Category: Statistics

West Afr J Med. 2025 Dec 30;42(9):747-754.

ABSTRACT

BACKGROUND: Obstructive sleep apnoea (OSA) and excessive daytime sleepiness (EDS) are recognized contributors to road traffic accidents (RTAs). However, the association between OSA, EDS, and RTAs remains underexplored among Nigerian truck drivers.

METHODS: A cross-sectional study was conducted among 306 adult male long-distance truck drivers in Ado-Ekiti, Nigeria. The Berlin Questionnaire was used to assess the risk of OSA while the Epworth Sleepiness Scale evaluated excessive daytime sleepiness (EDS), and self-reported previous RTAs were adapted in the questionnaire.

RESULTS: The mean age (SD) of the truck drivers was 42.3±9.1 years. The prevalence of snoring, excessive daytime sleepiness and dozing off while driving among the participants was 57%, 46.7% and 21% respectively. Overall, 43.5% of truck drivers were identified as having high risk for OSA. The risk factors associated with OSA were advanced age (50 years and above), self-reported systemic hypertension, obesity and increased neck circumference. In the three years preceding the study, approximately one-third of truck drivers reported being involved in RTAs which was associated with the use of stimulants aOR 11.63(95%CI 3.73 to 36.24, p=0.001), sleeping pills aOR 5.26(95%CI 1.50 to 18.40, p=0.001), high OSA risk aOR 2.21 (95%CI 1.60 to 4.80, p=0.03), EDS aOR 2.75(1.60 to 4.80, p=0.001) and extended working hours aOR 1.02(95%CI 1.00 to 1.04, p=0.03). More than 90% of the drivers were unaware that EDS constitutes a medical concern.

CONCLUSION: The high prevalence of excessive daytime sleepiness, and obstructive sleep apnoea among truck drivers highlights the underrecognized contributors to road traffic accidents. This underscores the need for targeted sleep disordered screening and regulatory interventions by policymakers to improve road safety in Nigeria.

PMID:42035348

Am J Ind Med. 2026 Apr 26. doi: 10.1002/ajim.70084. Online ahead of print.

ABSTRACT

INTRODUCTION: Use of aqueous film-forming foam (AFFF) is a source of exposure to per- and polyfluoroalkyl substances (PFAS) for firefighters working in aircraft rescue and firefighting (ARFF) settings. However, data characterizing the association between serum PFAS concentrations and exposure risk factors for ARFF firefighters are limited.

METHODS: In this cross-sectional study, ARFF firefighters (N = 193) from six U.S. commercial airports provided serum for quantification of nine PFAS and completed a survey in 2019-2020. A drinking water sample from each fire station was also analyzed for 29 PFAS. Serum PFAS concentrations were compared with demographically-similar participants from the National Health and Nutrition Examination Survey (NHANES) 2017-March 2020. Multivariable linear regression was used to identify factors associated with serum PFAS concentrations.

RESULTS: Geometric mean serum concentrations of perfluorohexane sulfonic acid (PFHxS), perfluorooctane sulfonic acid (PFOS) branched isomers, and perfluoroundecanoic acid (PFUnDA) were statistically higher in ARFF firefighters compared with NHANES participants. PFAS were detected in tap water at three fire departments, but only one department was characterized by detection of select PFAS (perfluorooctanoic acid (PFOA), PFOS, and PFHxS) in both water and serum. Past employment, detection of PFAS in drinking water, and age were positively associated with select PFAS concentrations; a recent change in workplace AFFF behavior or practice, female sex, and Black race exhibited inverse associations.

CONCLUSIONS: Participants reporting changes in workplace behavior, policy, or practice had lower summed PFAS concentrations, suggesting these measures may help reduce exposure. Continued research is needed to evaluate exposure reduction strategies for firefighters, particularly those working in ARFF settings.

PMID:42035339 | DOI:10.1002/ajim.70084

Stat Med. 2026 May;45(10-12):e70570. doi: 10.1002/sim.70570.

ABSTRACT

With the advent of high-throughput techniques, multi-omics data and various clinical outcomes have been collected for a range of diseases. Multi-omics data play a crucial role in uncovering complex biological processes, yet simultaneous representation learning of such high-dimensional, heterogeneous multi-modality data along with clinical outcomes remains limited. To address this gap, we propose a supervised knowledge-guided Bayesian factor model for integrative analysis of multi-omics and clinical outcome data. The proposed method simultaneously extracts an informative low-dimensional representation and predicts one or more clinical outcomes of interest. The two-level adaptive shrinkage in the novel hierarchical priors allows for the identification of both active modalities and features, resulting in a biologically meaningful structural identification of the high-dimensional data. Moreover, the method is robust to noisy edges in biological graphs that do not align with ground truth. Finally, the proposed method can handle different data types including both continuous and categorical data. Extensive simulation studies and real data analyses of Alzheimer’s disease (AD) data demonstrate the advantages of the proposed approach over existing methods. Notably, our analysis of multi-omics and imaging phenotype data from ADNI provides meaningful insights into the underlying biological mechanisms of AD.

PMID:42035335 | DOI:10.1002/sim.70570

West Afr J Med. 2025 Dec 30;42(9):739-746.

ABSTRACT

BACKGROUND AND OBJECTIVES: The links between periodontal disease and a number of systemic diseases including respiratory diseases have been widely reported in the literature. The burden and prevalence of periodontal disease and chronic obstructive pulmonary disease (COPD) is increasing globally. Periodontitis is now recognised as an independent risk factor for COPD. In addition, these two chronic diseases have similar pathogenic mechanisms. Despite these facts, the role of prevention of periodontitis in the management of COPD had not been fully explored. The aim of the study was to look at the effect of non-surgical periodontal therapy on the control of symptoms of Chronic Obstructive Pulmonary Disease (COPD) in our resource-limited settings.

METHODS: Sixty-nine COPD patients with concurrent periodontitis, who were at least 40 years old, were recruited from the Chest clinic of a tertiary institution in Ile Ife, Osun State, Nigeria between July 2021 and January 2023. Using GraphPad software, the participants were randomly categorised into two groups (control and intervention). The intervention group received non-surgical periodontal therapy (NSPT) and oral hygiene instructions (OHI) while the control group received oral hygiene instruction (OHI) only after the initial determination of the aMMP-8 assay and oral examinations. However, they had their non-surgical periodontal therapy after the three months follow-up. Clinical parameters such as COPD Assessment Test (CAT) scores, probing pocket depths (PPD), clinical attachment level (CAL) and a biomarker active matrix metalloproteinase-8 (aMMP-8) were recorded at baseline and after 3 months. Independent t-test was used for normally distributed variables for the two groups while Mann-Whitney U test was used for non-normally distributed variables. Paired t-test was used for the intra-group comparisons of the mean values and p value set at <0.05.

RESULTS: A total of 69 participants comprising 35 participants in the intervention group and 34 participants in the control group were enrolled in this study. The intervention group demonstrated statistically significant improvements in the CAT scores from 18.66 to 15.06 (p<0.04), aMMP-8 from 26.28ng/ml to 18.66ng/ml (p<0.001), mean PPD from 2.78mm to 2.64mm (p<0.05) and mean CAL from 4.64mm to 4.50mm (p<0.001) in comparison to the control group ( CAT scores from 18.91 to 17.59 p=0.07, aMMP-8 from 30.80ng/ml to 27.11ng/ml p=0.11, mean PPD from 2.82mm to 2.84mm p=0.37, and mean CAL from 4.88mm to 4.89mm p=0.69).

CONCLUSION: The results of this study emphasize the possible advantages of incorporating periodontal care into strategies for managing COPD.

PMID:42035331

West Afr J Med. 2025 Dec 30;42(9):733-738.

ABSTRACT

BACKGROUND: Tropical Diabetic Hand Syndrome (TDHS) is an acute, rapidly progressive hand infection affecting patients with diabetes mellitus (DM), often following trivial trauma. Unlike those with diabetic foot disease, neuropathy and vasculopathy play a minor role, while poor glycaemic control, delayed presentation, and minor injuries are key risk factors. TDHS is often not recognised in Nigeria despite its potential for disability and mortality. This study reviews the management outcomes of patients presenting with TDHS at a tertiary hospital in Nigeria.

METHODOLOGY: A retrospective review was conducted of all patients with DM managed for TDHS at the Jos University Teaching Hospital from 2015 to 2024. Data were extracted on socio-demographics, type and duration of diabetes, clinical presentation, treatment, and outcomes. Descriptive statistics were applied using SPSS version 25.

RESULTS: Thirteen patients were included: mean age 45.4 ± 11.2 years, with a female predominance (61.5%). Most (92.3%) had type 2 diabetes of a median duration of 6 years, and poor glycaemic control was observed in 86.6%. Abscesses (53.8%) and ulcers (30.8%) were the commonest presentations, predominantly affecting the digits (61.5%). Incision and drainage with dressings (that included the use of povidone iodine) was the main surgical treatment, while flap cover was rarely required. The mean hospital stay was 26.5 ± 23.9 days. Outcomes were favourable in 86.6% (discharged), with one death (7.7%) and one patient leaving against medical advice.

CONCLUSIONS: TDHS remains a preventable but serious complication of diabetes in Nigeria, predominantly affecting middle-aged women with poorly controlled type 2 diabetes. Prompt surgical and medical management yielded favourable outcomes, but prolonged hospitalisation and mortality highlight its burden. Strengthening diabetes care, patient education, and clinician awareness are vital to reducing incidence and improving outcomes.

PMID:42035327

J Health Psychol. 2026 Apr 26:13591053261437920. doi: 10.1177/13591053261437920. Online ahead of print.

ABSTRACT

Latent profile analysis (LPA) is an emerging approach to analyze the Revised Illness Perception Questionnaire (IPQ-R). LPA creates subgroups with similar illness perceptions. We used simulated data sets to provide suggestions and considerations for IPQ-R researchers implementing LPA. We explored 640 simulation parameters, varying sample size, IPQ-R distribution, covariance, and subscale means, simulating 3 distinct latent subgroups. We simulated 1000 samples for each setting via MClust package in R. Caution should be used when N < 100, as LPA only performs adequately (<50% detection). N ⩾ 100 still may not yield ideal performance depending on sample (e.g., subgroup sizes, within-group variance). With more differences between subgroups, LPA is more accurate. However, researchers have little control over mean differences, except indirectly (e.g., diverse sample). Researchers using LPA with IPQ-R data must carefully consider anticipated sample heterogeneity to establish appropriate sample size estimates. Resources provided in this manuscript can support these determinations.

PMID:42035326 | DOI:10.1177/13591053261437920

West Afr J Med. 2025 Dec 30;42(9):718-723.

ABSTRACT

BACKGROUND: Cryptosporidium is a water-borne protozoal parasite that infects humans and causes water-borne diarrhoea outbreaks.

OBJECTIVES: This cross-sectional study determined the prevalence of Cryptosporidium in wells in Ile-Ife, and assessed the risk factors associated with its presence in well water in Ile-Ife.

METHODS: Water samples were collected from 316 wells in the 10 wards that make up Ife East Local Government Area (LGA). A structured questionnaire was used to obtain relevant information on the wells from users. Modified acid-fast staining was used for the phenotypic identification of Cryptosporidium. Nested Polymerase Chain reaction (PCR) amplification of the 18S rRNA gene was carried out on the samples positive by staining. Cryptosporidium was confirmed by PCR and sequenced for species identification. Data was analysed using SPSS (version 21.0). Descriptive and inferential statistics were determined. A p-value of less than 0.05 was considered statistically significant.

RESULTS: The results showed that 11 (3.5%) of the 316 sampled wells were positive for Cryptosporidium by acid-fast staining, however only one was positive for Cryptosporidium by Nested PCR and was confirmed as Cryptosporidium parvum by sequencing. However, none of the risk factors investigated were significantly associated with the presence of Cryptosporidium in the well (p>0.05).

CONCLUSION: The study concluded that Cryptosporidium has low prevalence in wells in Ife East LGA. Cryptosporidium parvum was the species identified in the study area.

PMID:42035313

West Afr J Med. 2025 Dec 30;42(9):708-717.

ABSTRACT

BACKGROUND: Depression among women of reproductive age (WRA) is a major public health challenge because of its impact on mothers, children, and family members.

OBJECTIVE: The study determined the prevalence of depression and its associated factors among women of reproductive age at the three levels of healthcare in Ibadan, Nigeria.

METHODS: This cross-sectional facility-based study was conducted to compare the prevalence and correlates of depression among 991 pregnant, 662 postpartum, and 674 non-pregnant women using the Hospital Anxiety and Depression Scale (HADS). Data were analysed using descriptive statistics, the chi-square test, and binary logistic regression to determine the factors associated with and predictors of depression at p<0.05%.

RESULTS: The mean age of respondents was 29.9±6.3 years. Prevalence of depression was highest among pregnant women (38.5%), followed by non-pregnant (32.9%) and postpartum women (29.6%) (X2=14.93; p-value=0.001). Women whose husbands had primary education or below and those with financial problems were twice as likely to be depressed as those who did not. The presence of family problems and money-related issues were the predictors of depression across the groups.

CONCLUSION: Depression was common in women across the reproductive age lifespan. There is a need for screening for depression during routine health care to identify the women most at risk and for prompt intervention.

PMID:42035309

Ann Pharmacother. 2026 Apr 26:10600280261437728. doi: 10.1177/10600280261437728. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the efficacy and safety of mepolizumab, a humanized monoclonal antibody that targets interleukin-5, a key mediator in eosinophilic inflammation, in reducing moderate-to-severe exacerbations among patients with eosinophilic chronic obstructive pulmonary disease (COPD).

DATA SOURCES: PubMed, Scopus, Web of Science, and Cochrane databases were systematically searched using the terms: “Mepolizumab,” “COPD,” “Chronic Obstructive Pulmonary Disease,” for randomized controlled trials comparing subcutaneous mepolizumab (100 mg every 4 weeks) with placebo in patients with eosinophilic COPD from inception till July 2025.

STUDY SELECTION AND DATA EXTRACTION: Randomized controlled trials comparing subcutaneous mepolizumab with placebo in adults with eosinophilic COPD were included. Two independent reviewers screened studies and extracted data. Finally, 4 studies with a total of 1953 patients were included. Of these, 978 (50.0%) received mepolizumab.

DATA SYNTHESIS: Statistical analysis was performed using R software (version 4.5.0). Mepolizumab significantly prolonged the time to first moderate or severe exacerbation (hazard ratio [HR] = 0.80; 95% confidence interval [CI] 0.69-0.92; P = 0.016) and reduced the rate of moderate-to-severe exacerbations (rate ratio 0.80; 95% CI 0.78-0.83; P < 0.001). The risk of adverse events (AEs) (risk ratio [RR] = 1.00; 95% CI 0.95-1.06; P = 0.962) was similar between groups, while the risk of serious adverse events or death (RR = 0.83; 95% CI 0.72-0.96; P = 0.031) was significantly lower in the mepolizumab group.Relevance to Patient Care and Clinical Practice in Comparison With Existing Drugs:Mepolizumab provides a targeted, biomarker-guided treatment option, potentially reducing exacerbations without the added safety concerns like infections and metabolic complications as seen with existing therapies.

CONCLUSION AND RELEVANCE: Mepolizumab reduces the time to first moderate or severe exacerbation and prolongs symptom-free periods in patients with eosinophilic COPD, without increasing the risk of AEs.

PMID:42035307 | DOI:10.1177/10600280261437728

West Afr J Med. 2025 Dec 30;42(9):701-707.

ABSTRACT

BACKGROUND: Exploring the relationship between refractive error and ocular biometry in young African school children is essential for early detection, prevention, and management of visual impairments.

OBJECTIVES: This study aimed to profile the distribution of ocular biometry parameters and to identify correlates of spherical equivalent refraction (SE) among school children in Nigeria.

METHODS: A cross-sectional study was conducted among 295 secondary school students aged 10-19 years in Ife Central Local Government Area. Ocular measurements, including axial length, corneal radius of curvature, keratometric readings, anterior chamber depth, and horizontal corneal diameter, were obtained using the IOL Master. Refractive error was assessed with an autorefractor, and subjective refraction was also performed on all participants.

RESULTS: Out of the total participants, 109 students (37.0%) had refractive errors, comprising 43.1% males and 56.9% females. Astigmatism was the most common type of refractive error, found in 75 students (68.8%), followed by myopia in 22 (20.2%) and hypermetropia in 12 (11.0%). The median (IQR) axial length was 23.4 (0.8) mm. The average keratometric reading and average corneal radius of curvature were 43.5 ± 1.4 diopters and 7.8 ± 0.2 mm, respectively. The median (IQR) anterior chamber depth, horizontal corneal diameter and spherical equivalent refraction were 3.3 (0.3) mm, 12.2 (0.8) mm and -0.8 (1.3) diopters, respectively. Myopic students had longer axial lengths, deeper anterior chambers, and lower average keratometric readings. Spherical equivalent refraction was significantly negatively correlated with axial length (r = -0.147, p < 0.011), anterior chamber depth (r = -0.130, p < 0.026), and horizontal corneal diameter (r = -0.119, p < 0.042). A positive but non-significant correlation was observed with average keratometric reading (r = 0.009, p = 0.872).

CONCLUSION: Axial length, anterior chamber depth, and horizontal corneal diameter showed significant inverse relationships with spherical equivalent refraction.

PMID:42035305