Papers by Abayomi J . Afe
Journal of Mother and Child, 2025
Background: Prenatal care in the US is often mediated through managed care organisations. Other c... more Background: Prenatal care in the US is often mediated through managed care organisations. Other community-based health organisations also implement nurse-led care programs to help pregnant women navigate prenatal care services. The aim of this study is to assess the impact of such organisational services. Material and methods: This was a retrospective cohort analysis of data generated from providing community-based care management services to pregnant women in Houston, Texas. Clients' characteristics and outcomes were analysed and described. Results: About 60 pregnant women received care management services between 2022 and 2023. Out of these, 24 (40%) were teenagers (13-19 years of age), 28 (47%) were young adults (20-26 years), 5 (8%) were 27-30 years, and 3 (5%) were older than 35 years. The youngest patient was 15 years old and the oldest was 39 years. 50% (n = 30) were African-American, 38% (n = 23) were Hispanic, and 12% (n = 7) were white. 48% (n = 29) were in their second trimester, 30% (n = 18) were in their first trimester and 22% (n = 13) were in their third trimester. The earliest gestational age was four weeks, the oldest gestational age was 38 weeks, and the average was 20 weeks. The most common medical risk factors were anxiety, depression, and epilepsy. Others included anaemia, diabetes, alcoholism, smoking, PCOS, thalassemia, renal disease, COVID-19 infection, Lupus erythematosus, multiple gestation, and previous miscarriage. Half of the women, n = 27 (46%), had incorrect Medicaid health insurance that did not cover pregnancy care, and the other half, n=32 (54%), had no health insurance at all. Conclusion: While it took an average of 53 days for the women in this study to get enrolled in a managed care organisation, it only took an average of 22 days for them to attend their first doctor's appointment when care was directly coordinated by a nurse led community-based health organization. This speaks to the efficacy of nurseled, community-based care management in improving early access to prenatal care.
Additional file 5 of Acceptability of mentor mother peer support for women living with HIV in North-Central Nigeria: a qualitative study
Additional file 5. IDI guide for PMTCT providers (formal health workers, traditional birth attend... more Additional file 5. IDI guide for PMTCT providers (formal health workers, traditional birth attendants, government officials/policy-makers, program implementers).
Additional file 3 of Acceptability of mentor mother peer support for women living with HIV in North-Central Nigeria: a qualitative study
Additional file 3. FGD guide for PMTCT facilitators: male partners [8].
Additional file 6 of Acceptability of mentor mother peer support for women living with HIV in North-Central Nigeria: a qualitative study
Additional file 6. IDI questionnaire for PMTCT facilitators: community leaders.
Additional file 4 of Acceptability of mentor mother peer support for women living with HIV in North-Central Nigeria: a qualitative study
Additional file 4. IDI guide for PMTCT users.
Additional file 2 of Acceptability of mentor mother peer support for women living with HIV in North-Central Nigeria: a qualitative study
Additional file 2. FGD guide for PMTCT users: women living with HIV (m2m and MMs) [43].
Additional file 1 of Acceptability of mentor mother peer support for women living with HIV in North-Central Nigeria: a qualitative study
Additional file 1. FGD guide for PMTCT users: pregnant women at antenatal care clinics.
Additional file 7 of Acceptability of mentor mother peer support for women living with HIV in North-Central Nigeria: a qualitative study
Additional file 7. COREQ checklist.
Global Health Journal, 2024
Background: In the 2022–2023 global outbreak, the United States and state of Texas recorded a tot... more Background: In the 2022–2023 global outbreak, the United States and state of Texas recorded a total of 31,277 and 3,085 confirmed monkeypox (Mpox) cases as of November 2023. This study aims to investigate the demographic characteristics and risk factors of Mpox outbreak in Houston and document the epidemiologic control measures implemented with their outcomes.
Methods: Houston Health Department received reports of suspected Mpox cases with electronic case reports and laboratory reports from healthcare providers within Houston. These were then investigated and reclassified as either confirmed or not using DNA polymerase chain reaction tests. All the reported cases received between May 2022 and January 2023 were included in this study using convenient sampling methods. Descriptive statistics using frequency distribution was used to analyze the sociodemographic, clinical features and travel history of the cases. A two-sided Chi-squared test was used to determine association between Mpox test results and risk factors with significant level set at P < 0.05. Other infection control measures such as community engagement, health education, tracking and contact tracing, vaccination, referrals and laboratory sample logistics were implemented by the health department.
Results: Out of the total of 1,625 suspected persons investigated for Mpox, 724 (44.6 %) tested positive. Among the 724 confirmed cases, male was 700 (96.7 %), females 20 (2.8 %), transgender male 1 (0.1 %), transgender female 3 (0.4 %). Age groups 30–39 years constituted 43.6 %, 18–29 years 27.4 %, 40–49 years 18.2 %, 50–59 years was 8 %. Race distribution of positive cases; Whites 43.4 %, African American 38.7 %, Asian 1.4 %. Risk factors with P < 0.05 included male gender, age groups 30–39 years and 40–49 years, travel history to Mpox endemic areas, recent sexual contact with known or suspected Mpox cases, human immunodeficiency virus seropositivity. Identifying as gay and bisexual were also significant risk factors for Mpox infection.
Conclusion: The timely implementation of primary and secondary prevention measures targeted at the most at-risk populations was very effective at curtailing the spread of Mpox infection within the city of Houston.
International Journal of Science and Healthcare Research, 2024
Background: Tuberculosis (TB) remains a significant global health challenge, particularly in hi... more Background: Tuberculosis (TB) remains a significant global health challenge, particularly in high-burden countries like Nigeria. Despite
efforts to combat TB, a substantial number of cases remain undiagnosed and untreated, contributing to the continued spread of the disease. In response to this public health crisis, the USAID/Nigeria Tuberculosis Local
Organization (USAID/Nigeria TB LON) project, implemented by the Equitable Health Access Initiative (EHAI) in Lagos State, initiated a novel approach to TB case finding. This journal article provides an overview of the strategies, activities, challenges, and achievements of the Program within the USAID.
TB LON 3 project in Lagos State, with a focus on the period from March to September 2021
Methods: This approach involves collaboration with Traditional Medicine Practitioners (TMPs) to identify and link presumptive TB cases to
testing and treatment services.
Result: From March to September 2021, only 30 out of the 94 TMPs trained reported a total of 8,333 clients screened for Tuberculosis infections across 7 LGAs in Lagos State. 715 presumptive TB cases were identified
(representing 0.09% of screened cases) and 628 samples were further evaluated for TB (88% of identified presumptive cases) with 12 confirmed
TB positive cases reported (2% of presumptive cases), 11 linked to treatment, and 1 death reported.
Conclusion: This research offers compelling evidence supporting the efficacy of engaging Traditional Medicine Practitioners (TMPs) in
enhancing active Tuberculosis (TB) case finding in Lagos State. The substantial and positive impact observed underscores the potential of
this approach to play a pivotal role in TB control initiatives, fortifying the healthcare system's resilience in addressing TB within community
outside hospital facility.
International Journal of Science and Research Archive, Jun 30, 2023
Introduction: Rational use of Drugs is the prescription and dispensation of drugs to the appropri... more Introduction: Rational use of Drugs is the prescription and dispensation of drugs to the appropriate patients in appropriate doses, for required period and at lowest cost to them and their community. Irrational use refers to inappropriate use of drugs which include prescription and dispensation of too many drugs (polypharmacy), unnecessary and overuse of antibiotics and use of injection where oral drug suffices. A step towards preventing irrational drug use is to document it in a study such as this, so that appropriate corrective steps can be taken. Methods: This was a cross sectional cohort analysis of the prescribing records of primary health care workers from eight primary health care facilities. Result & Discussion: There were 513 prescriptions of 2, 590 drugs from the eight facilities;206 (40%) from a cohort of two comprehensive health centres and 307(60%) from a cohort of six basic health clinics. 206(40%) was diagnosisbased prescriptions, while 307(60%) was not based on diagnosis. About 426(83%) contain antibiotics prescriptions, while 87(17%) had no antibiotic prescriptions. About 395(77%) prescriptions contained injectable drugs while 118(23%) did not contain any injectable drug. Conclusion: The average of number drugs per prescription and the proportions of antibiotics and injectables prescriptions in this study were higher than the WHO recommendations. These values were equally higher than values in many studies. Healthcare workers at the basic health clinics did more diagnosis-based prescriptions, prescribed more antibiotics and more injectable than their counterparts at the comprehensive health centers.
Journal of HIV & Retro Virus, 2018
Background: Nigeria has 10% of the global burden of HIV/AIDS and had HIV prevalence rate of 3.0% ... more Background: Nigeria has 10% of the global burden of HIV/AIDS and had HIV prevalence rate of 3.0% in 2014. Adherence to ART is a determinant of viral suppression and risk of transmission, disease progression but suboptimal adherence has been a major challenge associated with a diversity of patient-and programme-related challenges. This study was done to find factors that influence adherence to HAART among HIV/AIDS Patients in Southwest Nigeria. Methods: Structured interviewer-administered questionnaires were used to collect information from the 225 participants. Findings: There were more female (80.4%) than male (19.6%) living with HIV infection. About 96% of the respondents were literate with 2.7% illiteracy rate. Employment rate was also more than half (59%). Over 90% were of the Christianity faith. None of these and other factors had any significant influence on ability of the study participants to adhere to HAART (P>0.05). Excellent or optimal HAART adherence level (≥ 95%) was found among 42% of the respondents. Another 49% had fair adherence level of between 85% and 94% while 8.4% had poor level of adherence of <85%. The five commonest reasons given for failure to adhere were forgetfulness, Stigma, seeing someone with HIV doing well on HAART, fear of discrimination and the fact that HIV has no known cure. Conclusion: In conclusion, demographic factors such as gender, religion, finance, education, marital status do not have any significant associations with adherence to HAART. In addition, less than half of the study participants living with HIV infection had excellent adherence level needed to ensure treatment success and good health. These findings showed that there is still a huge gap in PLHIV achieving optimal adherence on HAART and therefore health workers and HIV control programme implementers need to continually emphasize and support optimal adherence.
Journal of Maternal-fetal & Neonatal Medicine, 2009
and-conditions-of-access.pdf This article may be used for research, teaching and private study pu... more and-conditions-of-access.pdf This article may be used for research, teaching and private study purposes. Any substantial or systematic reproduction, redistribution , reselling , loan or sub-licensing, systematic supply or distribution in any form to anyone is expressly forbidden. The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material.
Clinical immunology & research, Dec 31, 2017
Background: The number of Nigerians infected with the HIV infection in 2016 was about 3million, w... more Background: The number of Nigerians infected with the HIV infection in 2016 was about 3million, which was the second highest burden globally and accounted for 9% of the worldwide burden of the HIV/AIDS. The country ART programme which commenced in 2001 had adult coverage of 48.3% in 2014. Effectiveness of the antiretroviral drug regimens requires a very good level of adherence (95%) to suppress viral replication. Despite all the strategies to address the adherence barriers to HAART, the problems of poor adherence are ever-present. Factors determining adherence to HAART drug regimens have been studied in various population but little is known on this subject among PLHIV in Nigeria. Identifying and overcoming the factors that reduce adherence to combination antiretroviral agents is of utmost importance for prolonged viral load suppression. Very few of the strategies developed to mitigate the challenges of non-adherence were based on the theories of health behavior. However, behavioural theories, if adopted, could assist in the development of more effective interventions to improve treatment adherence. This crosssectional study was conducted to explain the dynamics of HAART adherence among Nigerians living with HIV/ AIDS; using behaviour change theories such as the Theory of Planned Behavior (TPB) and Health Belief Model (HBM). Methods: This was a questionnaire-based study using closed ended-questionnaires administered by the on the 225 participants.
American Journal of Field Epidemiology
Background Vaccine hesitancy threatens a reversal of progress made in tackling vaccine-preventabl... more Background Vaccine hesitancy threatens a reversal of progress made in tackling vaccine-preventable diseases. The Houston, Texas, Health Department assessed COVID-19 vaccine availability and uptake in these facilities after the emergency use authorization of the COVID-19 vaccines in United States. Population and Methods A facility-based cross-sectional study was conducted using a structured interviewer-administered questionnaire to elicit data on facility demographics, vaccine availability, residents and staff vaccine uptake at time of assessment. The unit of inquiry was the facility. We calculated frequencies and assessed association with facility type. Facilities were classified as: small-scale facilities (SSF) ≤ 10 beds, medium scale (MSF) 11-50 beds, and large-scale (LSF) > 50 beds. Results A total of 118 facilities were enrolled, with 2,431 residents and 2,290 staff. Twenty-five (14.5%) of the facilities were LSF, 47 (39.8%) MSF, and 46 (39.0%) SSF. Overall, 70 (59.3%) facili...
International Journal of Science and Research Archive, 2023
Introduction: Rational use of Drugs is the prescription and dispensation of drugs to the appropri... more Introduction: Rational use of Drugs is the prescription and dispensation of drugs to the appropriate patients in appropriate doses, for required period and at lowest cost to them and their community. Irrational use refers to inappropriate use of drugs which include prescription and dispensation of too many drugs (polypharmacy), unnecessary and overuse of antibiotics and use of injection where oral drug suffices. A step towards preventing irrational drug use is to document it in a study such as this, so that appropriate corrective steps can be taken. Methods: This was a cross sectional cohort analysis of the prescribing records of primary health care workers from eight primary health care facilities. Result & Discussion: There were 513 prescriptions of 2, 590 drugs from the eight facilities;206 (40%) from a cohort of two comprehensive health centres and 307(60%) from a cohort of six basic health clinics. 206(40%) was diagnosisbased prescriptions, while 307(60%) was not based on diagnosis. About 426(83%) contain antibiotics prescriptions, while 87(17%) had no antibiotic prescriptions. About 395(77%) prescriptions contained injectable drugs while 118(23%) did not contain any injectable drug. Conclusion: The average of number drugs per prescription and the proportions of antibiotics and injectables prescriptions in this study were higher than the WHO recommendations. These values were equally higher than values in many studies. Healthcare workers at the basic health clinics did more diagnosis-based prescriptions, prescribed more antibiotics and more injectable than their counterparts at the comprehensive health centers.
BMC Pregnancy and Childbirth, 2021
Background Mentor mothers provide psychosocial and other support to pregnant and post-partum wome... more Background Mentor mothers provide psychosocial and other support to pregnant and post-partum women living with HIV (WLHIV), which has been shown to enhance maternal-infant outcomes in the prevention of mother-to-child transmission of HIV (PMTCT). Our objective was to assess the acceptability of mentor mothers as a PMTCT intervention, and to explore opinions on mentor mother program composition and delivery among stakeholders in North-Central Nigeria. Methods We conducted nine focus group discussions and 31 in-depth interviews with 118 participants, including WLHIV, pregnant women, male partners, health workers, traditional birth attendants, community leaders, PMTCT program implementers, and policymakers. Participants were purposively recruited from health facilities and surrounding communities in the Federal Capital Territory and Nasarawa State. Transcripts were manually analysed using a Grounded Theory approach, where theory was derived from the data collected. Results Most partici...
Journal of Infection Prevention, 2023
Background: Long-term care facilities (LTCFs) including assisted living facilities (ALFs) are hub... more Background: Long-term care facilities (LTCFs) including assisted living facilities (ALFs) are hubs for high transmission and
poor prognosis of COVID-19 among the residents who are more susceptible due to old age and comorbidities.
Aim: Houston Health Department conducted assessments of ALFs within the City of Houston to determine preparedness
and existing preventive measures at the facilities.
Methods: Onsite assessments were conducted at ALFs using a modified CDC Infection Control Assessment and Response
(ICAR) Tool. Data was obtained on IPC measures, training, testing, vaccination etc. Data was analyzed, frequencies
generated, and bivariate associations determined.
Results: A total of 118 facilities were assessed and categorized into small scale 46 (39%), medium scale 47 (40%), and large
scale 25 (21%). The facilities had 2431 residents and 2290 staff. Thirty-one (26%) facilities reported an outbreak in 2020,
while 14 (12%) had an ongoing outbreak. Twenty-three (97%) large-scale and 12 (26%) small-scale facilities had COVID-19
testing program. Vaccination coverage among residents ranged from 99% in large-scale to 40% in small-scale facilities but
was smaller among staff at 748 (45%) in large scale, 71 (36%) in small scale, and 193 (45%) in medium scale. While 24 (96%)
large-scale and 34 (77%) of small-scale facilities conducted staff training staff on IPC practices, 22 (92%) of large-scale and 19
(56%) of small-scale facility staff demonstrated capacity (p = 0.01), respectively. Visitor screening was done at 100% of largescale and 80% of small-scale and the medium-scale ALFs.
Discussion: Assisted living facilities within the city of Houston are at various levels of preparedness and interventions with
respect to COVID-19 response.
Texila International Journal of Public Health, 2022
Engagement and training of community health extension workers was the strategy adopted by Nigeria... more Engagement and training of community health extension workers was the strategy adopted by Nigeria to solve the problem of the dearth of skilled health workers at the primary health care level. This group of health workers were trained to use standing orders in the management of the patient at this level of care. The purpose of this study is to investigate the extent of utilization of standing order among community health extension workers. The research was cross-sectional in nature, and it used a self-applied structured questionnaire. The questionnaire was distributed between March and April 2022. There were 265 respondents with age ranges between 23 and 58 years, and the majority (86.7%) were females. 98.1% possessed a copy of the standing order, and 88.5% and 9.9% kept their standing orders in health facilities and home, respectively. 62.3% used it regularly, 19.6% occasionally, 8.3% sometimes and 9.8% rarely used it. Reasons given for not using standing orders included waste of time, patients who think I am not competent, and not containing new drugs. Regular utilization of standing order is low, and there is a need to educate the community extension workers on the importance of standing order at the primary health care level.
Journal of Community Health, 2012
Rationale and Aims: Antibiotic development was a major breakthrough in defeating infections; howe... more Rationale and Aims: Antibiotic development was a major breakthrough in defeating infections; however, their vast use has led to antimicrobial resistance (AMR) causing mortality, morbidity, and financial burden worldwide. Considering the limited introduction of newer antimicrobials to overcome resistance patterns, sufficient knowledge of their use can help manage this issue. Antimicrobial stewardship programmes (ASPs) with the mainstay of education can be a good resolution. The aim of this study was to seek aspects in which knowledge regarding antibiotics is lacking at our institutions. Materials and Methods: This cross-sectional study performed in Shiraz, South of Iran, was designed as a knowledge, attitude, and practice (KAP) study. A selfadministered questionnaire consisting of 15 questions was designed and handed out to health care workers including infectious disease practitioners, surgeons, internal medicine specialists and residents, general practitioners, medical students, and microbiology lab technicians and PhD graduates. Difference in response to questions was evaluated between the practitioner and nonpractitioner groups. Results: Completed questionnaires were collected (n = 126). According to the results, most participants (88.1%) agreed on establishment of local guidelines. Majority (94.4%) also believed that education regarding antibiotics can help reduce AMR. Good patient care was not believed to be impaired by limiting use of antibiotics (72.2%). A significant difference in the practitioner and nonpractitioner groups' practice score was observed. Conclusion: In our study, knowledge deficit was observed in some aspects of AMR. We can conclude that more practice and education are needed in ASP for the better performance in reducing resistant patterns.
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Papers by Abayomi J . Afe
Methods: Houston Health Department received reports of suspected Mpox cases with electronic case reports and laboratory reports from healthcare providers within Houston. These were then investigated and reclassified as either confirmed or not using DNA polymerase chain reaction tests. All the reported cases received between May 2022 and January 2023 were included in this study using convenient sampling methods. Descriptive statistics using frequency distribution was used to analyze the sociodemographic, clinical features and travel history of the cases. A two-sided Chi-squared test was used to determine association between Mpox test results and risk factors with significant level set at P < 0.05. Other infection control measures such as community engagement, health education, tracking and contact tracing, vaccination, referrals and laboratory sample logistics were implemented by the health department.
Results: Out of the total of 1,625 suspected persons investigated for Mpox, 724 (44.6 %) tested positive. Among the 724 confirmed cases, male was 700 (96.7 %), females 20 (2.8 %), transgender male 1 (0.1 %), transgender female 3 (0.4 %). Age groups 30–39 years constituted 43.6 %, 18–29 years 27.4 %, 40–49 years 18.2 %, 50–59 years was 8 %. Race distribution of positive cases; Whites 43.4 %, African American 38.7 %, Asian 1.4 %. Risk factors with P < 0.05 included male gender, age groups 30–39 years and 40–49 years, travel history to Mpox endemic areas, recent sexual contact with known or suspected Mpox cases, human immunodeficiency virus seropositivity. Identifying as gay and bisexual were also significant risk factors for Mpox infection.
Conclusion: The timely implementation of primary and secondary prevention measures targeted at the most at-risk populations was very effective at curtailing the spread of Mpox infection within the city of Houston.
efforts to combat TB, a substantial number of cases remain undiagnosed and untreated, contributing to the continued spread of the disease. In response to this public health crisis, the USAID/Nigeria Tuberculosis Local
Organization (USAID/Nigeria TB LON) project, implemented by the Equitable Health Access Initiative (EHAI) in Lagos State, initiated a novel approach to TB case finding. This journal article provides an overview of the strategies, activities, challenges, and achievements of the Program within the USAID.
TB LON 3 project in Lagos State, with a focus on the period from March to September 2021
Methods: This approach involves collaboration with Traditional Medicine Practitioners (TMPs) to identify and link presumptive TB cases to
testing and treatment services.
Result: From March to September 2021, only 30 out of the 94 TMPs trained reported a total of 8,333 clients screened for Tuberculosis infections across 7 LGAs in Lagos State. 715 presumptive TB cases were identified
(representing 0.09% of screened cases) and 628 samples were further evaluated for TB (88% of identified presumptive cases) with 12 confirmed
TB positive cases reported (2% of presumptive cases), 11 linked to treatment, and 1 death reported.
Conclusion: This research offers compelling evidence supporting the efficacy of engaging Traditional Medicine Practitioners (TMPs) in
enhancing active Tuberculosis (TB) case finding in Lagos State. The substantial and positive impact observed underscores the potential of
this approach to play a pivotal role in TB control initiatives, fortifying the healthcare system's resilience in addressing TB within community
outside hospital facility.
poor prognosis of COVID-19 among the residents who are more susceptible due to old age and comorbidities.
Aim: Houston Health Department conducted assessments of ALFs within the City of Houston to determine preparedness
and existing preventive measures at the facilities.
Methods: Onsite assessments were conducted at ALFs using a modified CDC Infection Control Assessment and Response
(ICAR) Tool. Data was obtained on IPC measures, training, testing, vaccination etc. Data was analyzed, frequencies
generated, and bivariate associations determined.
Results: A total of 118 facilities were assessed and categorized into small scale 46 (39%), medium scale 47 (40%), and large
scale 25 (21%). The facilities had 2431 residents and 2290 staff. Thirty-one (26%) facilities reported an outbreak in 2020,
while 14 (12%) had an ongoing outbreak. Twenty-three (97%) large-scale and 12 (26%) small-scale facilities had COVID-19
testing program. Vaccination coverage among residents ranged from 99% in large-scale to 40% in small-scale facilities but
was smaller among staff at 748 (45%) in large scale, 71 (36%) in small scale, and 193 (45%) in medium scale. While 24 (96%)
large-scale and 34 (77%) of small-scale facilities conducted staff training staff on IPC practices, 22 (92%) of large-scale and 19
(56%) of small-scale facility staff demonstrated capacity (p = 0.01), respectively. Visitor screening was done at 100% of largescale and 80% of small-scale and the medium-scale ALFs.
Discussion: Assisted living facilities within the city of Houston are at various levels of preparedness and interventions with
respect to COVID-19 response.