Olayemi F. Awopeju

Prevalence of asthma symptoms among university students 15 to 35 years of age in obafemi awolowo university, Ile-Ife, osun state

Introduction. Asthma continues to cause increasing morbidity and mortality among young adults in the developing world. There is scarcity of data on the prevalence of asthma among young Nigerian adults. Methods. We studied the prevalence of asthma among students (15–35 years of age) of the Obafemi Awolowo University using a standardized questionnaire. One thousand self-administered questionnaires were distributed; 903 were retrieved and analyzed (469 males, 434 females). Symptoms indicative of asthma were cough, chest tightness at rest and on exposure to irritants, and the presence of nocturnal symptoms. Students with three or more symptoms or who had a diagnosis of asthma were considered probable asthmatics and those with one or two symptoms as suspected asthmatics. Students in any of these two categories were defined as symptomatic respondents. Results. The 12-month prevalence of wheeze, night waking with cough, and chest tightness in the morning was 9.0% (n = 81) 9.4% (n = 85) and 8.0% (n = 72), respectively. One hundred and twenty-seven respondents (14.1%) comprising 49 males (10.4%) and 78 females (17.9%) had probable asthma. The remaining symptomatic respondents consisting of 20 males (4.3%) and 16 females (3.9%) had suspected asthma. Of these, only 32.5% (53/163) had been previously diagnosed and 22.1% were on occasional inhaled bronchodilator treatment. Conclusion. These results indicate a relatively high prevalence of asthma among the students. A greater proportion of them had not been diagnosed and were not receiving proper treatment.

A cross-sectional study with an improved methodology to assess occupational air pollution exposure and respiratory health in motorcycle taxi driving.

INTRODUCTION Motorcycle taxi driving is common in many African cities. This study tested whether this occupation is associated with more respiratory disorders in a context of widespread urban air pollution with an improved methodology. METHODS In a cross sectional study we compared 85 male motorcycle taxi drivers in the capital city of the Republic of Benin (Cotonou) with an age and neighborhood matched control group. All participants carried a portable carbon monoxide data logger for 8 hours per day to assess exposure to air pollution. Respiratory symptoms were obtained using a standardized questionnaire and pulmonary function was assessed by spirometry. RESULTS The two groups did not differ significantly (p>0.10) in their age, height, educational level, and exposures to smoke from biomass fuels and tobacco products. The taxi drivers were exposed to higher mean (SD) levels of carbon monoxide (7.6±4.9ppmvs. 5.4±3.8ppm p=0.001). They reported more phlegm and tended to have slightly lower levels of lung function, although these differences were not statistically significant. CONCLUSION In this cross sectional study of young motorcycle taxi drivers with substantial exposure to urban traffic and a matched control group, we found no evidence for respiratory impairment. A follow-up of such study population with other pollution exposure surrogate and other clinical endpoint may provide a more robust conclusion regarding the exposure response in this professional group.

Smoking prevalence and attitudes regarding its control among health professional students in South-Western Nigeria.

Background: Tobacco use is one of the leading preventable causes of morbidity and mortality globally; about 70% of smokers see physicians each year. Health care professionals have a very unique role in motivating people to quit smoking. Aim: The aims of this study were to document the smoking prevalence and attitudes regarding its control among these set of students who will be tomorrows health care providers. Subjects and Methods: A cross-sectional survey was conducted in two medical schools in South-Western Nigeria with their accompanied nursing and pharmacy students. All students in the selected schools were eligible to participate and students participation was voluntary. The Global Health Professional Students Survey core questionnaire was used to collect data on smoking prevalence and attitudes regarding its control. The data were summarized using percentages and confidence interval (CI) was calculated using standard error of mean. Pearsons Chi-square and fishers exact were employed to test the significance. Results: Life-time prevalence of cigarette smoking was 17.9% (121/675) with (95% confidence interval [CI] 15-20.8). Only 5.04% (34/675) with (95% CI 3.7-7.1) of the respondents were currently smoking. Ever smokers were significantly less likely than non-smokers to indicate that tobacco sales to adolescents should be banned (P < 0.01). Fewer smokers than non-smokers agreed that there should be a complete ban on advertising of tobacco products (P < 0.001). 93.3% of them said that they were taught about danger of smoking but only 48.6% ever heard of using anti-depressant in tobacco cessation program. Conclusions: Smoking prevalence among health professional students in South-West Nigeria is relatively low; however, majority believed that health-care providers serve as role models for their patients and the public.

Biomass smoke exposure as an occupational risk: cross-sectional study of respiratory health of women working as street cooks in Nigeria

Objective Little is known about respiratory health of women who are occupationally exposed to biomass smoke outside their homes. This study reports the exposure and respiratory health of street cooks in Ile-Ife, Nigeria. Methods We assessed exposure to biomass smoke by questionnaire in 188 street cooks and 197 control women and by personal diffusive samplers to quantify volatile organic compounds (VOCs) in a subsample of the women. Respiratory symptoms were assessed by a standardised questionnaire, and pulmonary function was assessed by spirometry before and after bronchodilation. Regression analysis was conducted to compare the outcome between the two groups. Results The study included 188 women (median age 40, IQR 30–50 years) who had worked as street cooks for a median of 7 years (IQR 3–15 years) and 197 control women with similar demographics. Benzene concentration in passive samplers worn by the street cooks was significantly higher compared with controls (median (IQR) 119.3 (82.7–343.7) µg/m3 vs 0.0 (0.0–51.2) µg/m3, p<0.001). The odds of reported respiratory symptoms were significantly higher among the street cooks than controls: cough (adjusted OR 4.4, 95% CI 2.2 to 8.5) and phlegm (adjusted OR 3.9, 95% CI 1.5 to 7.3). The street cooks also had higher odd of airway obstruction as measured by forced expiratory volume in 1 s/forced vital capacity <0.7: 11% 3% (adjusted OR of 3.3 (95% CI 1.3 to 8.7)). Conclusions This study provides evidence of adverse respiratory effects among street cooks using biomass fuels.

Association between exercise-induced asthma and parental socio-economic status among school-aged adolescents in a semiurban community in Nigeria

This study investigated the prevalence and association between exercise-induced asthma (EIA) and parental socio-economic status (PSES) among school-aged adolescents in a semiurban community in Nigeria. Three hundred and eighty-five adolescents (185 male and 200 female adolescents) whose ages ranged between 10 and 19 years participated in this cross-sectional study. Participants were recruited from four government approved secondary schools in Ido-Ekiti using a multistage sampling technique. Peak expiratory flow rate (PEFR) was assessed at baseline and after 6-min run test (6-MRT) on a level playing ground using a standard peak flow meter. PEFR measurements were repeated at 5th, 10th, 15th, and 20th min post 6-MRT. Participants who had >15.0% PEFR fall were considered to have EIA. PSES was assessed using a validated socio-economic status questionnaire. Descriptive and inferential statistics were used to analyze data. Alpha level was set at P<0.05. The mean ages of males and females were 13.9±2.0 and 13.8±1.6 years, respectively. More than half of the participants, 58.2% had EIA (>15.0% PEFR scores) while 53.5% belonged to middle PSES class. There was no significant difference between PEFR scores of male and female participants at baseline and 5th min post 6-MRT. However, male participants had significant higher PEFR than the female counterparts at 10th (t=2.090, P=0.037), 15th (t=2.162, P=0.031), and 20th min (t=2.978, P=0.003). There was significant association between EIA and PSES (χ2=152.4; P=0.001). The prevalence of EIA is very high among school-aged adolescents in Nigeria and was significantly associated with PSES.

Reduced Forced Vital Capacity in an African Population. Prevalence and Risk Factors

Rationale: Black Africans have reduced FVC compared with white persons, but the prevalence and determinants of reduced values are not well understood. Objectives: To evaluate the prevalence and factors leading to reduced FVC in a Nigerian population and to examine current theories regarding the determinants of this difference. Methods: We studied the ventilatory function of 883 adults aged 40 years or older participating in the Burden of Obstructive Lung Disease Study in Ile‐Ife, Nigeria. Respondents completed pre‐ and post‐bronchodilator spirometry test and provided information on their smoking history, respiratory symptoms, risk factors, and diagnoses, including anthropometric details. We used standard categories to define body mass index as either underweight, normal, overweight, or obese. We defined reduced FVC as a post‐bronchodilator FVC below the lower limit of normal using National Health and Nutrition Examination Survey (NHANES) equations, Global Lung Function Initiative 2012 equations, and local reference equations based on nonsmoking study participants without a respiratory diagnosis. We fit multivariate linear regression models to FVC as a continuous measure, adjusting for age, sex, height, and other confounders. Results: The prevalence of reduced FVC was 70.4% for men and 72.8% for women when using NHANES values for white Americans, 17.8% for men and 14.4% for women using NHANES equations for African Americans, and 15.5% for men and 20.5% for women using the Global Lung Function Initiative 2012 equations. Using the equations derived from nonsmoking respondents in the survey without a respiratory diagnosis, the prevalence of reduced FVC was less than 4% for both men and women. FVC was lower in participants who had less than 7 years of education (FVC, −96 ml; 95% confidence interval [CI], −172 to −19), were underweight (FVC, −269 ml; 95% CI, −464 to −73), were overweight (FVC, −132 ml; 95% CI, −219 to −46), and were obese (FVC, −222 ml; 95% CI, −332 to −112). Conclusions: There is a wide variation in the prevalence of reduced FVC based on the reference standard used. This variation is not satisfactorily explained by factors thought to affect FVC within individual populations. However, the prevalence strongly associates with both education level and body mass index in this population, regardless of the specific standard used.

Relationships between respiratory parameters, exercise capacity and psychosocial factors in people with chronic obstructive pulmonary disease

BACKGROUND Chronic obstructive pulmonary disease (COPD) affects respiratory functioning and psychosocial factors. However, little is known about perceived ability of people with COPD to engage in a regular exercise program. This study assessed respiratory parameters, exercise capacity, psychosocial factors and their relations in people with COPD. METHODS This cross-sectional study involved patients with COPD recruited from a Nigerian university teaching hospital. Respiratory parameters including forced expiratory volume in 1sec (FEV1) and forced vital capacity (FVC) were assessed by using a spirometer and FEV1/FVC ratio was calculated. Participants were sitting upright in a comfortable chair and wearing a nose clip for measurements. The procedure was performed in accordance with the American Thoracic Society criteria. Exercise capacity was assessed by the 6-min walk test (6MWT). Gait speed was assessed by the distance covered in 6min. Perceived exercise self-efficacy (PESE) and rating of perceived exertion (RPE) were assessed by exercise self-efficacy and Borg scales, respectively. Data were analysed using descriptive and inferential statistics. Alpha level was set at P<0.05. RESULTS The mean age of the 125 participants was 62.0±7.1years (60% male). The mean values for FEV1, FVC and FEV1/FVC were 1.8±0.6L, 2.4±0.5L and 58.0±8.8%, respectively, and the mean 6MWT and PESE values were 291.1±41.6m 63.1±11.2%. Exercise capacity was correlated with mean values for the respiratory parameters FEV1 (r=0.29; P=0.035), FVC (r=0.32; P=0.045) and FEV1/FVC ratio (r=0.37; P=0.007), and both exercise capacity and PESE were correlated with gait speed (r=0.96, P=0.001 and r=0.57; P=0.042) and RPE (r=0.42, P=0.050 and r=-0.44; P=0.032), but PESE was not correlated with respiratory parameter values (P>0.05). CONCLUSION Participants with COPD demonstrated reduced respiratory parameter values and low exercise capacity but moderate PESE. We found significant correlations between exercise capacity and respiratory parameter values, but PESE was correlated with only gait speed and RPE. The study has implications for respiratory health promotion and exercise adherence.

Asthma in a university campus: a survey of students and staff of Obafemi Awolowo University, Ile-Ife, Nigeria

Abstract Background: Asthma continues to be an important cause of morbidity and mortality in developing countries. But, its burden among adult populations in university campuses is not well described. Method: Through a multistage cluster sampling of students and staff of the Obafemi Awolowo University, Ile-Ife, Nigeria, we obtained a representative sample, each for students and staff. We administered the European Community Respiratory Health Survey (ECRHS) screening questionnaire to all the respondents. A subgroup did a spirometry test and completed a detailed questionnaire. Asthma was considered “possible”, if a respondent provided affirmative response to symptoms of “wheezing or whistling”, “attack of shortness of breath”, “diagnosed attack of asthma” in the last 12 months or “currently taking medicines for asthma”. Results: From population of 13 750 students and 1428 staff of the university, we systematically sampled 2750 (20%) students and all the staff. Amongst these, 2372 students and 455 staff completed the screening questionnaire. The mean age (SD) of the responders was 21.9 (3.2) and 46.1 (8.9) for students and staff and most of them were men; 58.6% and 65.9%, respectively. While an estimated 2.6% (95% CI: 1.7–3.5) of students had an asthma attack in the preceding 12 months, 14.5% (95% CI: 12.5–16.5) and 25.2% (95% CI: 22.8–27.7) reported shortness of breath and nocturnal cough, respectively. The staff population reported fewer symptoms. The proportion with “possible asthma” was 18.2% (95% CI: 16.0–20.4) for students and 8.0% (95% CI: 5.4–10.7) for staff. Conclusion: The prevalence of asthma is high among students and staff of Obafemi Awolowo University, Nigeria.