Pulmonary and Respiratory Medicine, Internal Medicine
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Scopus Publications
Scopus Publications
Outpatient burden of adult respiratory diseases in University of Ilorin Teaching Hospital, Nigeria OB Ojuawo, OO Desalu, AO Aladesanmi, CM Opeyemi, AT Azeez, et al. Nigerian Journal of Clinical Practice, 2022 Background: Respiratory diseases constitute a significant cause of morbidity globally. There is limited information on the epidemiology of respiratory diseases in North Central Nigeria particularly with the changing trend in risk factors. Aim: This study aimed at evaluating the pattern and morbidity related to respiratory diseases among adult outpatients attending a chest clinic in a tertiary healthcare facility, especially with increasing environmental pollution and biomass exposure globally. Patients And Methods: This was a retrospective review of the case records of 338 newly referred patients seen in the chest clinic of the University of Ilorin Teaching Hospital (UITH) with respiratory illnesses over a 2-year period (January 2017–December 2018). Results: The mean age of the recruited patients was 47.6 ± 19.8 years with a male to female ratio of 1.1:1. Microbiologically confirmed tuberculosis (30.2%), chronic obstructive pulmonary disease (COPD) (24.3%), and bronchial asthma (17.8%) were the commonest conditions managed in the clinic. Overall, noncommunicable respiratory diseases (61.2%) constituted a larger proportion of cases when compared to infective respiratory conditions. Almost 90% of the patients were never smokers. Systemic hypertension (15.1%) and human immunodeficiency virus infection (3.6%) were the commonest comorbid illnesses. Conclusion: Although tuberculosis constituted the most observed single condition, noncommunicable respiratory diseases predominated cumulatively among the new cases seen in the chest clinic of UITH, Ilorin. This raises the need for significant attention in terms of prevention and management of noncommunicable respiratory diseases, which appear to be on the uprising.
Etiology and Clinical Patterns of Chronic Cough in the Chest Clinic of a Tertiary Hospital in Nigeria Olufemi O Desalu, Olutobi B Ojuawo, Adeniyi Aladesanmi, Adekunle Adeoti, Christopher M Opeyemi, et al. International Journal of General Medicine, 2022 Purpose The burdens of chronic cough are mostly reported from Western and Asian countries. We aimed to determine the etiology and clinical patterns of chronic cough (CC) in the chest clinic of a tertiary hospital in Nigeria. Patients and Methods This survey was a cross-sectional study of 218 patients. Chronic cough was defined as cough >8 weeks duration. The evaluation and diagnosis of patients was based on a diagnostic protocol developed from the international respiratory societies cough guidelines and a previous study. Results The median age of patients was 50 years (interquartile range 30–68). One etiology was identified in 96.3% of cases; dual etiologies in 2.3%, and 1.4% had an unexplained cough. The most frequent causes of cough were COPD (33.5%), PTB (27.1%), and asthma (21.1%) which included 3 cases of cough variants of asthma (CVA). Other causes were post-tuberculosis lung disease (bronchiectasis and fibrosis) in 6.9%, lung cancer in 4.7%, and interstitial lung disease (ILD) in 3.2%. Gastroesophageal-related cough (GERC) accounted for <1.0%. Before the age of 45, the chronic cough was more frequent in the females than in the males, and the commonest cause was asthma, whereas, beyond age ≥ 45, the occurrence in males surpasses that of the females, and the commonest cause was COPD. Eighty-six percent reported shortness of breath as the most associated symptom. Systemic hypertension (15.6%) was the most frequent comorbidity, followed by HIV infection (3.7%). Chest radiograph, sputum GeneXpert MTB/RIF for TB, spirometry, and detailed history and trial of treatment, were enough to identify the cause in 72% of cases. Conclusion The etiology and clinical patterns of chronic cough in this study are different from the western countries. When evaluating and managing chronic cough, clinicians in sub-Saharan Africa and TB endemic countries should consider these geographical variations in etiologies and clinical presentation.
Urban–rural differences in the epidemiology of asthma and allergies in nigeria: A populationbased study Olufemi O Desalu, Adekunle O Adeoti, Olutobi B Ojuawo, Adeniyi O Aladesanmi, Micheal S Oguntoye, et al. Journal of Asthma and Allergy, 2021 Purpose Urbanization is associated with the risk of developing allergic conditions. Few studies have evaluated the urban–rural disparity of allergic diseases in sub-Saharan Africa. Objective To compare the epidemiology of adult asthma and allergies in urban and rural Nigeria. Subjects and Methods A population-based cross-sectional study was performed among 910 subjects in Kwara State, North Central Nigeria, comprising 635 urban and 275 rural adults who were randomly selected. We used standardized questionnaires for data collection. Results The age-adjusted prevalence of adults reporting a previous “asthma attack” or “currently taking asthma medication” within the preceding 12 months (ECRHS asthma definition) was 3.4% urban, 0.5% rural, current allergic rhinoconjunctivitis (26.2% urban, 22.2% rural), and current skin allergy (13.9% urban, 10.5% rural). The age-adjusted prevalence of “physician-diagnosed allergic conditions”: asthma (3.3% urban, 1.5% rural), allergic rhinoconjunctivitis (4.9% urban, 3.2% rural), and skin allergy (4.8% urban, 4.6% rural) were higher in urban areas than in rural areas. Urban areas recorded a higher age-adjusted 12 months prevalence of wheezing, night waking by breathlessness, night waking by chest tightness, asthma attack (p=0.042), and current use of asthma medication (p=0.031) than the rural areas. In the urban areas, 81% of those with asthma significantly had current allergic rhinoconjunctivitis, and 40.5% had current skin allergy, whereas in the rural areas, all subjects with asthma had current allergic rhinoconjunctivitis and 12.5% had current skin allergy (p=0.482). The most common trigger for asthma attack/respiratory symptoms among the urban household was exposure to environmental smoke (17.2%), and among the rural household, it was dust exposure (18.2%). Living in urban areas significantly increased the odds of having asthma [aOR: 5.6 (95% CI:1.6–19.6)] and allergic rhinoconjunctivitis [aOR: 1.7 (95% CI: 1.2–2.4)]. Conclusion This study shows that urban residents frequently reported more allergic and respiratory symptoms and were at risk of having asthma and allergic rhinitis compared to rural residents. The findings would assist the physicians in understanding the urban–rural differences in the occurrence of allergic conditions, symptom triggers, and comorbidity, which are relevant in patient’s clinical evaluation, treatment, and disease prevention.
Diagnosis of latent tuberculosis among hiv infected patients in ilorin, nigeria using tuberculin skin test and interferon gamma release assay A. Aladesanmi, O. Ojuawo, Olutosin Olukemi Aladesanmi, A. Fawibe, O. Desalu, et al. Pan African Medical Journal, 2021 Introduction Latent Tuberculosis Infection (LTBI) screening is recommended for individuals with a known risk factor for progression to active disease especially in the setting of HIV infection. This will ensure early diagnosis and prompt treatment. The purpose of our study was to compare tuberculin skin test (TST) with Interferon Gamma Release Assay (IGRA) in the diagnosis of LTBI among patients with known HIV infection at University of Ilorin Teaching Hospital (UITH), Ilorin. Methods this was a hospital based cross-sectional study at the Highly Active Antiretroviral therapy (HAART) Clinic and medical wards of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. A total of 282 consenting patients with HIV infection were recruited. Sociodemographic and clinical information was obtained using a well-structured questionnaire. The screening for LTBI was done using Tuberculin skin test (TST) and Interferon Gamma release assay (IGRA). Results the prevalence of LTBI among HIV infected patients was 40.6% and 53.1% using TST and QFT-IT respectively, while the overall prevalence considering positivity to either of the test was 66%. There was mild agreement (κ: 0.218) between TST and QFT-IT in the diagnosis of LTBI among patients with HIV infection. The association between CD4 count and TST was not statistically significant (p value = 0.388) but there was strong association between CD4 cell count and QFT results (p = 0.001). Conclusion the prevalence of LTBI is quite high among patients with HIV infection in our locality. There is a need to encourage screening of at-risk individuals to forestall the morbidity and mortality associated with TB in this population.
Clinical and microbiological profile of adult inpatients with community acquired pneumonia in ilorin, north central, nigeria Olutobi Babatope Ojuawo, Olufemi Olumuyiwa Desalu, Ademola Emmanuel Fawibe, Ayotade Boluwatife Ojuawo, Adeniyi Olatunji Aladesanmi, et al. African Health Sciences, 2020 Background: The optimal management of community acquired pneumonia (CAP) depends on the clinical and microbio- logical profile in the locality.
 Objectives: To determine the clinical and microbiological profile of patients admitted with CAP in Ilorin, Nigeria.
 Methods: One hundred and two consenting consecutively selected patients with clinical and radiologic confirmation of CAP were recruited in 12 months. The socio-demographic, physical examination and laboratory/radiologic parameters were documented in a questionnaire. Microbiological evaluation of their sputum was done and blood samples were taken for complete blood count, culture, serum urea and serological evaluation for atypical bacteria and some viral pathogens.
 Results: CAP constituted 5.9% of the total medical admissions during the one-year study period. The mean age of the pa- tients was 49 ± 22 years with the largest frequency in those aged 65 years and above. The commonest symptoms were short- ness of breath (96.1%) and cough (94.1%), with a median duration of 3 days from symptom onset to admission. Systemic hypertension was the commonest comorbid illness (25/102; 24.5%). Klebsiella pneumoniae was the predominant pathogen iso- lated (20/102; 28.1%). The susceptible antibiotics were Imipenem, Ceftazidime and Ceftriaxone. Intra-hospital mortality was 17.6%. CURB – 65 score of ≥ 2 and the presence of complications of CAP were the independent predictors of mortality.
 Conclusion: CAP constitutes a significant disease burden in Ilorin, Nigeria. Typical bacteria accounted for over half of the pathogens isolated from the patients with gram negative agents predominating. This highlights a possible shift in the micro- biological profile which could guide empirical treatment.
 Keywords: Community acquired pneumonia; microbiological profile; Nigeria.
Spirometric Abnormalities Following Treatment for Pulmonary Tuberculosis in Ilorin, Nigeria OlutobiBabatope Ojuawo, AdemolaEmmanuel Fawibe, OlufemiOlumuyiwa Desalu, AyotadeBoluwatife Ojuawo, AdeniyiOlatunji Aladesanmi, et al. Nigerian Postgraduate Medical Journal, 2020 Background: Pulmonary tuberculosis (PTB) contributes significantly to morbidity and mortality worldwide, and despite microbiological cure for the disease, many patients still demonstrate residual respiratory symptoms and spirometric abnormalities. Aim and Objectives: The study aimed at identifying the prevalence, pattern and factors associated with spirometric abnormalities in patients successfully treated for PTB in Ilorin, Nigeria. Materials and Methods: This was a hospital-based cross-sectional study at the pulmonary outpatient clinics of the University of Ilorin Teaching Hospital and Kwara State Specialist Hospital, Sobi, Ilorin. A total of 308 consenting patients who had been certified microbiologically cured for bacteriologically confirmed PTB in the preceding 3 years had assessment of residual pulmonary symptoms, spirometry and plain chest radiograph. Results: The prevalence of abnormal spirometry following treatment for PTB was 72.1% (confidence interval: 0.6682–0.7695), with restrictive pattern being the predominant abnormality (42.2%). Over half of the patients (56.5%) had at least one residual respiratory symptom. The significant predictors of abnormal spirometry were PTB retreatment (adjusted odds ratio [aOR] = 6.918; P = 0.012), increasing modified Medical Research Council dyspnoea scores (aOR = 7.935; P = 0.008) and increasing radiologic scores (aOR = 4.679; P ≤ 0.001) after treatment. Conclusion: There is significant residual lung function impairment in majority of the individuals successfully treated for PTB in Ilorin. This highlights the need for spirometric assessment and follow-up after treatment.
Current prevalence pattern of tobacco smoking in Nigeria: A systematic review and meta-analysis Davies Adeloye, Asa Auta, Ademola Fawibe, Muktar Gadanya, Nnenna Ezeigwe, et al. BMC Public Health, 2019 Background National smoking cessation strategies in Nigeria are hindered by lack of up-to-date epidemiologic data. We aimed to estimate prevalence of tobacco smoking in Nigeria to guide relevant interventions. Methods We conducted systematic search of publicly available evidence from 1990 through 2018. A random-effects meta-analysis and meta-regression epidemiologic model were employed to determine prevalence and number of smokers in Nigeria in 1995 and 2015. Results Across 64 studies (n = 54,755), the pooled crude prevalence of current smokers in Nigeria was 10.4% (9.0–11.7) and 17.7% (15.2–20.2) for ever smokers. This was higher among men compared to women in both groups. There was considerable variation across geopolitical zones, ranging from 5.4% (North-west) to 32.1% (North-east) for current smokers, and 10.5% (South-east) to 43.6% (North-east) for ever smokers. Urban and rural dwellers had relatively similar rates of current smokers (10.7 and 9.1%), and ever smokers (18.1 and 17.0%). Estimated median age at initiation of smoking was 16.8 years (IQR: 13.5–18.0). From 1995 to 2015, we estimated an increase in number of current smokers from 8 to 11 million (or a decline from 13 to 10.6% of the population). The pooled mean cigarettes consumption per person per day was 10.1 (6.1–14.2), accounting for 110 million cigarettes per day and over 40 billion cigarettes consumed in Nigeria in 2015. Conclusions While the prevalence of smokers may be declining in Nigeria, one out of ten Nigerians still smokes daily. There is need for comprehensive measures and strict anti-tobacco laws targeting tobacco production and marketing.
Profile of patients with chronic obstructive pulmonary disease in Ilorin who were never-smokers O. Ojuawo, A. Aladesanmi, C. Opeyemi, O. Desalu, A. Fawibe, et al. Nigerian Journal of Clinical Practice, 2019 Background: The most recognized risk factor for chronic obstructive pulmonary disease (COPD) worldwide is cigarette smoking. However, recent surveys have revealed an increasing trend from nonsmoking causes especially from biomass exposure. This study, therefore, aimed to determine the proportion of patients and the clinical pattern of COPD among never-smokers in Ilorin. Subjects and Methods: This is a retrospective study in which case records of patients with clinical diagnosis of COPD from January 2013 to December 2017 were reviewed. Data were collected with respect to their sociodemographic characteristics, clinical details, comorbid illnesses, and severity of the disease. Results: A total of 135 case records of patients with COPD were reviewed, of which 66 had spirometric confirmation of the disease. In all, 38 (57.6%) of them were never-smokers with a male-to-female ratio of 1:1.1. The mean age of the subjects was 64.5 ± 11.7 years. Cough and exertional dyspnea were the most common symptoms (89.5% each), and systemic hypertension was the most common comorbid illness. Firewood exposure constituted the most common nonsmoking risk factor (47.4%), and the majority of the patients had mild COPD. When compared with ever-smokers, the mean post bronchodilator lung function parameters were found to be significantly better in never-smokers. Conclusion: Over half of COPD cases in Ilorin were never-smokers with firewood exposure as the main risk factor. This study has further highlighted the need for increased awareness of the hazards of biomass fuel exposure in our setting.
Lung function abnormalities among garri processing workers in Ogbomoso, Nigeria AdeseyeAbiodun Akintunde, Taofeek Oloyede, JamiuA Adeniran, MosesO Tanimowo, EmmanuelAdemola Fawibe, et al. Nigerian Postgraduate Medical Journal, 2018 Background: Local production of garri (cassava crisps) is associated with air pollution and consequently lung function abnormalities among garri processing workers. This study was aimed at describing lung function abnormalities among Nigerians engaged in cassava crisps (garri) processing. Methods: A total of 351 workers and 351 controls were recruited at garri factories in Ogbomoso, Nigeria by multistage random sampling technique. Lung functional abnormalities were defined according to standardised European Respiratory Society/American Thoracic Society guidelines. Data analysis was performed using the IBM SPSS statistics version 22.0. Results: The mean age of patients was similar to that of controls (41.7 ± 14.9 vs. 41.6 ± 14.7 yearsP = 0.960). Larger proportion (46.2%) of cassava crisps factory workers had abnormal ventilatory function parameters compared to 6.8% in controls (P < 0.001). The mean peak expiratory flow among garri factory workers was significantly lower than that of the controls; 268.25 ± 86.20 versus 349.04 ± 97.21 (L/min) (P < 0.001), likewise the mean forced vital capacity (FVC) (litres) and forced expiratory volume (FEV1) (litres) of garri factory workers and controls were significantly lower than those of the controls; 2.55 ± 1.07 versus 2.87 ± 0.79 (P < 0.001) and 2.00 ± 0.76 versus 2.41 ± 0.83 (P < 0.001) with FEV1/FVC ratio of 0.82 ± 0.16 versus 0.87 ± 0.06 (P < 0.001), respectively. The restrictive pattern of ventilatory functional abnormality was predominant among garri factory workers, 92 (26.2%). Sixty-two (17.7%) and 8 (2.3%) of garri factory workers had an obstructive and mixed pattern of ventilatory function abnormalities, respectively. Conclusion: Garri processing workers had significant ventilatory function impairment. Preventive strategies should be encouraged to reduce occupational hazards associated with garri processing in Nigeria.
Normal CD4 Count Range among Healthy Nigerian Population in Ilorin J. K. Afolabi, A. Fadeyi, O. O. Desalu, I. A. Durotoye, A. E. Fawibe, et al. Journal of the International Association of Providers of AIDS Care, 2017 Background: For the establishment and monitoring of the immune status, CD4 count is critical. Objectives: To determine the CD4 count range of apparently healthy Nigerians resident in Ilorin and compare with the national value. Methods: An automated blood analyzer was used to determine the full blood count and CD4 count. The percentage of CD4 count was derived by using other variables. Results: Of the 1205 participants, the reference CD4 count (percentage of CD4) range for adult was 400 to 1288 cells/mm3 (19%-48%) and for children was 582 to 3652 cells/mm3 (17%-50%). CD4 count and percentage of CD4 were significantly ( P = .001) higher in females than in males, and the CD4 count declined significantly with increasing age ( r = −.174, P ≤ .0001). The percentage of CD4 count shows less variation with age ( r = −.051, P = .076). Adult residents of Ilorin had significantly lower absolute mean CD4 count (808 ± 260) than that of the national reference values of 847.0 ± 307.0 cells/mm3 ( P = .001). Conclusion: We therefore advocate the use of CD4 count range derived in this study is lower than that of the national reference values.
Reference values of haematological parameters of healthy adults in the North Central zone of Nigeria East African Medical Journal, 2015
Factors affecting interest in respiratory medicine as a subspecialty of choice: survey of internal medicine residents in Nigeria Nigerian Postgraduate Medical Journal, 2013
Unmet needs in asthma treatment in a resource-limited setting: findings from the survey of adult asthma patients and their physicians in Nigeria. Pan African Medical Journal, 2013
Utilisation of spirometry among hospitalised patients with clinical findings of COPD in a tertiary hospital in Nigeria. Nigerian Postgraduate Medical Journal, 2011
