Emmanuel O. Amoo

Estimating the prevalence, hospitalisation and mortality from type 2 diabetes mellitus in Nigeria: A systematic review and meta-analysis

Background There is not yet a comprehensive evidence-based epidemiological report on type 2 diabetes mellitus (T2DM) in Nigeria. We aimed to estimate country-wide and zonal prevalence, hospitalisation and mortality rates of T2DM in Nigeria. Methods We searched MEDLINE, EMBASE, Global Health, Africa Journals Online (AJOL) and Google Scholar for population and hospital-based studies on T2DM in Nigeria. We conducted a random-effects meta-analysis on extracted crude estimates, and applied a meta-regression epidemiological model, using the United Nations demographics for Nigeria in 1990 and 2015 to determine estimates of diabetes in Nigeria for the two years. Results 42 studies, with a total population of 91 320, met our selection criteria. Most of the studies selected were of medium quality (90.5%). The age-adjusted prevalence rates of T2DM in Nigeria among persons aged 20–79 years increased from 2.0% (95% CI 1.9% to 2.1%) in 1990 to 5.7% (95% CI 5.5% to 5.8%) in 2015, accounting for over 874 000 and 4.7 million cases, respectively. The pooled prevalence rate of impaired glucose tolerance was 10.0% (95% CI 4.5% to 15.6%), while impaired fasting glucose was 5.8% (95% CI 3.8% to 7.8%). Hospital admission rate for T2DM was 222.6 (95% CI 133.1 to 312.1) per 100 000 population with hyperglycaemic emergencies, diabetic foot and cardiovascular diseases being most common complications. The overall mortality rate was 30.2 (95% CI 14.6 to 45.8) per 100 000 population, with a case fatality rate of 22.0% (95% CI 8.0% to 36.0%). Conclusion Our findings suggest an increasing burden of T2DM in Nigeria with many persons currently undiagnosed, and few known cases on treatment.

Improving postnatal checkups for mothers in West Africa:A multilevel analysis

ABSTRACT This study examined multilevel factors related to postnatal checkups for mothers in selected West African countries. The study analyzed data from Demographic and Health Surveys (DHS) for five West African countries: Sierra Leone (2013), Cote d’Ivoire (2012), Guinea (2012), Niger (2012), and Liberia (2013). The weighted sample sizes were 2125 (Cote d’Ivoire), 2908 (Guinea), 1905 (Liberia), 5660 (Niger), and 3754 (Sierra Leone). The outcome variable was maternal postnatal checkups. The explanatory variables were community and individual/household characteristics. With the use of Stata 12, the chi-square statistic and multilevel mixed-effects logistic regression were applied. More than two-thirds of respondents in Guinea and Niger did not receive a postnatal checkup after their last birth, while in Cote d’Ivoire, Liberia, and Sierra Leone, more than half of respondents received a postnatal checkup after their last childbirth. Community characteristics accounted for the following variations in postnatal checkups: 33.9% (Cote d’Ivoire), 37.2% (Guinea), 27.0% (Liberia), 33.5% (Niger), and 37.2% (Sierra Leone). Community factors thus had important relations to use of postnatal care in West Africa. Interventions targeting more community variables, particularly community education and poverty, may further improve postnatal care in West Africa.

Male reproductive health challenges: appraisal of wives coping strategies

BackgroundSystematic studies on the association between men’s sexual dysfunction (low sexual desire, ejaculation disorders, erectile dysfunctions, genital ulcers, testicular disorders, prostate cancer or sexually transmitted infections) and marital conflict are emerging. However, the coping strategies adopted by wives in such circumstances are not commonly reported in the literature. Male sexual functioning is vital to the marital relationship, lack of it can result in intolerable cohabitation or relationship breakdown, and could also cause infertility, infidelity, and arouse stigma in Nigeria. The understanding of coping strategies by female partners could guide in the counselling and treatment of men’s sexual health problems. Effective coping has the potential to lessen or prevent negative outcomes, and thereby could reduce marital conflict.ObjectivesThis study examined the coping strategies adopted by women whose husbands have reproductive health challenges in two of the five states with the highest proportion of divorce/separation in Nigeria.MethodsFour focus group discussions were conducted in two local government areas. The women were recruited from a quantitative couple-study for men with sexual health problems. Focus group responses were transcribed and analysed using systematic-content-analysis with thematic organisation of the summaries and systematic typologies of participants’ responses.ResultsThe results revealed the coping strategies employed by women in this environment: seeking guidance from their religious leaders and family doctors, physical-sexual-therapy, abstinence and concubinage. The participants indicated that they encountered difficulties in discussing their husbands’ sexual health problems with a third party.ConclusionThe study concludes that husband’s sexual ability is crucial to the sustenance of the marital relationship. Religious leaders and family doctors often serve as mediators to husband-wife conflict management. Counselling is recommended in cases of sexual health problems. Husbands should be encouraged to seek treatment and share their sexual challenges with their spouse. The medical officers and religious leaders could also be trained in family-conflict management.

Are Men’s Reproductive Health Problems and Sexual Behavior Predictors of Welfare?:

The study examined men’s reproductive health problems and sexual behavior and their implications for men’s welfare in Nigeria. It used the Nigeria Demographic and Health Survey data set of 2013. The analysis used only male recode files, representing 17,359 males. The dependent variable is the computed wealth index, which was selected as proxy for welfare condition. Analysis involved univariate and multivariate levels. The findings indicated that 49.3% of the respondents currently have more than one sexual partner. The total lifetime sexual partner index identifies 70.2% of the men interviewed have had at least two sexual partners in their lifetime. It revealed that men who experience reproductive health challenges, such as sexually transmitted infections and genital ulcer, are 44% and 93%, respectively, less likely to enjoy good welfare condition. It also indicated that men in urban area are 7.256 times more likely to enjoy good welfare condition compared with their rural counterparts. There is a negative association between total lifetime sexual partnerships and exposure to good welfare. The study concludes that social workers, marriage counselors, other health personnel, and policy makers need to focus on the practice of multiple sexual partnership and reproductive health diseases as major determinants of men’s welfare. The authors suggest that the index of welfare should include reproductive health issues and indicators of sexual behavior. Also, there is need for the establishment of specialized reproductive health care services and centers that are accessible to all men for effective servicing of reproductive health needs of men in the country.

Introduction to Special Edition on Covenant University’s Perspectives on Nigeria Demography and Achievement of SDGs-2030

This special edition of African Population Studies (Etude de la Population Africaine) is the initiative of the Programme of Demography and Social Statistics, Covenant University, Ota, Nigeria, to harvest in a single compendium, the various research outputs that could provide insightful understanding and enhancement of the achievement of Sustainable Development Goals by 2030 (SDGs-2030) as it relates to Nigeria. The theme is Covenant University’s Perspectives on Nigeria Demography and Achievement of SDGs-2030. This expository compilation covers certain salient challenges of Nigeria, ranging from family breakdowns and wellbeing, Boko Haram insurgency, environment and climate change, effects of smoking, child mortality, agricultural output, human capital and inclusive growth, unsuspected self-help medical knowledge, and best approach to health-aid. The findings presented in this edition are ground breaking qualitative and empirical findings coming from indigenous data and knowledge in attempt to provide solutions to the problem of Nigeria and sub-Saharan Africa as a whole.

Spousal desertion and coping strategies among women with cervical cancer in Nigeria: a schematic framework for wellbeing

Background: Women that are not in good health cannot contribute to sustainable development but effective coping during and after sickness could enhance their contributions to development. Objective: The study examined the coping strategies among women with cervical cancer in different marital context in Nigeria Methods: In-depth interview from eight women survivors and patients of cervical cancer in two distinct marital contexts characterised by the presence or absence of husband from two states of Nigeria. Data were analysed using content analytic procedures and premised upon relationship-focused coping strategy theory. Results: The study identified basic coping strategies as seeking support from religious organisations and adjustment of sexual lifestyle. Conclusion: The study concluded that women’s coping strategies on cervical cancer varied according to marital context. The authors recommend counselling, increasing cervical cancer risk awareness and husband-wife support, especially during life-threatening sicknesses to engender quick recovery and improved well-being for sustaining women contributions to development.

Estimating the prevalence and health risks awareness of smoking in Nigeria: A meta-analysis approach

Background: The increase use of tobacco products in Nigeria, and lack of common aggregated data on its associate diseases and deaths are parts of emerging public concerns. Objective: This paper estimated national and zonal prevalence of smoking and health risks awareness in Nigeria. Methods: Random effects meta-analysis was conducted on estimates from 19 studies selected across 13 states, within the six-geopolitical zones of Nigeria, to pool nation-wide estimates of the prevalence and health risk awareness of smoking. Results: The sample and aggregated mean ages are 14.7 and 22.4 years, respectively. The overall pooled prevalence of current smoking in Nigeria was 19.7% (95%CI: 14.0-25.5), with male and female at 18.9% (CI:13.3-24.4) and 6.8% (CI:4.1-9.6), respectively. Conclusion: The findings suggest a relatively high prevalence of smoking among the youths in Nigeria. The authors recommend smokers’ counseling services among the youth to reduce health hazards and secure youth contributions to sustainable economic development.

Inter-spousal communication: A means for achieving concordant fertility goals

Background: Spousal communication strategy has gained attention as an effective means of reducing couple’s fertility preferences, its continuous measurement cannot be overemphasised in literature Objecive: This study examined concordance and discordance in the desired number of children among couples in Nigeria. Methods: The study used the 2013 Couple dataset of Nigeria Demographic and Health Survey. The method of data analyses involved univariate, chi-square and binary logistic regression. Results: The result showed that 34% of couples agreed on common fertility desires, while 66% disagreed. The logistic regression analysis using Likelihood Ratio test, showed that couples communication significantly explained the indirect effects of background variables on concordant fertility desire (P<0.001). Conclusion: We therefore, recommend that couples’ communication on family size preferences be encouraged by programs geared towards achieving SDG-3,5 aimed at improving women and child health and gender equality in decision making.

Trends and determinants of female age at first marriage in Sub-Saharan Africa (1990-2014): What has changed?

The study analysed trends and determinants of female age at first marriage in Ghana, Kenya and Zambia using DHS datasets across defined survey horizons: 1990-1999, 2000-1999 and 2010-2014. The data analysis employed frequency distribution, cross tabulation and Cox proportional regression techniques. The results revealed female median age at first marriage as 17. The result showed a reduction in the proportion marrying at age ≤17 between 1990 and 2014 by 9.8% (Ghana), 6.2% (Kenya) and 7.2% (Zambia). Women with tertiary education and rich households had lower hazard ratio to marry at age ≤17 compared with those without education and from poor households (HR: 0.39, CI: 0.0.36-0.43) and (HR: 0.86, CI: 0.81-0.90) respectively. The study supports the use of child-marriage market model to heighten female age at first marriage through access to tertiary education. The boost in female education could be harnessed for sustainable development through provisions of job opportunities.

Internal Migration and Welfare among Street Traders in Nigeria

This study examines the employment and income opportunities being enjoyed by migrants and non-migrants in street trading sub-sector of the urban informal economy in Nigeria. The welfare implication of such employment was also examined in the study using both the logistic model and the modified Mincers model. The data for the study was generated from a cross-section study conducted in four geopolitical zones of Nigeria in the year 2011. These zones are the South-West, South-East, South-South and the Northern parts of Nigeria. The main instrument of data collection was the questionnaire administered in the selected cities. Analysis of data revealed that the majority of street traders interviewed are migrants, and about 72 percent of them reported improvement in welfare. According to the result of the earnings function estimated, migration variable is a statistically significant variable affecting welfare, among others. Therefore the need for policy measures that will create income and employment opportunities in the rural areas and cities cannot be over-emphasised.