Hadijat Olaide Raji
@unilorin.edu.ng
Professor, Faculty of Clinical Sciences
Faculty of Clinical Sciences
University of Ilorin
EDUCATION
University of Ilorin, Ilorin, Nigeria
RESEARCH, TEACHING, or OTHER INTERESTS
Obstetrics and Gynecology, Reproductive Medicine
Scopus Publications
Scopus Publications
Aaron Oladipo Aboderin, Solomon Amfoabegyi, Abimbola Temitayo Awopeju, Michael Bahrami-Hessari, Emmanuel Isaac Acquah Garchie, Martin Gill, Akosua Karikari, Andrew Kirby, Olufunmilola Makanjuola, Bamidele Mutiu,et al.
Elsevier BV
Demilade A. Adedinsewo, Andrea Carolina Morales-Lara, Bosede B. Afolabi, Oyewole A. Kushimo, Amam C. Mbakwem, Kehinde F. Ibiyemi, James Ayodele Ogunmodede, Hadijat Olaide Raji, Sadiq H. Ringim, Abdullahi A. Habib,et al.
Springer Science and Business Media LLC
SummaryBackgroundExcessive opioid prescribing following surgery contributes to the growing opioid crisis. Prescribing practices are modifiable, yet data to guide appropriate prescription of opioids at surgical discharge remain sparse. This study aimed to evaluate factors associated with opioid consumption following discharge from surgery.MethodsAn international prospective multicentre cohort study was performed recruiting adult patients undergoing common general, orthopaedic, gynaecological and urological surgery, with follow‐up 7 days after discharge. The primary outcome measures were the quantities of prescribed and consumed opioids in oral morphine milligram equivalents. Descriptive and multivariable analyses were performed to investigate factors associated with the primary outcome measures.ResultsThis analysis included 4273 patients from 144 hospitals in 25 countries. Overall, 1311 (30.7%) patients were prescribed opioids at discharge. For those patients prescribed opioids, mean (SD) 179 (240) oral morphine milligram equivalents were prescribed, yet only 81 (145) oral morphine milligram equivalents were consumed within the first 7 days after discharge. An increased dose of opioids prescribed at discharge was associated with an increased dose of opioids consumed during the follow‐up period (β = 0.33 (95%CI 0.31–0.34), p < 0.001). The risk of prescribing more opioids than patients consumed increased as quantities of opioids prescribed at discharge exceeded 100 oral morphine milligram equivalents, independent of patient comorbidity, procedure and pain. Patients were prescribed more than twice the quantity of opioids they consumed in the first 7 days following discharge from surgery.ConclusionsOur data suggest that the current quantities of opioids provided at discharge exceed patient needs and may contribute to increasing community opioid use and circulation.
Edward Bywater, Laura Martinez, Sosthene Habumuremyi, Faustin Ntirenganya, Emmanuel Williams, Stephen Tabiri, Maria Fourtounas, Adesoji O. Ademuyiwa, Bokossa K. Covalic Melic, Dhruv N. Ghosh,et al.
Elsevier BV
, William Xu, Gordon Liu, Chris Varghese, Cameron Wells, Nicolas Smith, John Windsor, Lorane Gaborit, Sarah Goh, Aya Basam,et al.
Oxford University Press (OUP)
Abstract Background Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures. Methods This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge. Results The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1–30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80–100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (β coefficient 0.92, 95% c.i. −1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not. Conclusion Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely.
, Didier Ahogni, Aristide Ahounou, K. Alassan Boukari, Oswald Gbehade, Thierry K. Hessou, Sinama Nindopa, M. J. Bienvenue Nontonwanou, Nafissatou Orou Guessou, Arouna Sambo,et al.
Springer Science and Business Media LLC
Abstract Background Cluster randomised controlled trials (cRCT) present challenges regarding risks of bias and chance imbalances by arm. This paper reports strategies to minimise and monitor biases and imbalances in the ChEETAh cRCT. Methods ChEETAh was an international cRCT (hospitals as clusters) evaluating whether changing sterile gloves and instruments prior to abdominal wound closure reduces surgical site infection at 30 days postoperative. ChEETAh planned to recruit 12,800 consecutive patients from 64 hospitals in seven low-middle income countries. Eight strategies to minimise and monitor bias were pre-specified: (1) minimum of 4 hospitals per country; (2) pre-randomisation identification of units of exposure (operating theatres, lists, teams or sessions) within clusters; (3) minimisation of randomisation by country and hospital type; (4) site training delivered after randomisation; (5) dedicated ‘warm-up week’ to train teams; (6) trial specific sticker and patient register to monitor consecutive patient identification; (7) monitoring characteristics of patients and units of exposure; and (8) low-burden outcome-assessment. Results This analysis includes 10,686 patients from 70 clusters. The results aligned to the eight strategies were (1) 6 out of 7 countries included ≥ 4 hospitals; (2) 87.1% (61/70) of hospitals maintained their planned operating theatres (82% [27/33] and 92% [34/37] in the intervention and control arms); (3) minimisation maintained balance of key factors in both arms; (4) post-randomisation training was conducted for all hospitals; (5) the ‘warm-up week’ was conducted at all sites, and feedback used to refine processes; (6) the sticker and trial register were maintained, with an overall inclusion of 98.1% (10,686/10,894) of eligible patients; (7) monitoring allowed swift identification of problems in patient inclusion and key patient characteristics were reported: malignancy (20.3% intervention vs 12.6% control), midline incisions (68.4% vs 58.9%) and elective surgery (52.4% vs 42.6%); and (8) 0.4% (41/9187) of patients refused consent for outcome assessment. Conclusion cRCTs in surgery have several potential sources of bias that include varying units of exposure and the need for consecutive inclusion of all eligible patients across complex settings. We report a system that monitored and minimised the risks of bias and imbalances by arm, with important lessons for future cRCTs within hospitals.
James C Glasbey, Bryar Kadir, Adesoji O Ademuyiwa, Adewale O Adisa, Aneel Bhangu, Peter Brocklehurst, Sohini Chakrabortee, Pollyanna Hardy, Ewen Harrison, JC Allen Ingabire,et al.
Elsevier BV
, Adewale Adisa, Michael Bahrami-Hessari, Aneel Bhangu, Christina George, Dhruv Ghosh, James Glasbey, Parvez Haque, J C Allen Ingabire, Sivesh Kathir Kamarajah,et al.
Oxford University Press (OUP)
Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries.
, James Glasbey, Adesoji Ademuyiwa, Alisha Bhatt, Bruce Biccard, Jane Blazeby, Peter Brocklehurst, Sohini Chakrabortee, JC Allen Ingabire, Francis Moïse Dossou,et al.
Oxford University Press (OUP)
Abstract Background The Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation. Methods This was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model. Results In the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach’s α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever). Conclusion This study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways.
M. Monahan, J. Glasbey, T.E. Roberts, S. Jowett, T. Pinkney, A. Bhangu, D.G. Morton, A.R. de la Medina, D. Ghosh, A.O. Ademuyiwa,et al.
Elsevier BV
Callistus Elegbua, Hadijat Raji, Sikiru Biliaminu, Grace Ezeoke, and Abiodun Adeniran
African Journals Online (AJOL)
Background: Available information remains limited on inter-pregnancy interval (IPI) and its effect on maternal health and pregnancy outcome.
 Objectives: To determine the effect of IPI on maternal serum ferritin, haematocrit and pregnancy outcome.
 Materials and methods: A prospective cohort study of 316 women categorized into WHO recommended IPI of ≥24 months (group I) and IPI <24 months i.e. short IPI (SIPI) as group II after matching for gestational age and social status. Serum ferritin and haematocrit levels were assayed in first and second trimesters; primary outcome measures were maternal serum ferritin, haematocrit and pregnancy outcome gestational age at delivery, birth and placental weights, APGAR scores and neonatal intensive admission). Participants were followed up until six-week post-delivery. Data analysis was with SPSS version 21.0; p<0.05 wassignificant.
 Results: Women in group I had higher mean serum ferritin (37.40±3.15 vs. 32.61±2.68; P<0.001), booking haematocrit (33.24±3.59 vs. 27.92±2.67; P<0.001) and mean birth weight (3100±310 vs. 2700±350; P<0.001). Antenatal hospital admission (P0.002), preterm delivery (P<0.001) and neonatal intensive care admission (P<0.001) were higher for group II. There was no maternal mortality; perinatal mortality was zero (group I) and 95/1000 livebirth (group II).
 Conclusion: Low serum ferritin, haematocrit and adverse neonatal outcomes were associated with SIPI.
 Keywords: Inter-pregnancy interval; serum ferritin; haematocrit; pregnancy outcome.
Aaron B Andoh, Abantanga Atindaana Francis, Abdulhafiz A Abdulkarim, Abdulhafiz O Adesunkanmi, Abdulkadir A Salako, Abdulmajeed Soladoye, Abdulrahman A Sheshe, Abdulrasheed Sani, Abdulrazzaq O Lawal, Abdulwahab Lawal,et al.
Elsevier BV
James C Glasbey, Tom EF Abbott, Adesoji Ademuyiwa, Adewale Adisa, Ehab AlAmeer, Sattar Alshryda, Alexis P Arnaud, Brittany Bankhead-Kendall, M K Abou Chaar, Daoud Chaudhry,et al.
Elsevier BV
Katherine E Eddy, Joshua P Vogel, Nick Scott, Dagnachew Fetene, Tom Tidhar, Olufemi T Oladapo, Gilda Piaggio, My Huong Nguyen, Fernando Althabe, Rajiv Bahl,et al.
Elsevier BV
EJ Enabudoso, JA Akinmoladun, S Igbarumah, HO Raji, AI Njoku, JE Ikubor, OH Ogbebor, I Awowole, and LD Aliyu
Medknow
Louise HITCHMAN, Matthew MACHIN, and
Edizioni Minerva Medica
BACKGROUND
The COVIDSurg collaborative was an international multicenter prospective analysis of perioperative data from 235 hospitals in 24 countries. It found that perioperative COVID-19 infection was associated with a mortality rate of 24%. At the same time, the COVER study demonstrated similarly high perioperative mortality rates in vascular surgical patients undergoing vascular interventions even without COVID-19, likely associated with the high burden of comorbidity associated with vascular patients. This is a vascular subgroup analysis of the COVIDSurg cohort.
METHODS
All patients with a suspected or confirmed diagnosis of COVID-19 in the 7 days prior to, or in the 30 days following a vascular procedure were included. The primary outcome was 30-day mortality. Secondary outcomes were pulmonary complications (adult respiratory distress syndrome, pulmonary embolism, pneumonia and respiratory failure). Logistic regression was undertaken for dichotomous outcomes.
RESULTS
Overall, 602 patients were included in this subgroup analysis, of which 88.4% were emergencies. The most common operations performed were for vascular-related dialysis access procedures (20.1%, N.=121). The combined 30-day mortality rate was 27.2%. Composite secondary pulmonary outcomes occurred in half of the vascular patients (N.=275, 45.7%).
CONCLUSIONS
Mortality following vascular surgery in COVID positive patients was significantly higher than levels reported pre-pandemic, and similar to that seen in other specialties in the COVIDSurg cohort. Initiatives and surgical pathways that ensure vascular patients are protected from exposure to COVID-19 in the peri-operative period are vital to protect against excess mortality.
Adesoji O Ademuyiwa, Pollyanna Hardy, Emmy Runigamugabo, Pierre Sodonougbo, Hulrich Behanzin, Sosthène Kangni, Gérard Agboton, Luke Aniakwo Adagrah, Esther Adjei-Acquah, Ato Oppong Acquah,et al.
Elsevier BV
Covid Surg Collaborative
Oxford University Press (OUP)
There is little evidence around the potentially protective role of previous Bacillus Calmette-Guerin (BCG) vaccination on postoperative mortality in patients with perioperative SARS-CoV-2 vaccination. Prior BCG vaccination did not protect SARS-CoV-2 infected patients against postoperative pulmonary complications and 30-day mortality.
James Glasbey, Adesoji Ademuyiwa, Adewale Adisa, Ehab AlAmeer, Alexis P Arnaud, Faris Ayasra, José Azevedo, Ana Minaya-Bravo, Ainhoa Costas-Chavarri, John Edwards,et al.
Elsevier BV
Background
Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction.
Methods
This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index <20), moderate lockdowns (20–60), and full lockdowns (>60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926.
Findings
Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays.
Interpretation
Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services.
Funding
National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
Enoch Akowuah, Ruth A. Benson, Edward J. Caruana, Govind Chetty, John Edwards, Stefano Forlani, George Gradinariu, Gavin J. Murphy, Aung Ye Oo, Akshay J. Patel,et al.
Elsevier BV
M. Raji, I. Raji, Mairo Hassan, H. Raji, A. Bashir, I. Suleiman and Hauwa Abubakar
Introduction: Vesicovaginal fistula (VVF) has devastating effects on a woman's hygiene, self-esteem, interpersonal relationships, and environment disrupting all elements of her health. Despite VVF being a persistent condition, very few researches have been conducted in Nigeria to determine the quality of life (QoL) of these patients. This study was carried out with the aim of assessing the QoL of VVF patients receiving care in a repair center in Sokoto, Northwest Nigeria. Materials and Methods: This was cross-sectional study conducted at a VVF repair center in Sokoto. Study population comprised of patients who had undergone VVF repair at the health facility. The total number of study participants present at the facility was 81, and all were recruited into the study. The study assessed socio-demographics and QoL of the respondents. Data obtained were entered into IBM software package and subsequently analyzed. Level of significance was set at 5%. Results: The environmental domain had the highest mean score of 51.7 ± 11.8 while psychological domain had the least score of 41.3 ± 14.3. The mean overall QoL and general health were 49.5 ± 10.2. There was a moderate positive correlation between physical domain score and Age, (r = 0.258, P < 0.005). There was also a positive correlation between psychological domain score and Husband's educational status (rpb = 0.241, P < 0.05). Social relationship domain score positively correlated with being married (rpb = 0.414, P < 0.01). Conclusion: Older study participants had higher mean scores for physical and psychological domains, while younger study participants had higher overall QoL and general health scores compared with older study participants. Future research should compare the pre and postoperative QoL of women who undergo repair of obstetric fistula.
, Laura Bravo, Dmitri Nepogodiev, James C Glasbey, Elizabeth Li, Joana FF Simoes, Sivesh K Kamarajah, Maria Picciochi, Tom EF Abbott, Adesoji O Ademuyiwa,et al.
Oxford University Press (OUP)
To support the global restart of elective surgery, data from an international prospective cohort study of 8492 patients (69 countries) was analysed using artificial intelligence (machine learning techniques) to develop a predictive score for mortality in surgical patients with SARS-CoV-2. We found that patient rather than operation factors were the best predictors and used these to create the COVIDsurg Mortality Score (https://covidsurgrisk.app). Our data demonstrates that it is safe to restart a wide range of surgical services for selected patients.
O. Oladapo, Joshua P. Vogel, G. Piaggio, M. Nguyen, F. Althabe, A. M. Gülmezoglu, R. Bahl, Suman P N Rao, A. De Costa, Shuchita Gupta,et al.
Massachusetts Medical Society
BACKGROUND The safety and efficacy of antenatal glucocorticoids for women at risk of preterm birth in low-resource countries is unknown. METHODS We conducted a multicountry, randomized trial involving pregnant women at risk of preterm birth between 26 weeks 0 days and 33 weeks 6 days of gestation. Participants were assigned to intramuscular dexamethasone or identical placebo. Primary outcomes were neonatal death, any baby death (stillbirth or neonatal death), and composite possible maternal bacterial infection outcome. We applied superiority hypothesis for the infant primary outcomes and non-inferiority hypothesis for the maternal primary outcome. RESULTS The trial was stopped at the second interim analysis for benefits. We randomized 2852 women (and their 3070 babies) from 29 secondary and tertiary level hospitals across Bangladesh, India, Kenya, Nigeria, and Pakistan. Neonatal death occurred in 278 of 1417 infants (19.6%) in the dexamethasone group and 331 of 1406 infants (23.5%) in the placebo group (relative risk, 0.84; 95% confidence interval [CI] 0.72 to 0.97; P=0.03). Any baby death occurred in 393 of 1532 infants (25.7%) in the dexamethasone group and 444 of 1519 infants (29.2%) in the placebo group (relative risk, 0.88; 95% CI 0.78 to 0.99; P=0.04). Possible maternal bacterial infection did not differ between dexamethasone and placebo groups (4.8% vs. 6.3%, relative risk, 0.76; 95% CI 0.56 to 1.03), a finding consistent with noninferiority (P=0.002). Early neonatal death, severe respiratory distress at 24 hours, neonatal hypoglycemia at 6 hours, resuscitation at birth, and use of continuous positive airway pressure were lower in the dexamethasone group. Adverse events did not differ significantly between the groups. CONCLUSIONS Antenatal dexamethasone treatment of women at risk of early preterm birth in low-resource countries resulted in a significantly lower risk of neonatal death and any baby death, and no increase in possible maternal bacterial infection. (Funded by Bill and Melinda Gates Foundation; Australia and New Zealand Clinical Trials Registry number ACTRN12617000476336; Clinical Trials Registry-India number, CTRI/2017/04/008326)
Abdulrasheed A. Nasir, Lukman O. Abdur-Rahman, Omotayo O. Adesiyun, Kayode T. Bamigbola, Majeed B. Adegboye, Hadijat O. Raji, Olusola A.M. Adesiyun, and James O. Adeniran
Elsevier BV
LukmanOmotayo Omokanye, AbdulwaheedOlajide Olatinwo, KabirAdekunle Durowade, HadijatOlaide Raji, SekinatTitilayo Raji, SikiruAbayomi Biliaminu, and SalaudeenAdekunle Ganiyu
Medknow
Background: Infertility is the most important reproductive health and social issue confronting married couples in developing countries. Assisted Reproductive Technology (ART) offer a chance at parenthood to couples, who until recently would have had no hope of having a “biologically related” child. Aims and Objectives: This study aimed at determining the factors influencing the utilization of ART services at a public health facility in Ilorin, Nigeria. Materials and Methods: A cross-sectional descriptive study of consecutively consenting infertile couples seen at the ART unit of the Department of Obstetrics and Gynaecology, University of Ilorin Teaching Hospital, Ilorin, between January 1, 2012, and December 31, 2015. Results: The patients aged 22–52 years with a mean age of 36.1 ± 6.6 years and mean duration of infertility of 7.3 ± 5.8 years. Majority (87.3%) was aware of ART services; only a few (15.6%) had ever used it. Most (63.3%) were of the opinion that ART is financially accessible. Reasons for nonutilization of ART were high cost (44.3%) and nonavailability (29.4%). Measures to enhance the utilization of ART were cost reduction (61.2%) and awareness creation (27.2%). Knowledge on ART practices showed that 56.7% were aware that the procedure could fail and 35.1% knew that it could address male infertility. Female partner age and parity had a significant influence on awareness and utilization of ART services. Conclusion: Awareness of ART services is high; however, utilization is abysmally low. Efforts should be made to make the procedure more affordable and accessible to the masses.