AI-assisted abnormal CXR findings and correlation with behavioral risk factors: A Public Health Radiography approach to formulating policies and effective interventions
DOI:
https://doi.org/10.62486/latia2025323Keywords:
Artificial Intelligence, Abnormal chest x-ray, Behavioural risk factors, Public Health Radiography, Policies, InterventionsAbstract
Introduction: Cardiovascular, respiratory and related diseases (CVRDs) constitute over 40% cause of death worldwide, mostly reported in low-and-middle-income countries. The catastrophic effect of this spans across poor health outcomes, severe economic loss and significant societal consequences. Responding to this situation necessitates collective strategy to prevent further deterioration as these conditions are closely related, share common risk factors as well as control measures at the clinical, population and policy levels. Thus, this study is aimed at understanding the distribution of AI-assisted abnormal adult chest X-ray (CXR) and examine relationship with behavioral factors; to lay foundation for planned interventions.
Methods: Prospective mixed-methods research, cross-sectional in nature, conducted across six top-rated hospitals in Nigeria, representing the six geopolitical zones of the country via purposive sampling technique. Quantitative aspect involved data collection on demographics and abnormal findings from AI-assisted technology, while Qualitative aspect explored individual’s behavioral choices in relation to risk factors. Informed consent and ethical approval were obtained; SPSS software utilized for descriptive and correlation analysis.
Results: Cardiomegaly(15.35%), pleural effusion(14.03%), fibrous opacities(10.43%), pleural capping(8.51%), pulmonary mass(7.91%), apical opacities(7.55%), consolidation(6.59%), infiltration(5.88%) among the sixteen abnormal findings in decreasing order of magnitude. An early onset of these anomalies at 30 years was noted, hitting peak values at 40-44 years. A significant percentage of the population engages in unhealthy lifestyle, found to positively correlate with these anomalies in varying degrees; low education levels, health education gaps, poor income and environmental challenges clearly seen.
Conclusion: A Public Health Radiography approach- AI assisted, engaging with empirical evidence provides a novel and valuable strategy in designing effective interventions and policy making to address CVRDs burden.
References
Muthiah, V., George, A. M., Justine, V. T., Valentin, F., Gregory, A. The Global Burden of Cardiovascular Diseases and Risk: A Compass for Future Health. Journal of the American College of Cardiology 2022, 80(25):2361-2371. DOI: https://doi.org/10.1016/j.jacc.2022.11.005
Ojuawo, O.B., Desalu, O.O., Aladesanmi, A.O., Opeyemi, C.M., Azeez, A.T., Fawibe, A.E. et al. Outpatient Burden of Adult Respiratory Diseases in University of Ilorin
Teaching Hospital, Nigeria. Nigerian Journal of Clinical Practice 2022, 25(8):1233-1238. Doi: 10.4103/njcp.njcp_1864_21. DOI: https://doi.org/10.4103/njcp.njcp_1864_21
Burney, P., Jarvis, D. and Perez-Padilla, R. The global burden of chronic respiratory diseases in adults. The International Journal of Tuberculosis and Lung Disease 2015, 19(1):10-20. DOI: https://doi.org/10.5588/ijtld.14.0446
Giovanni, V., Sara, M., Salvatore, F., Sandra, B. Global burden of chronic respiratory diseases. Journal of aerosol medicine and pulmonary drug delivery 2020, 33(4):177-177. DOI: https://doi.org/10.1089/jamp.2019.1576
Adeniyi, B.O., Awokola, B., Irabor, I., Obaseki, D.O., Ayeni, E.O., Alele, B.K. et al.
Pattern of respiratory disease admissions among adults at Federal Medical Centre, Owo, South-West, Nigeria: A 5-year review. Annals of Medical and Health Sciences 2017, 7(1):96-101.
Adeoti, A.O., Fadare, J.O., Ajayi, E.A., Adekeye, K., Akolawole, M.A. Respiratoryrelated medical admissions in a tertiary institution in South-Western Nigeria. J Gen Pract (Los Angel) 2018, 6(352):pp. 2-8. DOI: https://doi.org/10.4172/2329-9126.1000352
Desalu, O. O., Oluwafemi, J. A. and Ojo, O. Respiratory diseases morbidity and mortality among adults attending a tertiary hospital in Nigeria. Jornal Brasileiro de Pneumologia 2009, 35(1):745-752. DOI: https://doi.org/10.1590/S1806-37132009000800005
Umoh, V. A., Otu, A., Okpa, H., Effa, E. The Pattern of Respiratory Disease Morbidity and Mortality in a Tertiary Hospital in Southern-Eastern Nigeria.
Pulmonary Medicine 2013, 2013(1):581973, pp. 2-5. Doi: https://doi.org/10.1155/2013/581973 DOI: https://doi.org/10.1155/2013/581973
Okechukwu, S. O., Olanike, A. O. and Tomilola, O. J. Cardiovascular Diseases in
Nigeria: Current Status, Threats, and Opportunities. Circulation 2023, 148(19):1441-1444. Doi: https://doi.org/10.1161/CIRCULATIONAHA.123.063671 DOI: https://doi.org/10.1161/CIRCULATIONAHA.123.063671
Vamadevan, S. A., David, A. W. and Dorairaj, P. Relationships among Major Risk Factors and the Burden of Cardiovascular Diseases, Diabetes, and Chronic Lung Disease, In Prabhakaran, D., Anand, S., Gaziano, T. A., Mbanya, J., Wu, Y., Nugent, R. (eds) Cardiovascular, Respiratory, and Related Disorders. 3rd edition. Washington (DC): The International Bank for Reconstruction and Development / The World Bank, 2017, pp. 8-20.
Leonard, A. K., Charles, G., Mary, I., Cemal, O., James, E., Peter, H. The Importance of healthy lifestyle behaviors in the prevention of cardiovascular disease. Progress in Cardiovascular Diseases 2022, 70(1):8-15.
Doi: https://doi.org/10.1016/j.pcad.2021.12.001 DOI: https://doi.org/10.1016/j.pcad.2021.12.001
Samantha, G. F., Mindy, M. K., Erick, J. F., Anagha, A.B., Gloria, J.G., Jacqueline,
E.S. Psychological Treatment Considerations in Medical Comorbidity, In Gordon, J.
G. (eds) Comprehensive Clinical Psychology. 2nd edition. Elsevier, 2022, pp. 225-251. Doi: https://doi.org/10.1016/B978-0-12-818697-8.00195-3 DOI: https://doi.org/10.1016/B978-0-12-818697-8.00195-3
GBD 2019 Chronic Respiratory Diseases Collaborators. Global burden of chronic respiratory diseases and risk factors, 1990-2019: an update from the Global Burden of Disease Study 2019. eClinicalMedicine 2023, 59(101936), pp. 2-8. Doi: https://doi.org/10.1016/j.eclinm.2023.101936 DOI: https://doi.org/10.1016/j.eclinm.2023.101936
Daniel, A. N., Chinedum, O. E. and Ukachukwu, O. A. Ischemic Heart Diseases in Nigeria: Exploring the challenges, current status, and impact of lifestyle interventions on its primary healthcare system. International Journal of Environmental Research and Public Health 2022, 19(1):211-215. DOI: https://doi.org/10.3390/ijerph19010211
Rasheedat, M. I., Jubril, A. A., Mohammed, B. A., Abdul-Wahab, B. R. J. Burden and spectrum of pediatric respiratory diseases at a referral hospital in North-Central Nigeria- A five year review. African Journal of Emergency Medicine 2020, 10(1):3-7. Doi: 10.1016/j.afjem.2019.09.001 DOI: https://doi.org/10.1016/j.afjem.2019.09.001
Hwang, E. J., Nam, J. G., Lim, W. H., Park, S. J., Jeong, Y. S., Kang, J. H. et al. Deep Learning for Chest Radiograph Diagnosis in the Emergency Department. Radiology 2019, 293(3):574-579. Doi: https://doi.org/10.1148/radiol.2019191225 DOI: https://doi.org/10.1148/radiol.2019191225
Mohsen, S., Marzieh, K. M., Hanieh, M., Sajad, B., Razieh, R., Zafar, M. et al. Belief and Behaviors of Radiographers concerning Digital Chest Radiography: Importance of Training courses. Journal of Clinical Care and Skills 2022, 3(4):2-13. Doi: https://doi.org/10.21203/rs.3.rs-1806948/v1 DOI: https://doi.org/10.21203/rs.3.rs-1806948/v1
Sean, C. G. and Michael, J. L. Current concepts in the staging of non-small cell lung cancer. Surgical Oncology 2002, 11(4):181-190. Doi: https://doi.org/10.1016/s0960-7404(02)00050-6 DOI: https://doi.org/10.1016/S0960-7404(02)00050-6
Joshua, B. Imaging the Chest: The Chest Radiograph, in Joshua, B (ed) Diagnostic imaging for the Emergency Physician. W.B Saunders, 2011, pp. 185-296. Doi: https://doi.org/10.1016/B978-1-4160-6113-7.10005-5 DOI: https://doi.org/10.1016/B978-1-4160-6113-7.10005-5
Jeffrey, S.K. and Melissa, L.R. A Systematic Approach to Chest Radiographic Analysis, In Juerg, H., Rahel, A. K., and Gustav, K. (eds) Diseases of the Chest, Breast, Heart and Vessels 2019-2022: Diagnostic and Interventional Imaging [Internet]. Cham (CH): Springer, 2019, pp. 3-20.
Leila, S., Mohammad, A.M., Eesa, M., Seid, S., Katayoun, R., Mohammad, H.N. et al. Behavioral determinants of cardiovascular diseases risk factors: A Qualitative directed content analysis. ARYA Atheroscler 2014, 10(2):71-81.
Airenakho, E., Oluwaseun, R.A., Blessyn, O.A., Asuwemhe, J.U., Mercy, O.D., Hannah, O.I. et al. Pattern and trends of respiratory diseases in an outpatient setting: a five-year review in a tertiary hospital in south-south, Nigeria. International Journal of Research in Medical Sciences 2023, 11(6):1919-1925. Doi: https://dx.doi.org/10.18203/2320-6012.jrms20231602 DOI: https://doi.org/10.18203/2320-6012.ijrms20231602
Akhigbe, R., Anthony, C. U., Michael, P. O., Beatrice, U.M., Bolaji, I.J. Abnormal chest radiographic patterns in patients with pulmonary tuberculosis in Lagos State, Nigeria: A single center study. International Journal of Medical and Health Research 2018, 5(1):36-40.
Adewuyi, S. A., Arogundade, R., Igashi, J. B., Chom, N.D., Hamidu, A.U., Campbell, O.B. The pattern of chest radiographs findings in metastatic cancer patients seen in a tertiary hospital in northern Nigeria. Niger Postgrad Med Journal 2011, 18(4):245-250. DOI: https://doi.org/10.4103/1117-1936.170513
Michael, E. A., Chisolum, O. O. and Samuel, J. U. Patterns of plain Radiographic findings among patients with chest trauma in Awka, Nigeria. International Journal of Medical Research 2018, 7(6):123-128.
Abacha, M., Ismail, S., Sadiq, A. A., Umar, A., Dahiru, G.A., Izge, I.Y., Dahiru, M. et al. Chest X-ray findings among adult patients attending Usmanu Danfodiyo University Teaching Hospital Sokoto North-western Nigeria. Annals of Clinical and Experimental Medicine 2020, 1(2):144-147. Doi: 10.47838/acem.26011977.127122020.asmeda.1.12 DOI: https://doi.org/10.47838/acem.26011977.127122020.asmeda.1.12
Igoh, E. O., Gabkwet, E. A., Balla, Z., Iyua, K. O., Salaam, A. J., Danjem, S. M. et al. Chest Radiography: A Review of 5-year findings in peripheral facilities in Jos, NorthCentral, Nigeria. African Journal of Biology and Medical Research 2021, 4(4):118-124. Doi: https://doi.org/10.52589/AJBMR-HDKKFW4D. DOI: https://doi.org/10.52589/AJBMR-HDKKFW4D
Jaykaran, C. and Tamoghna, B. How to Calculate Sample Size for Different Study Designs in Medical Research? Indian Journal of Psychological Medicine 2013, 35(2):121-125. DOI: https://doi.org/10.4103/0253-7176.116232
Twabi, H., Semphere, R., Mukoka, M., Chiume, L., Nzawa, R., Feasey, H. et al. Pattern of abnormalities amongs chest X-ray of adults undergoing computer-assisted digital chest X-ray screening for tuberculosis in peri-urban Blantyre, Malawi: A cross sectional study. Trop Med Int Health 2021, 26(11):1427-1437. Doi: 10.1111/tmi.13658 DOI: https://doi.org/10.1111/tmi.13658
Kawu, A.S., Akinrefon, A.A., Adeniyi, I. O. Variation in Educational Attainment Levels: Statistical Evidence from the Nigeria Demographics Health Surveys (2008, 2013 and 2018). International Journal of Development Mathematics 2024, 1(2):191-199. Doi: 10.62054/ijdm/0102.15. DOI: https://doi.org/10.62054/ijdm/0102.15
Robert, N., Mary F., Karia, G., Michel, R., Adeboye, A., Bala, Y. Progress towards global agenda 2030 for education SDG4 in Nigeria 2023.
National Bureau of Statistics. Nigeria Labour Force Statistics Report Q4 2022 & Q1 2023. 2023, pp. 1-35.
Akinola, R., Akhigbe, A., Mohammed, A., Jaiyesimi, M., Osinaike, O., Jinadu, F. et al. Evaluation of routine chest X-rays performed in a tertiary institution in Nigeria. Int J Cardiovascular Research 2014, 3(4):2-6. Doi: 10.4172/2324-8602.1000178. DOI: https://doi.org/10.4172/2324-8602.1000178
Ekpo, E. U., Egbe, N. O. and Akpan, B. E. Radiographers’ performance in chest X-ray interpretation: the Nigerian experience. Br J Radiol 2015, 88(1051):2-6. Doi: 10.1259/bjr.20150023. DOI: https://doi.org/10.1259/bjr.20150023
Zia, S. (2023) What to know about chest x-rays for tuberculosis (TB). Available at: https://www.medicalnewstoday.com/articles/tuberculosis-x-ray (Assessed: 10 February 2024)
Annemarie, M., Linda, M., Pim, A., Willem, J., Tim, L., Ricardo, P. Frequency of abnormal findings on routine chest radiography before cardiac surgery. The Journal of Thoracic and Cardiovascular Surgery 2018, 155(5):2035-2038. DOI: https://doi.org/10.1016/j.jtcvs.2017.12.124
Leonie, K., Marie, L., Ceicilia, B., Mai-Lis, H., Lena, V., Marju, O., Patrik, W. et al. Co-occurrence of unhealthy lifestyle behaviours in middle-aged adults: findings from the Swedish cardiopulmonary biolmage study (SCAPIS). Scientific reports 2024, 14(22853):2-6. Doi: 10.1038/s41598-024-71092-0 DOI: https://doi.org/10.1038/s41598-024-71092-0
Lan, T. H., Thi, N. A., Tan, T., Tien, D., Binh, N., Khue, M., Vinh, H. et al. Sex differences in clustering unhealthy lifestyles among survivors of Covid-19: latent class analysis. JMIR 2024, 10(1):2-5. DOI: https://doi.org/10.2196/50189
Doi: https://preprints.jmir.org/preprint/50189
Yoon, P., Jeonghee, L., Jae, H., Aesun, S., Jeongseon, K. Dietary patterns and colorectal cancer risk in a Korean population. Medicine 2016, 95(25):e3759, pp. 2-7. Doi: 10.1097/MD.0000000000003759 DOI: https://doi.org/10.1097/MD.0000000000003759
Mobolaji, M.S., Justice, E.E., Eniola, A.B., Rabiu, I.J., Okechukwu, S.O., Oyediran, E. O., Joshua, O.A. et al. Differentials in lifestyle practices and determinants among hypertensive adults from three geopolitical zones in Nigeria. Pan African Medical Journal 2024, 48(98):2-6. Doi: 10.11604/pamj.2024.48.98.40776 DOI: https://doi.org/10.11604/pamj.2024.48.98.40776
Ogundeko, T.O., Bassi, C.K., Bakam, C.K., Ramyil, M.S., Toma, B., Ogbole, E.A. et al. Ubiquity of alcohol and tobacco use among secondary school students in Bogoro- Bauchi state. WJPLS 2020, 6(2):51-59.
Victor, L., Tiwatayo, L. and Samson, A. Outdoor smoking in Nigeria: prevalence, correlates and predictors. BMC Public Health 2019, 19(1313):2-5. Doi: 10.1186/s12889-019-7601-8 DOI: https://doi.org/10.1186/s12889-019-7601-8
Obinna, D.O., Birinus, A.E., Obumneme, B.A., Mark, E., Uchenna, N.I., Ijeoma, N.O., Osita, I.O. et al. Prevalence and pattern of alcohol use among adults in an urban slum in south east Nigeria. Open Journal of Psychiatry 2019, 9(2):179-191. Doi: 10.4236/ojpsych.2019.92014 DOI: https://doi.org/10.4236/ojpsych.2019.92014
Okhumode, H. Y. Particle (soot) pollution in Port Harcourt Rivers state, Nigeria- double air pollution burden? Understanding and tackling potential environmental public health impacts. Environments 2017, 5(1):2-5. Doi: 10.3390/environments5010002 DOI: https://doi.org/10.3390/environments5010002
Davies, A., Janet, O., Asa, A., Boni, M., Nnenna, E., Chiamaka, O., Mary, T. et al. Epidemiology of physical inactivity in Nigeria: a systematic review and metaanalysis. Journal of Pubi Health 2022, 44(3):595-605. Doi: 10.1093/pubmed/fdab147 DOI: https://doi.org/10.1093/pubmed/fdab147
Joseph, W., Chiara, D., Irina, C. and Mary, N. Obesity cardiomyopathy in sudden cardiac death: A distinct entity? A comparative study. JACC: Advances 2023, 2(5):2-8. Doi: 10.1016/j.jacadv.2023.100414 DOI: https://doi.org/10.1016/j.jacadv.2023.100414
Neeraj, M. and Georgios, K. Respiratory complications of obesity: from early changes to respiratory failure. Breathe 2023, 19(1):220263, pp. 2-6. Doi: 10.1183/20734735.0263-2022 DOI: https://doi.org/10.1183/20734735.0263-2022
Heiner, B., Angela, B., Achim, B., Sabine, E., Dirk, H., Anja, K., Eva, L. et al. Critical review: vegetables and fruit in the prevention of chronic diseases. European Journal of Nutrition 2012, 51(1):637-663. Doi: 10.1007/s00394-012-0380-y. DOI: https://doi.org/10.1007/s00394-012-0380-y
Joanna, K., Larsson, S.C., Orsini, N., Linden, A., Wolk, A. Fruit and vegetable consumption and risk of COPD: a prospective cohort study of men. Thorax 2017, 72(6):500-509. Doi: 10.1136/thoraxjnl-2015-207851 DOI: https://doi.org/10.1136/thoraxjnl-2015-207851
Ana, C., Juan, S., Vanessa, R., Lucia, F., Nuria, R., Maria, E. et al. Smoking-related interstitial lung disease: a narrative review. Chronic Respiratory Disease 2024, 21(1):1-9. Doi: 10.1177/14799731241291538 DOI: https://doi.org/10.1177/14799731241291538
Celia, S., Marcio, R., Andre, C., Barbara, V., Rui, C., Susana, G. et al. Diffuse smoking-related lung diseases: Insights from a radiologic-pathologic correlation. Insights into Imaging 2019, 10(73):2-13. Doi: 10.1186/s13244-019-0765-z DOI: https://doi.org/10.1186/s13244-019-0765-z
Shucai, W., Fang, X., Yanfang, W., Han, W., Mo, W., Caixin, Y., Xiaoli, X. et al. Relevant risk factor ad follow-up of lung nodules in physical examination with lowdose CT screening. Iranian Journal of Public Health 2023, 52(2):350-359. Doi: 10.18502/ijph.v52i2.11888 DOI: https://doi.org/10.18502/ijph.v52i2.11888
Pavit, T., Rajeev, M., Reshma, K., Sanjeev, K. Tobacco smoking as a risk factor for tuberculous pleural effusion: a case-control study. Global Health Epidemiology and Genomics 2020, 12(5):e1, pp. 2-5. Doi: 10.1017/gheg.2020.1 DOI: https://doi.org/10.1017/gheg.2020.1
Richard, E., Lucy, S., Mubashar, I., Victoria, A. Pleural effusion in a patient with previous alcohol excess. Breathe 2024, 20(2):240036, pp. 2-6. Doi: 10.1183/20734735.0036-2024 DOI: https://doi.org/10.1183/20734735.0036-2024
Fernando, D., Eric, A. and Pablo, G. Alcoholic cardiomyopathy: an update. European Heart Journal 2024, 45(26):2294-2305. Doi: 10.1093/eurheartj/ehae362 DOI: https://doi.org/10.1093/eurheartj/ehae362
Sloan, A.L., Isaac, R.C., Brianna, M.D., Madison, B.B., Cherise, H., Natali, N. et al. Chronic alcohol consumption dysregulates innate immune response to SARS-CoV-2 in the lung. eBioMedicine 2023, 97(104812):2-6.
Doi: 10.1016/j.ebiom.2023.104812 DOI: https://doi.org/10.1016/j.ebiom.2023.104812
Cleveland Clinic (2024) Asbestosis.
Available at: https://my.clevelandclinic.org/health/diseases/22245-asbestosis
(Assessed: 12 February 2025)
Gregory, M.L. and Christopher, M.W. Pleural thickening: detection, characterization, and differential diagnosis. Seminars in Roentgenology 2023, 58(4):399-410 . Doi: 10.1053/j.ro.2023.06.001 DOI: https://doi.org/10.1053/j.ro.2023.06.001
Cao, Y., Sun, T., Wang, Z., Lei, F., Lin, L., Zhang, X., Song, X. et al. Association between one-year exposure to air pollution and the prevalence of pulmonary nodules in China. J Breathe Res 2023, 17(3):2-6. Doi: 10.1088/1752-7163/accbe4 DOI: https://doi.org/10.1088/1752-7163/accbe4
Konstantinos, M., Vasileios, T., Ioannis, P., Zoe, D., Aggeliki, K., Konstantinos, G. et al. Effect of hydration on pulmonary function and development of exercise-induced bronchoconstriction among professional male cyclists. Advances in respiratory medicine 2023, 91(3):239-253. Doi: 10.3390/arm91030019 DOI: https://doi.org/10.3390/arm91030019
Lee, H., Asmaa, A., Sarah, A., Chizoba, B., Julii, B., Tracey, B., Diane, B. et al. Effects of fluid and drinking on pneumonia mortality in older adults: A systematic review and meta-analysis. Clinical Nutrition ESPEN 2022, 47(1):96-105. Doi: 10.1016/j.clnesp.2021.11.021 DOI: https://doi.org/10.1016/j.clnesp.2021.11.021
Roberto, C., Elizabeth, A., Larry, D., James, A. Inflammation, physical activity, and chronic disease: An evolutionary perspective. Sports Medicine and Health Science 2020, 2(1):1-6. Doi: 10.1016/j.smhs.2020.03.004 DOI: https://doi.org/10.1016/j.smhs.2020.03.004
Matthew, A., and Aruni, B. Cardiovascular effects and benefits of exercise. Frontiers in cardiovascular medicine 2018, 5(135):2-6. Doi: 10.3389/fcvm.2018.00135 DOI: https://doi.org/10.3389/fcvm.2018.00135
Hopkinson, N.S. and Polkey, M.I. Does physical inactivity cause chronic obstructive pulmonary disease? Clin Sci (Lond) 2010, 118(9):565-572. Doi: 10.1042/CS20090458 DOI: https://doi.org/10.1042/CS20090458
Cristina, O., Teresa, L., Carmen, R., Lorena, S., Raquel, P., Juan, M., Inaki, G. Physical and social environmental factors related to co-occurrence of unhealthy lifestyle behaviors. Health and Place 2022, 75(1):102804, pp. 2-6. Doi: 10.1016/j.healthplace.2022.102804 DOI: https://doi.org/10.1016/j.healthplace.2022.102804
Michael, T. C. and Ruth, S. S. The social determinants of mental health. Focus 2015, 13(4):2-6. Doi: 10.1176/appi.focus.20150017. DOI: https://doi.org/10.1176/appi.focus.20150017
AlJohara, M., Ambreen, K., Turky, H., Ali, M., Riaz, Q., Khaled, M. Factors associated with an unhealthy lifestyle among adults in Riyadh City, Saudi Arabia. Healthcare 2021, 9(2):221-225. Doi: 10.3390/healthcare9020221 DOI: https://doi.org/10.3390/healthcare9020221
Danaei, M., Palenik, C. J., Abdollahifard, G., Askarian, M. Social determinants of health and attempt to change unhealthy lifestyle: A Population-based study. International Journal of Preventive Medicine 2017, 8(1):88-90. Doi: 10.4103/ijpvm.IJPVM_106_17 DOI: https://doi.org/10.4103/ijpvm.IJPVM_106_17
Ronald, B., Idrissa, B., Maaike, F., Carole, D., Philip, V. L., Samantha, D., Ellen, G. et al. e-Health interventions for healthy aging: a systematic review. Systematic Review 2020, 9(128):2-10. Doi: 10.1186/s13643-020-01385-8 DOI: https://doi.org/10.1186/s13643-020-01385-8
Agata, F., Shannon, H. and Effy, V. Global youth perspectives on digital health promotion: a scoping review. BMC Digital Health 2023, 1(25):2-6. Doi: 10.1186/s44247-023-00025-0 DOI: https://doi.org/10.1186/s44247-023-00025-0
Simon, K. (2023) Digital 2023: Nigeria.
Available at: https://datareportal.com/reports/digital-2023-nigeria
(Assessed: 20 February 2025)
Akinola, O., and Karen, A. (2021) Social media and the state: challenging the rules of engagement. Available at: https://issafrica.org/iss-today/social-media-and-the-statechallenging-the-rules-of-engagement (Assessed 20 February 2025)
Oluwadamilare, A. (2020) 60% of Nigerians are still not connected to the internet and only about 10% are active on social media. Available at: https://technext24.com/2020/01/31/60-of-nigerians-are-still-notconnected-to-the-internet-and-only-about-10-are-active-on-social-media/ (Assessed: 20 February 2025)
Jiyeon, H. and Hyeyoung, K. P. Factors affecting the acceptability of technology in healthcare among older Korean adults with multiple chronic conditions: A cross sectional study adopting the senior technology acceptance model. Clinical Interventions in Aging 2020, 15(1):1873-1881. Doi: 10.2147/CIA.S268606. DOI: https://doi.org/10.2147/CIA.S268606
Sara, C., Pablo, S., Cristina, F., Esperanza, S., Isabel, E., Sergio, C. Factors associated with the acceptance of new technologies for aging in pace by people over 64 years of age. Int J. Environ. Res. Public Health 2022, 19(5):2-15. Doi: 10.3390/ijerph19052947. DOI: https://doi.org/10.3390/ijerph19052947
Adi, A., Mostafa, A. and Khaled, S. Technology Acceptance in Healthcare: A systematic review. Applied sciences 2021, 11(22):10537, pp. 2-35. Doi: 10.3390/app112210537. DOI: https://doi.org/10.3390/app112210537
Jia, Y., Jeremie, S., Shruthi, C., Beth, S., Jarell, J., Joanna, M., Terence, T. A cross sectional study of role of technology in health for middle-aged and older adults in Singapore. Scientific reports 2024, 14(18645):2-8.
Doi: 10.1038/s41598-024-68410-x. DOI: https://doi.org/10.1038/s41598-024-68410-x
Crystal, M., Elizabeth, T., Richard, N., Leanne, W., Tim, S., Julia, N., Isobel, F. et al. Educational attainment and willingness to use technology for health and to share health information- The reimagining healthcare survey. International Journal of Medical Informatics 2022, 164(104803):2-6. Doi: 10.1016/j.ijmedinf.2022.104803. DOI: https://doi.org/10.1016/j.ijmedinf.2022.104803
Lee, M., Lee, H., Kim, Y., Kim J., Cho, M., Jang, J. et al. Mobile app-based health promotion programs: A systematic review of the literature. Int J Environ Res Public Health 2018, 15(12): 2838-2842. Doi: 10.3390/ijerph15122838. DOI: https://doi.org/10.3390/ijerph15122838
Marta, l., Ana, R., David, G., Nuno, M., Andre, V., Andreia, C., Miguel, A. Usability and utility of a mobile app to deliver health-related content to an older adult population: Pilot noncontrolled quasi-experimental study. JMIR Form Res 2024, 8:e46151, pp. 2-7. Doi: 10.2196/46151 DOI: https://doi.org/10.2196/46151
Po-Jen, K. and Ching-Min, C. Usability of mobile applications: a concept analysis in health promotion. Taiwan Journal of Public Health 2022, 41(2):142-155. Doi: 10.6288/TJPH.202204_41(2).110113
Kamalapriya, A., Liane, B., Anna, H., Alexander, J., Emma, G., Banu, P., Murali, P. et al. App-based oral health promotion interventions on modifiable risk factors associated with early childhood caries: A systematic review. Front. Oral. Health 2023, 4(1):2-6. Doi: 10.3389/froh.2023.1125070 DOI: https://doi.org/10.3389/froh.2023.1125070
Junhan, C. and Yuan, W. Social media use for health purposes: Systematic review. Journal of Medical Internet Research 2021, 23(5):e17917, pp. 2-5. Doi: 10.2196/17917 DOI: https://doi.org/10.2196/17917
Atousa, G., Maximilian, C. and Maria, P. Th potential of social media in health promotion beyond creating awareness: an integrative review. BMC Public Health 2022, 22(2402):2-6. Doi: 10.1186/s12889-022-14885-0 DOI: https://doi.org/10.1186/s12889-022-14885-0
Ina, W., Meera, V. and Stephanie, M. How effective are interactive social media interventions for changing health and health behaviors? A Cochrane Review summary with commentary. Research Triangle Park, NC: RTI Press, 2023, pp. 2-7. Doi: 10.3768/rtipress.2023.rb.0034.2309 DOI: https://doi.org/10.3768/rtipress.2023.rb.0034.2309
Rajshri, R. and Jessica, M. Evolving role of social media in health promotion. In, Bishan, S. (ed). Health Promotion- Principles and Approaches. Rijeka: IntechOpen, 2023, pp. 10-126. Doi: 10.5772/intechopen.107637 DOI: https://doi.org/10.5772/intechopen.107637
Vijaya, K., Rama, B., Manasi, C., Kalikrishna, V., Lakshmi, M., Ramanarayana, B. The impact of telemedicine and remote patient monitoring on healthcare delivery: A comprehensive evaluation. Cureus 2024, 16(3):e55534, pp. 2-7. Doi: 10.7759/cureus.55534 DOI: https://doi.org/10.7759/cureus.55534
Ju-Chi, L., Chun-Yao, C., Tzu-Hurng, C., Chen-Ning, L., Jin-Jer, C., Wen-Rui, H. Unveiling the potential: Remote monitoring and telemedicine in shaping the future of heart failure management. Life 2024, 14(8):936-942. Doi: 10.3390/life14080936 DOI: https://doi.org/10.3390/life14080936
Jennifer, C., Stacie, P., Amol, J., Todd, P., Eric, K. An infrastructure framework for remote patient monitoring interventions and research. Journal of Medical Internet Research 2024, 26:e51234, pp. 2-6. Doi: 10.2196/51234 DOI: https://doi.org/10.2196/51234
Kegomoditswe, B., Adamu, M., Boyce, S., Abid, Y., Caspar, L. Remote patient monitoring systems: Applications, architecture, and challenges. Scientific African 2023, 20(1):e01638, pp. 2-10. Doi: 10.1016/j.sciaf.2023.e01638 DOI: https://doi.org/10.1016/j.sciaf.2023.e01638
Barbara, A.L., Tashara, M.L., June, M.T., Cindy, W.L. Biobehavioral factors that shape nutrition in low-income populations: A Narrative review. America Journal of Preventive Medicine 2017, 52(2):s118-s126. Doi: 10.1016/j.amepre.2016.08.003 DOI: https://doi.org/10.1016/j.amepre.2016.08.003
Anna, L., Cornelia, G. and Christoph, D. Digital Health Promotion and Prevention in Settings: Scoping Review. Journal of Medial Internet Research 2022, 24(1):e21063, pp. 2-6. Doi: 10.2196/21063 DOI: https://doi.org/10.2196/21063
Lee, A., Leung, S. Health outcomes. In, Michalos, A.C. (ed) Encyclopedia of quality of life and well-being research. Dordrecht: Springer, 2014, pp. 2730-2735. Doi: 10.1007/978-94-007-0753-5_1251 DOI: https://doi.org/10.1007/978-94-007-0753-5_1251
National academies of sciences, engineering and medicine; Health and medicine division; Board on population health and public health practice; Committee on the review of federal policies that contribute to racial and ethnic health inequalities; Sheila, P., Daniel, E. and Amy B. (eds). Federal Policy to Advance Racial, Ethnic, and Tribal Health Equity. Washington DC: The national academies press, 2023. Doi: 10.17226/26834 DOI: https://doi.org/10.17226/26834
Emma, B., Lauren, M., Michelle, M., Juliet, H., Angela, B., Andrew, J. Systematic review of the effect of polices to restrict the marketing of foods and non-alcoholic beverages to which children are exposed. Obes Rev 2022, 23(8):e13447, pp. 2-6. Doi: 10.1111/obr.13447. DOI: https://doi.org/10.1111/obr.13447
Anna, H., Joshua, P., Fang, Z., Anjali, R., Steven, L., Eric, B., Sara, N. et al. Calories labeling and product reformulation: A longitudinal analysis of supermarket prepared foods. Am J Prev Med 2021, 61(3):377-385. Doi: 10.1016/j.amepre.2021.03.013 DOI: https://doi.org/10.1016/j.amepre.2021.03.013
Guillermo, R.P., Prabhat, J., Willaim, S., Alan, F. Taxation of tobacco, alcohol, and sugar-sweetened beverages: reviewing the evidence and dispelling the myths. BMJ Global Health 2023, 8(8):e011866, pp. 2-10. Doi: 10.1136/bmjgh-2023-011866 DOI: https://doi.org/10.1136/bmjgh-2023-011866
Katharine, G., Kathleen, K., Hannah, H., Khawlah, A., Emily, C., Ashlea, B. et al. Local food system approaches to address food and nutrition security among lowincome populations: A systematic review. Advances in Nutrition 2024, 15(4):2-5. Doi: 10.1016/j.advnut.2023.100156 DOI: https://doi.org/10.1016/j.advnut.2023.100156
Federal Republic of Nigeria Official Gazette. National Environmental (Air Quality Control) Regulations, 2014. Lagos: The Federal Government Printer, 2014, pp. B827850.
Federal Republic of Nigeria Official Gazette. National Environmental (Air Quality Control) Regulations, 2021. Lagos: The Federal Government Printer, 2021, pp. B3345-3377.
Environmental Law Research Institute (2021) A Synopsis of Laws and Regulations on the Environment in Nigeria. Available at: https://elri-ng.org/environmental-law-policies-in-nigeria/ (Assessed 22 February 2025)
EPA (2024) Progress Cleaning the Air and Improving Peoples’s Health. Available at: https://www.epa.gov/clean-air-act-overview/progress-cleaning-air-andimproving-peoples-health (Assessed 22 February 2025).
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Victor Chigbundu Nwaiwu, Sreemoy Kanti Das (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.
