. To compare the species composition of asymptomatic and symptomatic infections, further sample collection was carried out in 2017 at one of the previously sampled schools, and at a nearby hospital. Whilst the species composition of the asymptomatic infections was similar to that observed in 2016, the symptomatic infections were markedly different, with single infections of P. falciparum observed in 91% of patients, P. falciparum + P. malariae in 5% and P. falciparum + P. ovale in 4%.

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Research paper thumbnail of Prevalence and socio-demographic factors associated with non-protective immunity against tetanus among high school adolescents girls in Nigeria

Italian Journal of Pediatrics, Mar 17, 2014

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Research paper thumbnail of Obesity Affects Health-Related Quality of Life in Schools Functioning Among Adolescents in Southwest of Nigeria

Nigerian Journal of Clinical Practice

Background: The relationship between body mass index (BMI) and health-related quality of life (HR... more Background: The relationship between body mass index (BMI) and health-related quality of life (HRQoL) in adolescence is important but there is a dearth of this information among developing countries such as Nigeria. To assess the relationship between BMI and HRQoL among healthy schooling adolescents in Southwestern Nigeria. Aims: We assessed the relationship between BMI and HRQoL among healthy schooling adolescents in southwestern Nigeria. Methods: In a cross-sectional study design, 650 adolescents were selected and interviewed about their quality of life in the preceding 1 month using a validated instrument with contents adapted from the Pediatric Quality of Life Inventory (PedsQLTM) questionnaire. The BMI was calculated and plotted on the Center for Disease Control and Prevention percentile chart to categorize as underweight, normal, overweight, or obese. Comparisons were made using Student's t-test, ANOVA, and linear regression model at P = 0.05. Results: Participants mean BMI and overall HRQoL score was 19.0 ± 3.0 kg/m2 and 73.7 ± 11.7, respectively. The prevalence of underweight, overweight, and obesity was 6.9%, 2.3%, and 0.6%, respectively. Females (72.3 ± 12.2) had a significantly lower overall mean HRQoL score than males (75.0 ± 11.1), P = 0.048. Post-hoc ANOVA showed that obese adolescents had significantly lower mean HRQoL in school functioning domain (55.0 ± 20.8) than underweight (83.5 ± 14.), and normal BMI (81.3 ± 16.3) participants (P < 0.05). Conclusion: Obesity reduces HRQoL in the school functioning domain among adolescents in Ibadan, Nigeria. Our finding buttresses the need to monitor body mass and size in high schools for enhancing quality of life.

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Research paper thumbnail of SD-Bioline malaria rapid diagnostic test performance and time to become negative after treatment of malaria infection in Southwest Nigerian Children

Annals of African Medicine

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Research paper thumbnail of Infant Care Practices at Home in the First Weeks of Life in Ibadan, South-West Nigeria

West African journal of medicine, Dec 29, 2022

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Research paper thumbnail of Comparison of point-of-care glucometers and laboratory based glucose oxidase test in determining blood glucose levels

Nigerian Journal of Paediatrics

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Research paper thumbnail of Persistence of Plasmodium Falciparum HRP2 Antigen After Effective Antimalarial Therapy

Annals of Ibadan postgraduate medicine, Jun 1, 2021

Introduction: Histidine Rich Protein 2 based (HRP2-based) malaria rapid diagnostic tests (mRDTs) ... more Introduction: Histidine Rich Protein 2 based (HRP2-based) malaria rapid diagnostic tests (mRDTs) have been shown to perform as well as routine light microscopy, however, they are limited by some factors including persistence of HRP2 antigenemia. In this paper we report the evaluation of an HRP2-based mRDT in a prospective study that enrolled children and followed them up for 28 days. Methods: Children aged below five years, with acute episode of fever/pyrexia, were enrolled. The enrolled participants had expert malaria microscopy and RDT done at enrolment (Day 0), and on days 1, 2, 3, 7, 14, 21, and 28. The malaria RDT test was considered positive when the antigen and control lines were visible in their respective windows, negative when only the control band was visible and invalid when the control band was not visible. Faint test lines were considered positive. The RDT results were compared to those of expert microscopy. Results: Two hundred and twenty-six children aged 29.2 ± 15.5 months were enrolled. The proportion of children positive by expert malaria microscopy and RDT was 100% and 95.6% respectively. During the 28 day follow up of the children the proportions positive by microscopy and RDT on days 3, 7, 14, and 28 were 1% and 94.6%, 0% and 93.5%, 0% and 91%, and 16.5% and 80.6% respectively. Gender and age dependent analysis of proportion of positive children were similar. Proportion of children with persistence of HRP2 antigen appeared to be lower in those with parasite density below 200/µL, however, this observation requires further evaluation in larger studies. Conclusion: the study revealed a high proportion of persistence of HRP2 antigen in the children 28 days after effective antimalarial therapy. Histidine rich protein 2 based malaria rapid diagnostic tests are not recommended for monitoring of antimalarial therapies.

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Research paper thumbnail of Electrocardiographic features in children with severe falciparum malaria at the University College Hospital, Ibadan

Research Journal of Health Sciences

Introduction: The high burden of Malaria morbidity and mortality in children is due to its potent... more Introduction: The high burden of Malaria morbidity and mortality in children is due to its potential to cause multi-organ dysfunction. There is however limited information on the specific electrocardiographic features in falciparum malaria in paediatric age group.Aim: To investigate the electrocardiographic (ECG) features in children with (complicated) severe falciparum malaria (SM) and acute uncomplicated malaria (AUM) at the University College Hospital, Ibadan.Methods: This was a comparative cross-sectional study conducted among 398 children with symptomatic and confirmed Plasmodium falciparum malaria and apparently healthy controls. The frequencies of ECG features were described and compared among these children.Results: The prevalence of ECG abnormality was 79.7% and 63.2% in Severe Malaria SM and Acute uncomplicated malaria AUM patients, respectively. Sinus tachycardia was significantly more frequent in SM than AUM and control groups (p <0.001). The risk of an ECG abnormalit...

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Research paper thumbnail of Non-Malaria Causes of Fever among under-5 Children with Negative Results for Malaria Rapid Diagnostic Test in South-Western Nigeria

Journal of Tropical Pediatrics

Background Although the global malaria burden is decreasing, there are still concerns about overd... more Background Although the global malaria burden is decreasing, there are still concerns about overdiagnosis of malaria and the danger of misdiagnosis of non-malaria causes of fever. Clinicians continue to face the challenge of differentiating between these causes despite the introduction of malaria rapid diagnostic tests (mRDTs). Aim To determine the prevalence and causes of non-malaria-caused fever in children in South-Western Nigeria. Methods Secondary analysis of data obtained to evaluate the effect of restricting antimalarial treatment to positive mRDT children in rural and urban areas of southwest Nigeria. Clinical examinations, laboratory tests for malaria parasites (including thick blood film and mRDT) and bacterial identification were performed on children aged 3–59 months (n = 511). The non-malaria group comprised febrile children who had both negative mRDT and microscopy results, while the malaria group included those who were positive for either mRDT or microscopy. We compa...

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