Nnamdi Azikiwe University

A bstract Background Pre-eclampsia (PE) is a risk factor for various adverse pregnancy outcomes, including some diseases later in life. Knowledge of the pattern of weekly maternal weight gain, a modifiable risk factor, could be helpful in management. However, the association between late-onset PE (LOPE) and excessive maternal weight gain is inconclusive. Objectives To evaluate the association of weekly maternal weight gain in the third trimester with LOPE. Materials and Methods This is a multi-center case–control study. Health facilities in the southern part of Nigeria were purposively selected. Both Student’s t test and logistic regression were carried out. The receiver operating characteristic curve was used to obtain a mean weekly weight gain cutoff value predictive of LOPE. Results The prevalence of excessive weekly weight gain was 68.2% (n = 73) in cases compared with controls (50.5%) (n = 54), P = 0.010. Third trimester mean total and weekly maternal weight gain was significantly higher in cases than in controls: 5.59 kg (standard deviation [SD] = 4.07) versus 3.89 kg (SD = 2.61), P = 0.004; 1.04 kg (SD = 0.76) versus 0.65 kg (SD = 0.51), P < 0.001, respectively. A critical cutoff value of 0.85 kg per week has an accuracy of 64.65% (area under the curve = 0.653, 95% confidence interval = 0.580–0.726; P < 0.001). Conclusion Excessive weekly maternal weight gain is associated with LOPE. A critical cutoff value of 0.85 kg per week could be predictive. This value is not sensitive enough as a screening parameter for late-onset LOPE. Prospective cohort studies are recommended to improve the outcomes of the study.

The study examined the extraction of bio-oil from pumpkin seed and compared the optimization of the production of Fatty acid ethyl ester (FAEE) via the transesterification process using Response Surface Methodology (RSM), and Artificial Neural Network (ANN). This research uniquely highlights the utilization of pumpkin seed oil, a non-edible and sustainable feedstock, and combines RSM and ANN methodologies to enhance the precision of biodiesel optimization. The transesterification experiment was conducted at 60 min reaction time under varying temperature ranges, catalyst weight, stirrer speed, and ethanol-oil molar ratio. The RSM optimized conditions for maximum production were determined to be a 1.3% catalyst concentration, 6:1 ethanol-to-oil molar ratio, 50 � C temperature, and 550 rpm stirrer speed, resulting in a 90% biodiesel yield. The statistical evaluation metrics confirmed the neural network predictions were compromised to 80% yield due to limitations such as insufficient data size and the inherent complexity of the ANN model. The biofuel produced satisfied ASTM specifications peculiar to sustainable environmental applications. The mechanistic parameters revealed variations in thermodynamic stability and feasibility across reaction orders (zero, pseudo-first, and pseudo-second), emphasizing the temperature-dependent effects of the transesterification kinetic pathway on yield, design, and efficiency. HIGHLIGHTS � Combined RSM and ANN was used to optimize biodiesel production, achieving a 90% yield � Pumpkin seed oil was utilized as a non-edible sustainable biodiesel source � Pseudo-second-order reaction is the most efficient for KOH-based biodiesel conversion � 35.63 m 3 plug flow reactor was designed for continuous biodiesel production � Produced biodiesel met ASTM standards, for sustainable energy applications ARTICLE HISTORY

Background E-cigarettes and hookah have gained significant popularity, particularly among young people in recent years, despite limited research on their safety and efficacy. Advertisements for these products are widespread across various media platforms, further increasing their popularity and raising awareness among youths. This study aimed to assess the knowledge and risk perception of e-cigarettes and hookah among youths in Anambra State, Nigeria. Method This descriptive cross-sectional study was conducted in three tertiary institutions, selected through simple random sampling from the three Senatorial Districts of Anambra State. Participants (n = 272), aged 18–35 years, were recruited using a multi-stage stratified random sampling technique A self- administered, semi- structured questionnaires was shared amongst students of the three tertiary institutions that met the inclusion criteria. Descriptive statistics were generated, and chi-square tests were conducted to determine the level of significance at p < 0.05. Result The study showed that most participants (66.7%) reported the internet/media as their primary source of information about these substances. Majority (64.7%) perceived both e-cigarettes and hookah as equally harmful in terms of health risks, while 50.7% considered both substances equally addictive. Participants identified respiratory (65.4%) and cardiovascular (71.7%) diseases as the major health risks associated with e-cigarette and hookah use. Most users of these substances were within the 25–29 age group, and 7.4% of participants reported using both e-cigarettes and hookah. The majority of first-time users tried these devices in cafés/restaurants, followed by nightclubs. Conclusion This study demonstrates high awareness but limited comprehensive knowledge of the health risks associated with e-cigarette and hookah use among youths in Anambra State. The prevalence of use in social settings reveals the need for targeted education on their risks. Incorporating these products into smoke-free policies and regulating access in youth-centered environments are essential to curbing their growing use and associated health risks.

Complexity of climate variability and application of pesticides on rice production in Nigeria was investigated. A multi-stage sampling procedure using a structured questionnaire was utilized to sample 401 rice growers. Data for the study were gathered from primary and secondary sources and analyzed using descriptive statistics, the local average treatment effect (LATE), the beta regression model, principal component analysis (PCA), and the autoregressive distributed lag (ARDL) model. The rice farmers were found to be of fruitful age (56 years), male (85%), educated (mean = 12.0), and experienced (18 years). The majority of the rice farmers (89.8%) were conversant with climate change variations, and (50.4%), had a high degree of pesticide use. Climate variables such as temperature, rainfall, number of wet days, evaporation, and sunshine hours were discovered to have both beneficial and adverse significant effects on rice productivity. The use and application of pesticides on rice field increased yield by 987.01% and 710.6% with a negative decrease of 247%. Age, gender, access to credit, education level and climate events were significant determinants of pesticide usage and application among rice farmers. Increased crop failure (0.703), increased soil salinity and acidity (0.700), decreased yield (0.711) and increased insect/pest infestations (0.670) were noted as major perceived consequences of variability in climate and pesticide use. Rice growers were recommended to seek for early climate signals/forecast before embarking on rice cultivation and to adhere strictly to specified instructions regarding pesticide application.

Background The escalating prevalence of dementia in Africa, propelled by rapidly ageing population, necessitates innovative approaches to raise awareness and address associated challenges. The prevalent misconception of dementia as a result of witchcraft or wizardry is a challenge, and the media acts as a key agent in dispelling such myths. By reaching divers audiences, the media reinforces the notion that dementia is not confined to Africa alone but it is a global concern. It also aids in overcoming the shame and stigma associated with dementia, encouraging individuals to seek consultation. Method A comprehensive analysis of media initiatives used by the African Dementia Consortium (AfDC) during the World Alzheimer’s Month and subsequently was conducted. Digital Platforms (Instagram, LinkedIn, Facebook), print and traditional media (publications, journals, newspaper, radio and television stations) were examined for their effectiveness in achieving recruitment objectives, destigmatizing and promoting early diagnosis. Quality tools, such as cameras and recorders, were utilized to capture relevant information, while the outcome was evaluated based on their impact on target audience assessed by greater participation. Result Media Platforms have proven instrumental in recruitment efforts by disseminating information that reaches diverse demographic groups in Africa. Through compelling visual and textual content, the media has played a key role in destigmatizing dementia, challenging prevalent misconceptions, and fostering a more inclusive understanding of the condition. In addition, media initiatives have contributed significantly to the promotion of early diagnosis by disseminating educational content that empowers individuals to recognize early signs and seek timely medical intervention. Conclusion Both the digital and traditional media play vital roles in visually and textually representing dementia, correcting misconceptions, and fostering understanding. Allocating increased resources to media initiatives hold immense benefit for Africa, contributing to a more positive perspective on dementia and dispelling negative attitudes.

Background Cognitive assessment should be actively incorporated into the clinical evaluation of patients in Primary Health Care (PHC) settings. This is because of the imminent demand with the changing demographics especially in low‐ and middle‐income countries (LMICs) concerning dementia and Alzheimer’s disease. Method A cross‐sectional mixed‐method descriptive study was conducted to evaluate the useability and performance of a tablet‐based cognitive assessment tool (TabCAT) for use in geriatric primary healthcare settings in southeast Nigeria. Result In our study involving 207 participants, with an average age of 64.69 years, educational levels varied, with 51.8% having primary education, 41.2% secondary, and 6.6% tertiary. The research found that education had a significant positive impact on associative memory, processing speed, executive function, language skills, and visuospatial skills (p<0.001). Rural residents exhibited higher scores in associative memory, processing speed, executive function, language, and visuospatial skills (p<0.000). However, gender and location did not show significant contributions to cognitive performance across the examined domains. Conclusion There is an urgent need to deploy and routinely conduct cognitive assessments in primary healthcare clinics for elderly patients for early detection of cognitive changes to improve healthy living.

Background Historically, efforts to engage under‐represented communities in health research have encountered limited success, attributable to inadequate community participation, acceptability, and ownership. Globally, an innovative strategy to foster community involvement in research is the establishment of Community Advisory Boards (CABs). These boards consist of stakeholders from the target community, providing partnership and support throughout all phases of the research, from conception to implementation and evaluation. In pursuit of effective recruitment and retention into the Recruitment and Retention of Alzheimer’s Disease Diversity Genetic Cohorts‐ Alzheimer’s disease Sequencing Project (READD – ADSP) Study, each participating site within the African Dementia Consortium (AfDC) constituted a Community Advisory Board. Method A comprehensive standard operating procedure outlining the group’s activities and delineating the composition and role of the CAB within the READD_ADSP project was developed. Eligible members received letters of invitation, and those who agreed were convened for an inaugural meeting to discuss project aims, objectives, and other pertinent details using the SOP as template. Result About 14 CAB with 120 members have been established across the nine African sites. Each board comprised a diverse mix of geriatricians, public health leaders, community and religious leaders, retiree organizations, dementia caregivers, NGO dedicated to person living with dementia, media organizations, legal experts, and communication experts. Inaugural meetings at each site demonstrated a high level of interest and motivation to collaborate with the research team for the promotion of recruitment, retention, and advocacy. Using culturally appropriate names for dementia, case identification and referral system, lack of awareness and skilled personnel were among many concerns raised at the cab meetings. There is ongoing to continue to address these concerned raised for effective recruitment at the community. Conclusion The strategic partnership with community stakeholders, facilitated through the Community Advisory Boards, proved effective in achieving recruitment and retention goals for dementia research.

Background Harmonized neuropsychological battery for research in Alzheimer’s disease and related dementia (ADRD) in sub‐Sahara Africa is very important if we are to understand ADRD phenotype and mechanisms in the region and how they relate and differ from other regions. No study in Nigeria has examined factor structure (construct validity) at both exploratory and confirmatory levels of harmonized neuropsychological battery for research in Nigeria. This study was a move in this direction using already established neuropsychological test battery the Uniform Data Set Neuropsychological Battery version 3 (UDSNB 3.0) of the Alzheimer’s Disease Center United States. Method UDSNB 3.0 fully completed by 349 older adults (220 females) between the 65 – 85 years were used to test for construct validity. Exploratory and confirmatory factor analyses as well as Cronbach Alpha internal consistencies were analyzed. Result Principal axis factor analysis (PA) method with orthogonal rotation (varimax with Keiser normalization) and eigenvalue greater than 1 was used for exploratory factor analysis (EFA). Four factors were extracted: first – Executive function/language (Phonemic and category fluencies, number span tasks – forward and backward and multilingual naming test) accounted for 17.23% of the variance, second – Memory (Craft Story immediate and recall) accounted for 16.30%, third factor – Visual spatial (Benson Complex Figure Immediate, recall and recognition) accounting 11.59% and fourth factor – Processing speed accounting 5.64%. Confirmatory factor analysis (CFA) did not fit the four factor exploratory model: CMIN/DF = 4.23; CFI= 0.75; RMSEA=0.12. However, a good model fit was established: CMIN/DF= 2.13; CFI=0.94; RMSEA=0.07, when executive function was unbundled into working memory (Number Span – forward and backward) and language (phonemic and category fluencies) and recognition task of the Benson Complex Figure removed from the model. Moderate internal consistencies were found among the subtests. Conclusion UDSNB 3.0 showed good model fit on a five factor structure : Working memory, language, memory, visual spatial and processing speed. These domains could be measured in Nigeria older adults using UDSNB 3.0 cognitive tasks.

Background Cognitive assessment should be actively incorporated into the clinical evaluation of patients in Primary Health Care (PHC) settings. This is because of the imminent demand with the changing demographics especially in low‐ and middle‐income countries (LMICs) concerning dementia and Alzheimer’s disease. Method A cross‐sectional mixed‐method descriptive study was conducted to evaluate the useability and performance of a tablet‐based cognitive assessment tool (TabCAT) for use in geriatric primary healthcare settings in southeast Nigeria. Result In our study involving 207 participants, with an average age of 64.69 years, educational levels varied, with 51.8% having primary education, 41.2% secondary, and 6.6% tertiary. The research found that education had a significant positive impact on associative memory, processing speed, executive function, language skills, and visuospatial skills (p<0.001). Rural residents exhibited higher scores in associative memory, processing speed, executive function, language, and visuospatial skills (p<0.000). However, gender and location did not show significant contributions to cognitive performance across the examined domains. Conclusion There is an urgent need to deploy and routinely conduct cognitive assessments in primary healthcare clinics for elderly patients for early detection of cognitive changes to improve healthy living.

Background The escalating prevalence of dementia in Africa, propelled by rapidly ageing population, necessitates innovative approaches to raise awareness and address associated challenges. The prevalent misconception of dementia as a result of witchcraft or wizardry is a challenge, and the media acts as a key agent in dispelling such myths. By reaching divers audiences, the media reinforces the notion that dementia is not confined to Africa alone but it is a global concern. It also aids in overcoming the shame and stigma associated with dementia, encouraging individuals to seek consultation. Method A comprehensive analysis of media initiatives used by the African Dementia Consortium (AfDC) during the World Alzheimer’s Month and subsequently was conducted. Digital Platforms (Instagram, LinkedIn, Facebook), print and traditional media (publications, journals, newspaper, radio and television stations) were examined for their effectiveness in achieving recruitment objectives, destigmatizing and promoting early diagnosis. Quality tools, such as cameras and recorders, were utilized to capture relevant information, while the outcome was evaluated based on their impact on target audience assessed by greater participation. Result Media Platforms have proven instrumental in recruitment efforts by disseminating information that reaches diverse demographic groups in Africa. Through compelling visual and textual content, the media has played a key role in destigmatizing dementia, challenging prevalent misconceptions, and fostering a more inclusive understanding of the condition. In addition, media initiatives have contributed significantly to the promotion of early diagnosis by disseminating educational content that empowers individuals to recognize early signs and seek timely medical intervention. Conclusion Both the digital and traditional media play vital roles in visually and textually representing dementia, correcting misconceptions, and fostering understanding. Allocating increased resources to media initiatives hold immense benefit for Africa, contributing to a more positive perspective on dementia and dispelling negative attitudes.

Background Soft tissue tumors (STTs) in adolescents are relatively rare, and their characteristics and behavior have not been well studied in this age group. The aim of this study was to describe the clinicopathologic patterns of STTs in adolescents aged 10–19 years according to the 2020 WHO classification. Method A 10-year retrospective cross-sectional study of 632 surgical samples from adolescents was conducted at a tertiary health facility to determine the frequency, histological patterns and characteristics of STTs in this population. The data were analyzed via SPSS 23. Results STTs accounted for 12.5% of all histologically diagnosed lesions in adolescents, with a mean age of 15 ± 2.9 years, 54.4% occurring in females and 35.4% in middle adolescents. The majority (64.56%) of STTs were benign, while malignant and intermediate-grade neoplasms accounted for 25.32% and 10.13%, respectively. Vascular tumours were the most common, followed by adipocytic and fibroblastic/myofibroblastic tumours, with hemangiomas being the most common. The most prevalent symptom was a painless mass (82.3%), with the head and neck (25.3%) being the most commonly involved body site. Most of the STTs patients presented within the first two years of occurrence (36.7%, n = 29/79). However, age, age group and sex were not significantly associated with the WHO grades of these STTs. Conclusion This study provided valuable insights into the characteristics and behavior of STTs in adolescents, highlighting the importance of early diagnosis and management. These findings suggest that adolescent STTs affect females more than males , involve the head and neck more and are more benign, with vascular tumours being the most common type of STT in this age group.

Papaya (Carica papaya L.) is valued in tropical and subtropical regions for its nutraceutical and medicinal properties. This study evaluated the antibacterial activity of aqueous and ethanolic extracts of unripe papaya fruit against microbial isolates. Extracts were obtained via maceration, and their antimicrobial activities were assessed using agar dilution and agar well diffusion techniques. Gas chromatography-mass spectrometry (GC-MS) was employed to identify bioactive compounds in the extracts. The extracts were tested against Salmonella typhi, Bacillus subtilis, Staphylococcus aureus, Klebsiella pneumoniae, and Candida albicans. Both extracts demonstrated significant antimicrobial activity, with the aqueous extract showing the highest efficacy. However, S. aureus was resistant to the ethanol extract, while S. typhi was resistant to the aqueous extract. The optimal concentration for inhibition was 200 mg/mL for both extracts. The aqueous extract exhibited minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) of 12.5 mg/mL against S. aureus, B. subtilis, K. pneumoniae, and C. albicans. The ethanol extract had MICs of 50 mg/mL for B. subtilis, 25 mg/mL for S. typhi, and 12.5 mg/mL for K. pneumoniae and C. albicans. GC-MS analysis identified key bioactive compounds, including hexamethylcyclotrisiloxane, dodecamethylcyclohexasiloxane, and dihydroxyphenylglycol, contributing to the extracts' antimicrobial properties. These findings support the traditional use of C. papaya as a natural antimicrobial agent and highlight its potential as a complementary treatment for antimicrobial-resistant infections. Further studies on its pharmacodynamics are recommended.

Over the past decade, Anambra State, Nigeria, has implemented mass administration of medicines (MAMs) to combat soil-transmitted helminthiasis (STH), a significant public health challenge in low-income regions. Nevertheless, these efforts have predominantly focused on pre-school and school-aged children, leaving a notable gap in understanding STH infection rates and the efficacy of these campaigns among secondary school adolescents, who have been excluded from this initiative. Our study aimed to address this critical knowledge gap by assessing soil-transmitted helminthiasis (STH) prevalence and contextual factors hindering effective control among adolescents in Anambra State, Nigeria. We actively engaged 443 adolescents with a mean age of 14 years in a school-based cross-sectional study in selected communities within the Anaocha Local Government Area from 8 February to 7 July 2023 following informed consent and assent procedures. Employing a stratified random sampling technique, we collected demographic data and assessed STH risk factors using a structured questionnaire hosted on the Kobo Toolbox platform. For quantitative analysis of STH infections, the Kato-Katz technique was used. Analysis was performed using SPSS version 25, incorporating descriptive statistics and multinomial logistic regression, with statistical significance set at p<0.05. Of the 443 (213 males (48.0%) and 230 females (52.0%) adolescents studied, the overall prevalence of STH observed was 35.2% (156/443). Ascaris lumbricoides was the prevalent STH species (16.9%), followed by Trichuris trichiura (1.4%) and hookworm (0.5%). Only light-intensity infection was observed. Mixed infections were observed in 16.5% of adolescents, involving A. lumbricoides and hookworm (10.8%), followed by A. lumbricoides and T. trichiura (3.2%) and all three STH (2.5%). The observed overall prevalence was not statistically significant with respect to gender (OR: 0.961; 95% CI: 0.651–1.420; p > 0.05) or age (OR: 0.686; 95% CI: 0.459–1.025; p>0.05). Class (grade level) (OR = 1.75, 95% CI: 1.25–2.45, p = 0.003), knowledge and transmission of STH infection (OR = 0.60, 95% CI: 0.42–0.86, p = 0.008), parental occupation (OR = 1.90, 95% CI: 1.35–2.67, p < 0.001), parents’ literacy level (OR = 0.68, 95% CI: 0.48–0.96, p = 0.027), and the type of toilet (OR = 2.15, 95% CI: 1.54–3.00, p < 0.001) were all significantly correlated with STH infection. These findings highlight the role of adolescents in sustaining soil-transmitted helminthiasis (STH) transmission. Coupled with school-based deworming expansion, innovative improvements in water, sanitation, hygiene, and awareness can provide a cost-effective, sustainable solution for combatting STH infections in Anambra State.

Unlabelled: Lead optimization is vital for turning hit compounds into therapeutic drugs. This study builds upon a prior in silico research, where the hit compounds had better binding affinity and stability compared to a reference drug. Using a genetic algorithm, 12,500 analogs of the top compounds from the prior study were generated. Virtual screening was done using a quantitative structure-activity relationship (QSAR) model. Top analogs, selected based on pChembL values below 6.000nM, underwent molecular docking targeting Human Eg5. The top five analogs from this study (Compound 9794, Compound 8592, Compound 9786, Compound 2744, and Compound 3246) demonstrated strong binding energies and interactions with key amino acids (GLU 116, GLU 117, and ARG 119). MMGBSA analysis revealed comparable affinities to the co-crystallized ligand, suggesting the top analogs' potential as Human Eg5 inhibitors. Induced fit docking highlighted Compound 9786's superior efficacy. Quantum Polarized Ligand Docking indicated promising scores for Compounds 8592 and 9786. ADMET predictions offered insights into pharmacological properties, with all compounds predicted to be HIA-positive and non-carcinogenic. Further MD simulation study confirms the stability of the top compounds in the active site of Eg5. This study shows the significance of integrated strategies in drug design. However, in vitro and in vivo studies should be conducted for these promising candidates to confirm their efficacy as Eg5 inhibitors. Supplementary information: The online version contains supplementary material available at 10.1007/s40203-024-00300-6.

Background Afro‐textured hair exhibits distinct physicochemical properties with possible variations in measurable hair parameters. Standardized documentation of trichoscopic norms of afro‐textured hair in indigenous Africans is notably lacking. Methods A cross‐sectional study involving 122 South Africans of both genders of African ancestry (mean age 20.9 ± 3.3 years) with natural afro‐textured hair was performed to establish trichoscopic norms. Standard images, one overview, and five microimages (one 20× and four 50× magnifications) were captured with the FotoFinder Medicam1000V2 videodermoscope. Hair density (HD; N/cm ² ); hair shaft thickness (HST; μm); the proportion of thin, mid, and thick hairs (%); cumulative hair thickness (mm/cm ² ); and follicular units (FU; N/cm ² ) were assessed. Results The average HD was 139.1 ± 33.88 hairs/cm ² with significant variations across different scalp areas. The average hair thickness was 62.59 ± 8.45 μm with the frontal scalp showing the greatest HST, the proportion of thick hairs, cumulative hair thickness, and FU densities; the temporal had the greatest proportion of thin hairs, whereas the occipital showed the highest proportion of triple hair FU. Male participants exhibited significantly greater average hair thickness, more thick hairs, and more double and triple FU, whereas females had higher cumulative hair thickness density, more thin and intermediate hairs, and more single follicular units. Conclusion Baseline trichoscopic values for natural afro‐textured hair in indigenous South Africans reveal lower hair densities, variations in shaft diameters, and follicular unit patterns compared to other racial groups. Significant gender‐based differences are evident in some of the measured parameters. Tailored reference values are essential for accurate clinical evaluations and hair transplant planning.

Objectives Transfusion-transmitted infections are a serious complication of blood transfusion. Devising a means of detecting at-risk blood donors may be beneficial in low- and middle-income countries such as Nigeria. We sought to determine the impact of ABO blood group on the prevalence of transfusion transmitted infections. Methods A retrospective observational study was carried out at the blood bank of Chukwuemeka Odumegwu Ojukwu University Teaching Hospital in Nigeria using data from blood donors. Information retrieved about donors included sex; blood group; and results of HIV, hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV), and Venereal Disease Research Laboratory screening results. Microsoft Excel was used to sort the data and, the data analysis was conducted using R, version 4.3.2 (R Foundation for Statistical Computing). P < .05 was considered statistically significant. Results A total of 2356 donor records were reviewed; the majority of these donors were male. The prevalence of HIV, HBsAg, HCV, and venereal diseases in the study population was 0.5%, 3.3%, 1.6%, and 0.6%, respectively. There was a possible increased risk of HCV among blood group B donors (P < .02799). Conclusions Blood group B donors were found to have a higher risk of contracting HCV infection than other donors. This finding could give more insights on donor selection and screening. Further studies that are more broadly based are required to validate our findings.

Background Despite assumptions that insurance coverage would boost oral healthcare utilization in Nigeria, there is insufficient evidence supporting this claim. This study investigates the associations between residential location, awareness of the oral health insurance scheme, history of dental service utilization, and acceptance of oral health insurance among individuals benefiting from the Ilera Eko Scheme; a scheme that integrates preventive and curative oral health care into the state health insurance scheme. Methods A cross-sectional survey was conducted from July to November 2023 recruiting from a database of 1520 enrollees aged of 18 and 72-years-old who had been on the scheme for at least three months. An interviewer-administered questionnaire was used to collect the data from participants living in five regions of Lagos State. The dependent variable was dental service utilization. The independent variables were awareness about Ilera Eko health insurance scheme, history of oral health problem, residential location of the respondents (Lagos Island, Badagry, Epe, Ikorodu and Ikeja), and perception about the scheme. The confounding variables were the age at last birthday, sex at birth (male or female), educational level (no education, primary, secondary, and tertiary education), level of income (< 50,000, 50,000–10000, 150,000–200,000, > 200,000), employment status (employed, self-employed and unemployed), marital status (single, married, divorced. widow/widower) and duration on the scheme (< 6 months, 6–12 months, > 12 months). A binary logistic regression analysis was conducted to determine the associations between the dependent and independent variables, controlling for confounders. Results The study recruited 485 participants of which 31 (6.4%) had used the oral health care services. Respondents with oral health problems had higher odds of using the scheme (AOR:21.065; p < 0.001). Residents in Ikeja had significantly lower odds of using the scheme when compared with residents in Lagos Island (AOR: 0.174; p = 0.005). Conclusion Respondents with oral health problems had higher odds of using the oral health insurance scheme. Innovative approaches are needed to drive the utilization of free dental service packages on health insurance schemes in Lagos State, especially for preventive care.

This study evaluated asymmetry of weight bearing on the lower limbs and the association between percentage weight bearing asymmetry (PWBA) and functional ambulation performance in ambulant stroke survivors. Participants were 53 stroke survivors (male = 35, female = 18) aged 40-86 years (mean=58.87; SD=9.21years) with hemiparesis. Weight bearing through the lower limbs in standing was assessed by two juxtaposed bathroom weighing scales while functional ambulation performance was evaluated with the Emory Functional Ambulation Profile (E-FAP). Data were summarized with mean and standard deviation and further analyzed using the Pearson product moment correlation at 0.05 alpha level. Participants bore 60.3% (SD =7.1%) of their body weights on the unaffected legs and had a mean PWBA of 20.8 % (SD=14.7%). There was a significant positive correlation (r = 0.675, p < 0.0001) between PWBA and total E-FAP scores of participants. PWBA could hence be used to monitor functional ambulation recovery in stroke survivors.