Oladimeji Akeem Bolarinwa
@unilorin.edu.ng
Professor, Faculty of Clinical Sciences
University of Ilorin
RESEARCH, TEACHING, or OTHER INTERESTS
Endocrinology, Diabetes and Metabolism, Epidemiology
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Oluwatosin Wuraola Akande, Moise Muzigaba, Ehimario Uche Igumbor, Kelly Elimian, Oladimeji Akeem Bolarinwa, Omotosho Ibraheem Musa, and Tanimola Makanjuola Akande
Springer Science and Business Media LLC
Abstract Background The implementation of the country-wide comprehensive sexuality education (CSE) curriculum among in-school adolescents remains abysmally low and mHealth-based interventions are promising. We assessed the effect of a mHealth-based CSE on the sexual and reproductive health (SRH) knowledge, attitude and behaviour of in-school adolescents in Ilorin, northcentral Nigeria. Methods Using schools as clusters, 1280 in-school adolescents were randomised into intervention and control groups. Data was collected at baseline (T0), immediately after the intervention (T1) and 3 months afterwards (T2) on SRH knowledge, attitude and practice of risky sexual behaviour (RSB). Data analysis included test of associations using Chi-square, independent t-test and repeated measures ANOVA. Predictors were identified using binary logistic regression. Results In the intervention group, there was a statistically significant main effect on mean knowledge score (F = 2117.252, p = < 0.001) and mean attitude score (F = 148.493, p = < 0.001) from T0 to T2 compared to the control group which showed no statistically significant main effects in knowledge (p = 0.073), attitude (p = 0.142) and RSB (p = 0.142). Though the mean RSB score declined from T0 to T2, this effect was not statistically significant (F = 0.558, p = 0.572). Post-intervention, being female was a positive predictor of good SRH knowledge; being male was a positive predictor of RSB while being in a higher-class level was a negative predictor of RSB. Conclusion The mHealth-based CSE was effective in improving SRH knowledge and attitude among in-school adolescents. This strategy should be strengthened to bridge the SRH knowledge and attitude gap among in-school adolescents. Trial registration Retrospectively registered on the Pan African Clinical Trial Registry (pactr.samrc.ac.za) on 19 October 2023. Identification number: PACTR202310485136014
Bilqis Wuraola Alatishe-Muhammad, Godwin ThankGod John, Mubarak Adeyemi Ijaiya, Mojirola Martina Fasiku, and Oladimeji Akeem Bolarinwa
Lincoln University College
Introduction: As a result of the rapid development and approval of the COVID-19 vaccine during the pandemic, there was serious misinformation about the safety of the COVID-19 vaccine. Providing evidence-based proof of the safety of the COVID-19 vaccine could dispel this scepticism. The study aimed to assess the pattern and incidence of COVID-19 vaccine reactions among adult clients in a tertiary health facility following immunization. Methods: The cross-sectional study was conducted in a tertiary care institute among recipients of the first dose of the of the COVID-19 vaccine between April and July 2021. Study populations were adults above 18 years. Participants were assessed for any reactions four times. Immediately after vaccination and later, same day one, day 2, day 3, and on/after day 7. A telephone interview was conducted, and the recipients were assessed according to the time and type of reactions, actions taken following reactions, and severe forms of reactions. Results: A total of 1535 participants were assessed post-COVID-19 vaccination reactions, and 805 (52.4%) reported at least one of the COVID-19 vaccine reactions following vaccination, and less than a percent reported perceived severe adverse reactions. Pain at the injection site (5.0%), myalgia (2.8%), and headache (1.6%) were the common adverse events reported immediately after vaccination. The majority of the respondents (93.4%) were willing to take the second dose of the of the COVID-19 vaccine. The major factor associated with COVID-19 vaccine reactions following vaccination was the age group. Conclusion: Many people still experience a certain type of discomfort after vaccinations; this discomfort is often mild to moderate and is more prevalent in young adults. Most of the reactions resolve after a few days without intervention.
Deborah Tolulope Esan, Falilat Idowu Bolarinwa, Blessed Obem Oyama, Oluwaseyi Isaiah Olabisi, Joel Adeleke Afolayan, Carlos Guillermo Ramos, and Oladimeji Akeem Bolarinwa
Elsevier BV
Olugbenga Ayodeji Mokuolu, Oladimeji Akeem Bolarinwa, Oluwatumobi Racheal Opadiran, Hafsat Abolore Ameen, Mehul Dhorda, Phaik Yeong Cheah, Chanaki Amaratunga, Freek de Haan, Paulina Tindana, and Arjen M. Dondorp
Springer Science and Business Media LLC
Abstract Background Recent reports of artemisinin partial resistance from Rwanda and Uganda are worrisome and suggest a future policy change to adopt new anti-malarials. This is a case study on the evolution, adoption, and implementation of new anti-malarial treatment policies in Nigeria. The main objective is to provide perspectives to enhance the future uptake of new anti-malarials, with an emphasis on stakeholder engagement strategies. Methods This case study is based on an analysis of policy documents and stakeholders’ perspectives drawn from an empirical study conducted in Nigeria, 2019–2020. A mixed methods approach was adopted, including historical accounts, review of programme and policy documents, and 33 qualitative in-depth interviews and 6 focus group discussions. Results Based on policy documents reviewed, the adoption of artemisinin-based combination therapy (ACT) in Nigeria was swift due to political will, funding and support from global developmental partners. However, the implementation of ACT was met with resistance from suppliers, distributors, prescribers, and end-users, attributed to market dynamics, costs and inadequate stakeholder engagement. Deployment of ACT in Nigeria witnessed increased developmental partner support, robust data generation, ACT case-management strengthening and evidence on anti-malarial use in severe malaria and antenatal care management. A framework for effective stakeholder engagement for the future adoption of new anti-malarial treatment strategies was proposed. The framework covers the pathway from generating evidence on drug efficacy, safety and uptake; to making treatment accessible and affordable to end-users. It addresses which stakeholders to engage with and the content of engagement strategies with key stakeholders at different levels of the transition process. Conclusion Early and staged engagement of stakeholders from global bodies to community level end-users is critical to the successful adoption and uptake of new anti-malarial treatment policies. A framework for these engagements was proposed as a contribution to enhancing the uptake of future anti-malarial strategies.
BC Nwachukwu, BW Alatishe-Muhammad, S Ibizugbe, DI Alake, and OA Bolarinwa
Medknow
ABSTRACT Background: The recent drop in immunization coverage in Nigeria has left more than 3.25 million children unimmunized and has risen concern over immunization completion among the under-five children. More so among underserved communities of pastoralist nomads and farmers that were isolated from immunization services because of operational and sociocultural factors. Materials and Methods: A cross-sectional analytical (comparative analysis) study was carried out among 550 eligible caregivers of under-five children in nomadic and farming communities in Niger State, Nigeria. The mothers and caregivers paired with under-five children were recruited into the study using a multistage sampling technique. Data was collected using a validated interviewer-administered questionnaire. Data was analyzed with the statistical software package (version 23). Results: More than half of the under-five children studied were males in both the nomadic (57.5%) and farming (52.0%) communities. The aggregated score of immunization knowledge was significantly (P < 0.001) better (Good 44.4%; Fair 49.8%) among farmers compared to their nomads’ counterpart (Good 21.1%; Fair 43.6%). Conversely, almost all the respondents (98.2%) in nomadic community significantly had a good overall perception of childhood immunization compared to 77.1% in the farming community. More farmers’ children (99.6%) had received immunization compared to 92.4% of the nomads’ children. About 87.3% of farmers compared to 76% of the nomads’ (76.0%) children reported immunization completion. About 50.5% of the farmers’ and 41.4% of the nomads’ children have achieved immunization on card inspection. Conclusion: This study revealed that average immunization completion reported among under-five children in both farming and nomadic communities is higher than the national average. It is recommended that more strategies are needed to intensify immunization campaigns targeted at populations in Nigeria.
BC Nwachukwu, BW Alatishe-Muhammad, S Ibizugbe, ID Alake, and OA Bolarinwa
Medknow
ABSTRACT Background: The recent drop in immunization coverage in Nigeria has left more than 3.25 million children unimmunized and has risen concerns over immunization completion among the under-five children. More so among underserved communities of pastoralist nomads and farmers that were isolated from immunization services because of operational and sociocultural factors. Materials and Methods: A cross-sectional analytical (comparative analysis) study was carried out among 550 eligible caregivers of under-five children in nomadic and farming communities in Niger State, Nigeria. The mothers and caregivers paired with under-five children were recruited into the study using a multi-stage sampling technique. Data were collected using a validated interviewer-administered questionnaire. Data were analyzed with SPSS (version 23). Results: More than half of the under-five children studied were males in both the nomadic (57.5%) and farming (52.0%) communities. The aggregated score of immunization knowledge was significantly (p < 0.001) better (Good 44.4%; Fair 49.8%) among farmers compared to their nomad counterparts (Good 21.1%; Fair 43.6%). Conversely, almost all the respondents (98.2%) in the nomadic community significantly had a good overall perception of childhood immunization compared to 77.1% in the farming community. More farmers’ children (99.6%) had received immunization compared to 92.4% of the nomads’ children. About 87.3% of farmers compared to 76% of the nomads’ (76.0%) children reported immunization completion. About 50.5% of the farmers’ and 41.4% of the nomads’ children have achieved immunization on card inspection. Conclusion: This study revealed that average immunization completion reported among under-five children in both farming and nomadic communities is higher than the national average. It is recommended that more strategies are needed to intensify immunization campaigns targeted at populations in Nigeria.
OluwatosinWuraola Akande, MojirolaMartina Fasiku, OladimejiAkeem Bolarinwa, and TanimolaMakanjuola Akande
Medknow
Ikeoluwapo O. Ajayi, William O. Balogun, Oluwarotimi B. Olopade, Gbadebo O. Ajani, David O. Soyoye, Oladimeji A. Bolarinwa, Michael A. Olamoyegun, Bilqis W. Alatishe-Muhammad, Ifedayo A. Odeniyi, Olukemi Odukoya,et al.
Frontiers Media SA
BackgroundType 2 diabetes mellitus (T2DM) is a disease of public health importance globally with an increasing burden of undiagnosed pre-diabetes and diabetes in low- and middle-income countries, Nigeria in particular. Pre-diabetes and diabetes are established risk factors for cardiovascular complications. However, data are scanty on the current prevalence of these conditions in Nigeria, based on haemoglobin A1c (HbA1c) diagnosis as recommended by the WHO in 2009. We aimed to determine the prevalence of pre-diabetes, diabetes, and undiagnosed diabetes among the adult population of Nigeria using HbA1c.MethodologyA cross-sectional, multi-site population study was carried out in selected states in Nigeria (namely, Ekiti, Lagos, Osun, Oyo, and Kwara states) involving 2,708 adults (≥18 years) in rural and urban community dwellers, without prior diagnosis of pre-diabetes or diabetes. Participants with ongoing acute or debilitating illnesses were excluded. Data were collected using an interviewer-administered pretested, semi-structured questionnaire. Socio-demographic, clinical (weight, height, blood pressure, etc.), and laboratory characteristics of participants including HbA1c were obtained. Data were analysed using STATA version 16.ResultsThe mean age of participants was 48.1 ± 15.8 years, and 65.5% were female. The overall prevalence of pre-diabetes and undiagnosed diabetes was 40.5% and 10.7%, respectively, while the prevalence of high blood pressure was 36.7%. The prevalence of pre-diabetes was the highest in Lagos (48.1%) and the lowest in Ekiti (36.7%), while the prevalence of diabetes was the highest in Kwara (14.2%) and the lowest in Ekiti (10%). There was a significant association between age of the participants (p&lt; 0.001), gender (p = 0.009), educational status (p = 0.008), occupation (p&lt; 0.001), tribe (p = 0.004), marital status (p&lt; 0.001), blood pressure (p&lt; 0.001), and their diabetic or pre-diabetic status. Independent predictors of diabetes and pre-diabetes include excess weight gain, sedentary living, and ageing. Participants within the age group 45–54 years had the highest total prevalence (26.6%) of pre-diabetes and diabetes.ConclusionOver half of the respondents had pre-diabetes and diabetes, with a high prevalence of undiagnosed diabetes. A nationwide screening campaign will promote early detection of pre-diabetes and undiagnosed diabetes among adult Nigerians. Health education campaigns could be an effective tool in community settings to improve knowledge of the risk factors for diabetes to reduce the prevalence of dysglycaemia.
Oluwapelumi Olufemi Adeyemi, Nnaemeka Darlington Ndodo, Mariam Kehinde Sulaiman, Oyeronke Temidayo Ayansola, Oluwabunmi Idera Nimat Buhari, Olusola Anuoluwapo Akanbi, Oladimeji Akeem Bolarinwa, Chimaobi Chukwu, Ireoluwa Yinka Joel, Adesuyi Ayodeji Omoare,et al.
Public Library of Science (PLoS)
The COVID-19 global pandemic is being driven by evolving SARS-CoV-2 variants with consequential implications on virus transmissibility, host immunity, and disease severity. Continuous molecular and genomic surveillance of the SARS-CoV-2 variants is therefore necessary for public health interventions toward the management of the pandemic. This study is a retrospective analysis of COVID-19 cases reported in a Nigerian tertiary institution from July to December 2021. In total, 705 suspected COVID-19 cases that comprised 547 students and 158 non-students were investigated by real time PCR (RT-PCR); of which 372 (~52.8%) tested positive for COVID-19. Using a set of selection criteria, 74 (~19.9%) COVID-19 positive samples were selected for next generation sequencing. Data showed that there were two outbreaks of COVID-19 within the university community over the study period, during which more females (56.8%) tested positive than males (47.8%) (p<0.05). Clinical data together with phylogenetic analysis suggested community transmission of SARS-CoV-2 through mostly asymptomatic and/or pre-symptomatic individuals. Confirmed COVID-19 cases were mostly mild, however, SARS-CoV-2 delta (77%) and omicron (4.1%) variants were implicated as major drivers of respective waves of infections during the study period. This study highlights the importance of integrated surveillance of communicable disease during outbreaks.
Falilat Idowu Bolarinwa, Deborah Tolulope Esan, and Oladimeji Akeem Bolarinwa
SAGE Publications
Introduction The importance of spirituality in health and wellness has been documented in the literature. While the developed countries have reported robust evidence of spirituality in nursing practices, there is scant evidence in low- and middle-income countries like Nigeria. Objectives This study assessed the spiritual care practices of the nurses attending to cancer patients in a tertiary health institution in Ilorin. It further determined factors associated with spiritual caring practices among nurses. Methods A descriptive cross-sectional study was conducted between November 2021 and December 2021 to assess spiritual care practices among nurses caring for cancer patients. During the study period, 66 nurses were recruited randomly from the hospital's medical and surgical clinics, palliative care department, and Obstetrics and Gynecology department. Twelve items validated Nurses’ spiritual care practices questionnaire was adapted for this study. Data were analyzed using IBM SPSS version 23. Results The mean age of the respondents was 36.5 years ( + 10.1) while female respondents made up 83.3%. About 48% of the nurses had good spiritual caring practices while 52% had poor spiritual caring practices. Nurses with training in oncology (96%) with p = .001 and those with spirituality training (86.2%) with p = .017 showed significant association with spiritual care practices. This study concluded that spiritual care practices among nurses are sub-optimal with training as a significantly associated factor with spiritual care practices. Conclusion It is, therefore, suggested that spiritual care practices should be incorporated into all nursing training and curriculum. This will allow them to better support the spiritual needs of the patients, especially those with chronic diseases like cancer.
Paulina Tindana, Rosemonde Guissou, Oladimeji Akeem Bolarinwa, Fatoumata Tou, Freek de Haan, Mehul Dhorda, Arjen M. Dondorp, Chanaki Amaratunga, Olugbenga Ayodeji Mokuolu, Jean Bosco Ouedraogo,et al.
Public Library of Science (PLoS)
Background Artemisinin-based combination therapies (ACTs) are the recommended treatment for uncomplicated Plasmodium falciparum malaria in all malaria endemic countries. Artemisinin resistance, partner drug resistance, and subsequent ACT failure are widespread in Southeast Asia. The more recent independent emergence of artemisinin resistance in Africa is alarming. In response, triple artemisinin-based combination therapies (TACTs) are being developed to mitigate the risks associated with increasing drug resistance. Since ACTs are still effective in Africa, where malaria is mainly a paediatric disease, the potential deployment of TACTs raises important ethical questions. This paper presents an analysis of stakeholders’ perspectives regarding key ethical considerations to be considered in the deployment of TACTs in Africa provided they are found to be safe, well-tolerated and effective for the treatment of uncomplicated malaria. Methods We conducted a qualitative study in Burkina Faso and Nigeria assessing stakeholders’ (policy makers, suppliers and end-users) perspectives on ethical issues regarding the potential future deployment of TACTs through 68 in-depth interviews and 11 focus group discussions. Findings Some respondents suggested that there should be evidence of local artemisinin resistance before they consider deploying TACTs, while others suggested that TACTs should be deployed to protect the efficacy of current ACTs. Respondents suggested that additional side effects of TACTs compared to ACTs should be minimal and the cost of TACTs to end-users should not be higher than the cost of current ACTs. There was some disagreement among respondents regarding whether patients should have a choice of treatment options between ACTs and TACTs or only have TACTs available, while ACTs are still effective. The study also suggests that community, public and stakeholder engagement activities are essential to support the introduction and effective uptake of TACTs. Conclusion Addressing ethical issues regarding TACTs and engaging early with stakeholders will be important for their potential deployment in Africa.
James Ayodele Ogunmodede, Adebusola Jane Ogunmodede, Bolade Folasade Dele-Ojo, Idris Abiola Yusuf, Adeseye Abiodun Akintunde, Oladimeji Akeem Bolarinwa, Taiye Peter Omojasola, Ibraheem Adeola Katibi, and Ayodele Babatunde Omotoso
African Journals Online (AJOL)
Background: Several observational reports from different parts of the world have shown that systemic hypertension (hypertension) was the single commonest comorbid condition in hospitalized COVID-19 patients. Hypertension is also the most prevalent comorbidity reported among patients who developed severe disease, were admitted to Intensive Care Unit, needed mechanical ventilatory support, or who died on admission. The objective of this systematic review is to study the association between hypertension and specific clinical outcomes of COVID-19 disease which are- development of severe COVID-19 disease, need foradmission in the intensive care unit (ICU) or critical care unit (CCU), need for mechanical ventilation or death
 Methods: We searched the PubMed, SCOPUS, and Google Scholar databases up till June 28, 2020 for original research articles that documented the risk factors of mortality in patients with COVID-19 using the PRISMA guideline.
 Results: One hundred and eighty-two articles were identified using pre-specified search criteria, of which 33 met the study inclusion criteria. Only three were prospective studies. Most studies documented hypertension as the most prevalent comorbidity. The association of hypertension with development of severe COVID-19 disease was not conclusive, majority of studies however found an associated with mortality.
 Conclusion: Hypertension affects the clinical course and outcome of COVID-19 disease in many cohorts. Prospective studies are needed to further understand this relationship.
 Keywords: Hypertension and COVID-19; SARS –Cov-2; severity; mortality; ICU care; mechanical ventilation.
MojirolaMartina Fasiku, OluwatosinWuraola Akande, OladimejiAkeem Bolarinwa, and TanimolaM Akande
Medknow
Background: Caring for patients in the hospital can cause a lot of stress for the caregivers, especially those who are involved with informal caregiving such as family members. Little is known in Nigeria on the stress of informal caregiving in the hospital environment. This study assessed the informal caregivers' stress level and their determinants in a tertiary hospital in Ilorin, Nigeria. Methodology: This was a hospital-based cross-sectional study. Between September and October 2019, using a simple random sampling method, data were collected from 400 informal caregivers of patients in University of Ilorin Teaching Hospital with interviewer-administered questionnaire which included socio-demographic characteristics, Caregivers Strain index (CSI) and caregivers' stress from institution and other factors index (CSIOI). Analysis was performed, and prevalence and determinants of stress of informal caregiving were presented using descriptive statistics and logistic regressions. P < 0.05 was considered statistically significant. Results: The majority, 381 (95.2%) of the informal caregivers, reported great stress levels using CSI, while 227 (56.7%) experienced a great level of stress with the CSIOI. Predictors of caregiver stress were perception that staying around was stressful (odds ratio [OR] - 17.5, P < 0.001), felt their patients will not be well cared for if not around (OR - 6.1, P < 0.001), staying at the hospital for >30 days (OR - 2.6, P = 0.001). Conclusion: The informal caregivers experienced a great level of stress taking care of their patients on admission in the hospital. It is, therefore, expedient that issues surrounding the comfort of the informal caregivers as they care for their patients should be included in hospital policies.
Oladimeji Akeem Bolarinwa, Tanimola Makanjuola Akande, Wendy Janssens, Kwasi Boahene, and Tobias Rinke de Wit
Pan African Medical Journal
Introduction a subsidized community health insurance programme in Kwara State, Nigeria was temporarily suspended in 2016 in anticipation of the roll-out of a state-wide health insurance scheme. This article reports the adverse consequences of the scheme´s suspension on enrollees´ healthcare utilization. Methods a mixed-methods study was carried out in Kwara State, Nigeria, in 2018 using a semi-quantitative cross-sectional survey amongst 600 former Kwara community health insurance clients, and in-depth interviews with 24 clients and 29 participating public and private healthcare providers in the program. Both quantitative and qualitative data were analyzed and triangulated. Results most of former enrollees (95.3%) kept utilizing programme facilities after the suspension, mainly because of the high quality of care. However, majority of the enrollees (95.8%) reverted to out-of-pocket payment while 67% reported constraints in payment for healthcare services after suspension of the program. In the absence of insurance, the most common coping mechanisms for healthcare payment were personal savings (63.3%), donations from friends and families (34.7%) and loans (11.8%). Being a male enrollee (odd ratio=1.61), living in a rural community (odd ratio =1.77), exclusive usage of Kwara Community Health Insurance Programme (KCHIP) prior to suspension (odd ratio=1.94) and suffering an acute illness (odd ratio=3.38) increased the odds of being financially constrained in accessing healthcare. Conclusion after the suspension of the scheme, many enrollees and health facilities experienced financial constraints. These underscore the importance of sustainable health insurance schemes as a risk-pooling mechanism to sustain access to good quality health care and financial protection from catastrophic health expenditures.
Oladimeji Akeem Bolarinwa, Soter Ameh, Caleb Ochimana, Abayomi Olabayo Oluwasanu, Okello Samson, Shukri F. Mohamed, Alfa Muhihi, and Goodarz Danaei
Public Library of Science (PLoS)
Willingness and ability to pay for insurance that would cover primary healthcare services has not been evaluated consistently in different African communities. We conducted a cross-sectional community health survey and examined willingness and ability to pay in 3676 adults in seven communities in four countries: Nigeria, Tanzania, Uganda and Kenya. We used an open-ended contingency valuation method to estimate willingness to pay and examined ability to pay indirectly by calculating the ratio of healthcare expenditure to total household income. Slightly more than three quarters (78.8%) of participants were willing to pay for a health insurance scheme, and just a little above half (54.7%) were willing to pay for all household members. Across sites, median amount willing to pay was $2 per person per month. A little above half (57.6%) of households in Nigeria were able to pay the premium. The main predictors of likelihood of being unwilling to pay for the health insurance scheme were increasing age [aOR 0.99 (95% CI 0.98, 1.00)], being female [0.68 (0.51, 0.92], single [0.32 (0.21, 0.49)], unemployment [0.54 (0.34, 0.85)], being enrolled in another health insurance scheme [0.45 (0.28, 0.74)] and spending more on healthcare [1.00 (0.99, 1.00)]. But being widow [2.31 (1.30, 4.10)] and those with primary and secondary education [2.23 (1.54, 3.22)] had increased likelihood of being willing to pay for health insurance scheme. Retired respondents [adjusted mean difference $-3.79 (-7.56, -0.02)], those with primary or secondary education [$-3.05 (-5.42, -0.68)] and those with high healthcare expenditure [$0.02 (0.00, 0.04)] predicted amount willing to pay for health insurance scheme. The willingness to pay for health insurance scheme is high among the seven communities studied in East and West Africa with socio-demography, economic and healthcare cost as main predictive factors.
Freek de Haan, Oladimeji Akeem Bolarinwa, Rosemonde Guissou, Fatoumata Tou, Paulina Tindana, Wouter P. C. Boon, Ellen H. M. Moors, Phaik Yeong Cheah, Mehul Dhorda, Arjen M. Dondorp,et al.
Public Library of Science (PLoS)
Introduction Triple artemisinin-based combination therapies (TACTs) are being developed as a response to artemisinin and partner drug resistance in the treatment of falciparum malaria in Southeast Asia. In African countries, where current artemisinin-based combination therapies (ACTs) are still effective, TACTs have the potential to benefit the larger community and future patients by mitigating the risk of drug resistance. This study explores the extent to which the antimalarial drug markets in African countries are ready for a transition to TACTs. Methods A qualitative study was conducted in Nigeria and Burkina Faso and comprised in-depth interviews (n = 68) and focus group discussions (n = 11) with key actor groups in the innovation system of antimalarial therapies. Results Evidence of ACT failure in African countries and explicit support for TACTs by the World Health Organization (WHO) and international funders were perceived important determinants for the market prospects of TACTs in Nigeria and Burkina Faso. At the country level, slow regulatory and implementation procedures were identified as potential barriers towards rapid TACTs deployment. Integrating TACTs in public sector distribution channels was considered relatively straightforward. More challenges were expected for integrating TACTs in private sector distribution channels, which are characterized by patient demand and profit motives. Finally, several affordability and acceptability issues were raised for which ACTs were suggested as a benchmark. Conclusion The market prospects of TACTs in Nigeria and Burkina Faso will depend on the demonstration of the added value of TACTs over ACTs, their advocacy by the WHO, the inclusion of TACTs in financial and regulatory arrangements, and their alignment with current distribution and deployment practices. Further clinical, health-economic and feasibility studies are required to inform decision makers about the broader implications of a transition to TACTs in African counties. The recent reporting of artemisinin resistance and ACT failure in Africa might change important determinants of the market readiness for TACTs.
Rasheedat Ibraheem, Moshood Akintola, Mohammed Abdulkadir, Hafsat Ameen, Oladimeji Bolarinwa, and Muhammed Adeboye
African Journals Online (AJOL)
Background: Reminders via mobile devices deployed as short message services (SMS) or calls have been identified to be a useful strategy in improving routine immunization uptake in several countries.
 Objective: To identify the timeliness of appointments with reminders (calls or SMS), SMS health education and the routine care, and the vaccination completion rates in Ilorin, Nigeria.
 Method: Mother-infant pairs presenting for the first vaccination appointment were randomized into four (three inter- ventions, one control) groups, each consisting of 140 participants. Intervention groups were reminders via calls (A), SMS reminders (B), immunization fact SMS messages (C) and controls on usual care (D). Reminders were made a day before the appointment while SMS immunization facts were sent at five weeks, nine weeks and eight months. Appropriate timing was defined as the scheduled visit ±3 days.
 Results: The immunization completion rates after the nine months’ visit were 99.2%, 99.3%, 97% and 90.4% for Groups A, B, C and D respectively. Compared with controls, Group A had the highest odds [AOR 8.78 (6.10, 12.63)] of presenting at an appropriate time, followed by Group B [AOR 2.56 (1.96, 3.35)], then Group C [AOR 2.44 (1.87, 3.18)].
 Conclusion: Reminders/SMS immunization facts improve vaccination completion rates.
 Keywords: Call reminders; short message services (SMS) reminders; SMS immunization; vaccination timing; Nigeria.
Hezekiah Olayinka Shobiye, Oladimeji Akeem Bolarinwa, Mojirola Martina Fasiku, Tanimola Makanjuola Akande, and Wendy Janssens
Public Library of Science (PLoS)
BackgroundGlobally, the possession of medicines stored at home is increasing. However, little is known about the determinants of possessing medicines, their usage according to clinical purpose, which we term ‘correct drug match’, and the role of health insurance.MethodsThis study uses data from a 2013 survey evaluating a health insurance program in Kwara State, Nigeria, which upgraded health facilities and subsidized insurance premiums. The final dataset includes 1,090 households and 4,641 individuals. Multilevel mixed-effects logistic regressions were conducted at both the individual level and at the level of the medicines kept in respondents’ homes to understand the determinants of medicine possession and correct drug match, respectively, and to investigate the effect of health insurance on both.ResultsA total of 9,266 medicines were classified with 61.2% correct match according to self-reported use, 11.9% incorrect match and 26.9% indeterminate. Most medicines (73.0%) were obtained from patent proprietary medicine vendors (PPMVs). At 36.6%, analgesics were the most common medicine held at home, while anti-malarial use had the highest correct match at 96.1%. Antihistamines, vitamins and minerals, expectorants, and antibiotics were most likely to have an incorrect match at respectively 35.8%, 33.6%, 31.9%, and 26.6%. Medicines were less likely to have a correct match when found with the uneducated and obtained from public facilities. Enrolment in the insurance program increased correct matches for specific medicines, notably antihypertensives and antibiotics (odds ratio: 25.15 and 3.60, respectively).ConclusionSince PPMVs serve as both the most popular and better channel compared to the public sector to obtain medicines, we recommend that policymakers strengthen their focus on these vendors to educate communities on medicine types and their correct use. Health insurance programs that provide affordable access to improved-quality health facilities represent another important avenue for reducing the burden of incorrect drug use. This appears increasingly important in view of the global rise in antimicrobial resistance.
Paulina Tindana, Freek de Haan, Olugbenga Ayodeji Mokuolu, Rosemonde Guissou, Oladimeji Akeem Bolarinwa, Jean Bosco Ouedraogo, Fatoumata Tou, Wouter P.C Boon, Ellen H.M Moors, Arjen M Dondorp,et al.
F1000 Research Ltd
Introduction: According to the World Malaria Report 2019, Africa accounts for 94% of the global malaria deaths. While malaria prevalence and mortality have declined over the years, recent reports suggest that these gains may stand the risk of being reversed if resistance to Artemisinin Combination Therapies (ACTs) spreads from Southeast Asia to Africa. Efforts are being made to develop new treatments that will address the looming threat of ACT resistance, including the development of triple artemisinin combination therapies (TACTs). The proposed study seeks to explore the views of stakeholders on the key ethical, regulatory and market-related issues that should be considered in the potential introduction of triple artemisinin combination therapies (TACTs) in Africa. Methods: The study employed qualitative research methods involving in-depth interviews and focus group discussions (FGDs) with stakeholders, who will be directly affected by the potential deployment of triple artemisinin combination treatments, as regulators, suppliers and end-users. Participants will be purposively selected and will include national regulatory authorities, national malaria control programs, clinicians, distributors and retailers as well as community members in selected districts in Burkina Faso and Nigeria. Discussion: The proposed study is unique in being one of the first studies that seeks to understand the ethical, social, regulatory and market position issues prior to the development of a prospective antimalarial medicine.
OladimejiAkeem Bolarinwa, MuniratAyoola Afolayan, BosedeFolashade Rotimi, and Bilqis Alatishe-Mohammad
Medknow
In recent times, many states of the federation have attempted to implement a social health insurance scheme. This is with a view to achieving universal health coverage in their states. One of the main target populations of the scheme is the informal sector workers. There are still concerns about whether enough pieces of evidence were used to establish the scheme across the country. This perspective article briefly highlights some evidence to support the informal sectors willingness to participate and pay for a statewide health insurance scheme in Nigeria.
Samson Okello, Alfa Muhihi, Shukri F. Mohamed, Soter Ameh, Caleb Ochimana, Abayomi Olabayo Oluwasanu, Oladimeji Akeem Bolarinwa, Nelson Sewankambo, and Goodarz Danaei
Springer Science and Business Media LLC
Abstract Background Few studies have characterized the epidemiology and management of hypertension across several communities with comparable methodologies in sub-Saharan Africa. We assessed prevalence, awareness, treatment, and control of hypertension and predicted 10-year cardiovascular disease risk across seven sites in East and West Africa. Methods Between June and August 2018, we conducted household surveys among adults aged 18 years and above in 7 communities in Kenya, Nigeria, Tanzania, and Uganda. Following a standardized protocol, we collected data on socio-demographics, health insurance, and healthcare utilization; and measured blood pressure using digital blood pressure monitors. We estimated the 10-year cardiovascular disease (CVD) risk using a country-specific risk score and fitted hierarchical models to identify determinants of hypertension prevalence, awareness, and treatment. Results We analyzed data of 3549 participants. The mean age was 39·7 years (SD 15·4), 60·5% of whom were women, 9·6% had ever smoked cigarettes, and 32·7% were overweight/obese. A quarter of the participants (25·4%) had hypertension, more than a half of whom (57·2%) were aware that they had diagnosed hypertension. Among those diagnosed, 50·5% were taking medication, and among those taking medication 47·3% had controlled blood pressure. After adjusting for other determinants, older age was associated with increased hypertension prevalence, awareness, and treatment whereas primary education was associated with lower hypertension prevalence. Health insurance was associated with lower hypertension prevalence and higher chances of treatment. Median predicted 10-yr CVD risk across sites was 4·9% (Interquartile range (IQR), 2·4%, 10·3%) and 13·2% had predicted 10-year CVD risk of 20% or greater while 7·1% had predicted 10-year CVD risk of > 30%. Conclusion In seven communities in east and west Africa, a quarter of participants had hypertension, about 40% were unaware, half of those aware were treated, and half of those treated had controlled blood pressure. The 10-year predicted CVD risk was low across sites. Access to health insurance is needed to improve awareness, treatment, and control of hypertension in sub-Saharan Africa.
Idayat Durotoye, Rasheed Odunola, Oluwapelumi Adeyemi, Alex Akanmu, Oladimeji Bolarinwa, Muhammed Adeboye, Ali Abdullahi, Zulkarnain Bolajoko, Wasiu Durosinmi, George Adebisi,et al.
Wiley
An outbreak of Coronavirus Disease 2019 (COVID-19) was first reported from Wuhan, China in December 2019. The rapid spread of COVID-19 principally through respiratory droplets and fomites transitioned into a global pandemic in waves of outbreaks across regions. 1 The projected colossal impact of the pandemic on economies particu-larly in low to middle income countries (LMIC), 2 have prompted pertinent questions about Africa's preparedness. 3 This report highlights early responses of a Nigerian institution to the COVID-19 pandemic. The University of Ilorin (Unilorin), Ilorin, Nigeria is an international institution of higher learning, which was established by the Nigerian Government in 1976. It occupies a 15 000-ha landmass that cuts across several rural communities in Kwara State, North-central Nigeria and 180 miles (289.7 km) from the Lagos epicenter of the COVID-19 outbreak in Nigeria. The Unilorin community comprises over 4500 workers and 56 600 students across 15 faculties, one College of Health Sciences, and a School of Preliminary Studies. Following the first reported case of COVID-19 in Lagos, Nigeria, a COVID-19 Prevention Committee (herein referred to as The Committee ) was setup by the University management to safeguard the University community. Within 3 weeks of the COVID-19 outbreak in Nigeria, the committee successfully implemented a string of containment measures before the first confirmed case was reported in Ilorin, Kwara State. The sweeping impact of COVID-19 on healthcare facilities across climes, emphasizes the importance of early preparation of healthcare facilities. 4 The Unilorin health services was setup to meet the health needs of students and staff of the University community within a clinic facility that operates in collaboration with the University of Ilorin Teaching Hospital, where cases that require specialist's attention are referred. Within the week of the outbreak of COVID-19 in Nigeria, the University clinic operations were modified to meet the imminent challenges of the epidemic. Routine and nonemergency visits to the University Healthcare Center were
OladimejiAkeem Bolarinwa
Medknow
Sample size is one of the important considerations at the planning phase of a research proposal, but researchers are often faced with challenges of estimating valid sample size. Many researchers frequently use inadequate sample size and this invariably introduces errors into the final findings. Many reviews on sample size estimation have focused more on specific study designs which often present technical equations and formula that are boring to statistically naïve health researchers. Therefore, this compendium reviews all the common sample size estimation formula in social science and health research with the aim of providing basic guidelines and principles to achieve valid sample size estimation. The simplification of the sample size formula and detailed explanation in this review will demystify the difficulties many students as well as some researchers have with statistical formulae for sample size estimation.
Chukwuma Anyaike, Oladele Ademola Atoyebi, Omotoso Ibrahim Musa, Oladimeji Akeem Bolarinwa, Kabir Adekunle Durowade, Adeniyi Ogundiran, and Oluwole Adeyemi Babatunde
Pan African Medical Journal
Introduction This study aims to assess the treatment adherence rate among People Living With HIV/AIDS (PLWHA) receiving treatment in a Nigerian tertiary Hospital. Methods This was a cross-sectional study that assessed self-reported treatment adherence among adults aged 18 years and above who were accessing drugs for the treatment of HIV. Systematic random sampling method was used to select 550 participants and data were collected by structured interviewer administered questionnaire. Results The mean age of respondents was 39.9±10 years. Adherence rate for HIV patients was 92.6%. Factors affecting adherence include lack of money for transportation to the hospital (75%), traveling (68.8%), forgetting (66.7%), avoiding side effects (66.7%), and avoiding being seen (63.6%). Conclusion The adherence rate was less than optimal despite advancements in treatment programmes. Adherence monitoring plans such as home visit and care should be sustained.