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Klingebiel, T, Fehse B, Sputtek A, Zander A, Kroger N, Zabelina T, Fehse N, Koehl U, Schieder H, Ayuk F, Renges H, Oyekunle A.  2006.  CD34(+)-selected stem cell boost for delayed or insufficient engraftment after allogeneic stem cell transplantation. Cytotherapy. 8:375-80., Number 4 AbstractWebsite

BACKGROUND: Poor graft function without rejection may occur after stem cell transplantation (SCT). CD34(+) stem cell boost (SCB) can restore marrow function but may induce or exacerbate GvHD. We therefore investigated the feasibility and efficacy of CD34(+)-selected SCB in some patients with poor graft function. We present the results for eight patients (median age 46 years) transplanted initially for myelofibrosis, acute leukemia, myeloma and NHL. Six patients had received HLA-matched and two mismatched grafts (PB, BM; n=5, 3). After a median of 128 days post-transplant, the median leukocyte and platelet counts were, respectively, 2.05/nL and 18/nL. None had achieved platelet counts >50/nL even though donor chimerism was >95% in seven recipients. METHODS: Positive selection of CD34(+) stem cells was performed on a CliniMACS device, observing GMP and achieving a median of 98.5% purity. The patients received a median of 1.7 x 10(6)/kg CD34(+) cells and 2.5 x 10(3)/kg CD3(+) T lymphocytes. RESULTS: Hemograms at days +30, +60 and +90, respectively, showed steadily increasing median leukocyte (2.55, 3.15 and 4.20/nL) and platelet (29, 39 and 95/nL) counts. After a median follow-up of 144 days, five patients remained alive. No patient had developed acute or chronic GvHD. One patient died of leukemic relapse and two others of systemic mycosis. DISCUSSION: These preliminary results point to the possibility of safely improving graft function using CD34(+) positively selected stem cells without necessarily increasing the incidence of GvHD in patients with poor graft function post-SCT. Experience with more patients and longer follow-up should clarify the optimal role for this procedure.

Knapp, GC, Tansley G, Olasehinde O, Alatise OI, Wuraola F, Olawole MO, Arije OO, Gali BM, Kingham PT.  2019.  Mapping Geospatial Access to Comprehensive Cancer Care in Nigeria. Journal of Global Oncology . 5:1-8.Website
Knapp, GC, Tansley G, Olasehinde O, Wuraola F, Adisa A, Arowolo O, Olawole MO, Romanoff AM, Quan ML, Bouchard-Fortier A, Alatise OI, Kingham PT.  2021.  Geospatial access predicts cancer stage at presentation and outcomes for patients with breast cancer in southwest Nigeria: A population-based study. . Cancer . 127(9):1432-1438.Website
Kolawole, KA, Folayan MO, Agbaje HO, Oyedele TA, EO O, Onyejaka NK, Chukwumah NM, Oshomoji OV.  2016.  Association between forced sexual initiation and HIV status, sexual risk behavior, life stressors and the coping strategies among adolescents in Nigeria . PLoS One . 11(2):e0148322.doi:10.1371/journal.pone.0148322.
Kolawole, KA, Folayan MO, Agbaje H, Oyedele TA, Onyejaka NK, Ozeigbe EO.  2018.  Oral habits and malocclusion in children resident in Ile-Ife, Nigeria. European Archive of Paediatric Dentistry.. :1-9.doi:10.1007/s40368-018-0391-3.
Kombe, F, Folayan M, Ambe J, Igonoh A, Abayomi A, members GET.  2016.  Taking the bull by the horns: ethical consideration in designing multiple clinical trials and research protocols in the context of a dangerous pathogen outbreak . Social Science and Medicine. 148:163-70.doi:10.1016/j.socscimed.2015.11.017..
Komolafe, MA, Sunmonu TA, Fabusiwa F, Komolafe EO, Afolabi O, Kett M, Groce N.  2011.  Women's perspectives on epilepsy and its sociocultural impact in South Western Nigeria, 2011. African Journal of Neurological Sciences. 30(2) Abstract

Background There has been little study of the specific implications of living with epilepsy for women in societies where they already face gender based marginalization. Purpose Understanding the sociocultural aspects of epilepsy in women will help to improve the management of epilepsy in the community. Methods A series of six focus groups were held in urban and rural Southwest Nigeria. Results Epilepsy was commonly attributed to a spiritual attack, witchcraft and other supernatural causes. Denial of the diagnosis of epilepsy was common among women with nocturnal or focal seizures. Majority of women with epilepsy preferred multiple modalities of care in the following order: traditional, spiritual and western. The cost of traditional care was astronomical and most were already impoverished by the time they sought western care. WWE experienced stigma, social exclusion, isolation particularly from paternal relations, in -laws, and community members. Epilepsy related stigma contributed to schooling problems, difficulty in getting married, separation, divorce and problems with childcare and role fulfilment. One unanticipated result of this study was that public announcements made to identify rural study participants created a demand for western health services in rural populations previously unaware that epilepsy could be controlled through western medication. Conclusion Women with epilepsy face significant and persistent social, economic and cultural barriers. There is the need to educate women, their family and community members to reduce misconceptions and stigma. Community based medical treatment can be improved by taking into consideration the surrounding social, economic and cultural challenges faced by women with epilepsy. The care of epilepsy need to be incorporated into the primary health care system; regular awareness campaigns to be carried out in order to improve knowledge and attitudes and reduce stigma and social exclusion of women with epilepsy. Specific social welfare programmes and educational programme should be established to encourage the full integration of women with epilepsy in the society. © 2002-2012 African Journal of Neurological Sciences. All rights reserved.

KOMOLAFE, MO, OYEWOLE MO.  2018.  Awareness and Perception of Office Property Users on Green Building in Lagos, Nigeria. International Journal of Built Environment and Sustainability. 5(3):208-213.
Komolafe, EO, Komolafe MA, Adeolu AA.  2008.  Factors implicated for late presentations of gross congenital anomaly of the nervous system in a developing nation, 2008. British Journal of Neurosurgery. 22(6) Abstract

Background. Gross congenital lesions of the nervous system are obvious at birth and usually present early for management and corrective surgery. However in tropical and developing nations, late presentations are common. Aims: To determine the factors responsible for very late presentations of gross congenital lesions. Methods. We conducted a prospective study of all cases of congenital CNS anomalies that presented very late (>6 months after birth) to our neurosurgical clinic over an eight year period (2000-2008). Results. A total of 81 patients were seen during the study period. The age ranged from 6months to 47years. Hydrocephalus accounted for about half of the cases 37 (48.3%). The others were spina bifida 15 (18.5%), encephalocele 10 (12.4%), subgaleal inclusion dermoid cyst 7 (8.6%), and craniosynostosis 6 (7.4%), neurofibroma 4(4.9%), and anencephaly 2 (2.5%). Reasons given for late presentations were ignorance, poverty and in some the expectation that the baby would die. Other reasons for late presentation were that the patient was either about to start school or get married. Conclusion. Late presentations of congenital CNS lesions are associated with many complications most of which could have been avoided with early medical treatment. Health education should include issues regarding congenital malformations delivered by trained experts. © The Neurosurgical Foundation.

Komolafe, EO, Adeolu AA, Komolafe MA.  2007.  Treatment of cerebrospinal fluid shunting complications in a nigerian neurosurgery programme: Case illustrations and review, 2007. Pediatric Neurosurgery. 44(1) Abstract

Background/Aims: For a century since the first cerebrospinal fluid (CSF) shunt surgery, ventriculoperitoneal (VP) shunt insertion for the treatment of hydrocephalus has routinely been performed. A lot of common and rare complications following this procedure have been reported in 24-47% of the cases. The aim of this paper was to present our experience with the treatment of hydrocephalus in our centre and highlight our management of two unusual complications with the available resources. Methods: Retrospective clinical review. Results: A total of 86 patients with hydrocephalus were seen in our unit. There were 52 males and 34 females (male:female ratio 3:2). The age of the patients ranged from 1 day to 68 years. The majority of the patients (92%) were below 5 years of age. Sixty-five patients had shunting procedures [VP shunt: 62 (95.4%); endoscopic third ventriculostomy: 3 (4.6%)]. Of the 62 patients with VP shunts, 16 (25.8%) had complications while 2 of the 3 patients with endoscopic third ventriculostomies had complications. The complications following the VP shunts were CSF shunt sepsis (n = 12; 19.4%), abdominal complications (n = 3; 4.8%), subdural haematoma (n = 2; 3.2%) and scalp necrosis in 1 patient. Conclusion: VP shunt procedures have come to stay and will remain with us despite recent advances such as endoscopic third ventriculostomy. Care should be taken to prevent all complications whether common or rare by paying particular attention to patient selection, shunt selection and surgical details. The adaptation of local technology and justified use of limited facilities and resources can go a long way in the management of both common and rare complications in developing nations. Copyright © 2008 S. Karger AG.

Komolafe, MA, Ogunlade O, Komolafe EO.  2007.  Stroke mortality in a teaching hospital in South Western Nigeria, 2007. Tropical Doctor. 37(3) Abstract

Stroke, a major cause of morbidity and mortality, is on the increase and with increasing mortality. Our retrospective review of all stroke admissions from 1990-2000 show that cerebrovascular disease accounted for 3.6% (293/8144) of all medical admissions; it has a case fatality rate of 45% with the majority (61%) occurring in the first week; the mean age of stroke deaths was 62 years (standard deviation-13); and severe as well as uncontrolled hypertension is the most important risk factor. Community-based programmes aimed at early detection and treatment of hypertension, in addition to screening for those with high risk factors, should be put in place. © 2007, Royal Society of Medicine Press. All rights reserved.

Komolafe, MA, Sanusi AA, Idowu AO, Balogun SA, Olorunmonteni OE, Adebowale AA, Fawale MB, Mosaku KS.  2021.  Sleep medicine in Africa: Past, present, and future, 2021. Journal of Clinical Sleep Medicine. 17(6) Abstract

Interest in sleep and sleep disorders in Africa dates back thousands of years, influenced by various cultural and religious beliefs. However, the practice of sleep medicine as a specialty has been inadequate compared to other regions of the world. The objective of this study was to explore the current status of sleep medicine in Africa vis-à-vis education, professional societies, and facilities, and to identify challenges of the specialty in the region. A literature search of major electronic databases (PubMed, Google Scholar) was done. This revealed that there is a high prevalence of sleep disorders in Africa and a significant association with epilepsy, human African trypanosomiasis, human immunodeficiency virus, and other diseases. There are 6 sleep societies in Africa located in 4 countries. Forty-one sleep laboratories were identified located in 4 countries. The challenges hindering development of sleep medicine in Africa include lack of awareness, poor funding, lack of facilities, and inadequate training.

Komolafe, MA, Komolafe EO, Olugbodi AA, Adeolu AA.  2006.  Which headache do we need to investigate?, 2006 Cephalalgia. 26(1) Abstract
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Komolafe, MA, Olaogu MOB, Adebiyi AM, Obembe AO, Fawale MB, Adebowale AA.  2015.  Stroke risk factors among participants of a world stroke day awareness program in South-Western Nigeria, 2015. Nigerian Journal of Clinical Practice. 18(6) Abstract

Introduction: Stroke is a major cause of death and disability in population across the world. Hypertension is the most common stroke risk factor globally as well as in the Nigerian population, however other modifiable risk factors such as obesity are becoming increasingly prevalent due to unhealthy diets and sedentary lifestyle. Materials and Methods: We screened 224 volunteers from Ile-Ife during the 2011 and 2012 world stroke day commemorative activities. Blood pressures (BP) were measured and body mass index (BMI) was determined from weight and height measurements. The data from 40 (18%) were incomplete and were excluded from further analysis. Results: The 184 subjects eligible for analysis comprised 85 males (46.2%) and 99 females (53.8%), with a male to female ratio of 0.85:1. Their ages ranged from 16 to 95 years (mean, 53 ± 16 years). 25% of the study population had stage 1 or 2 hypertension (mean systolic blood pressure: 127 ± 27 mmHg, mean diastolic blood pressure: 78 ± 16 mmHg), while 34.8% and 14.7% were overweight and obese, respectively (mean BMI: 25.8 ± 5.0 kg/m2). Conclusion: Stroke risk factors such as hypertension and obesity were common among the participants of the world stroke day awareness program in an urban area of Nigeria. Community screening and modification of these risk factors should be intensified in order to reduce stroke morbidity and mortality.

Komolafe, MA, Komolafe EO, Sunmonu TA, Olateju SO, Asaleye CM, Adesina OA, Badmus SA.  2008.  New onset neuromyelitis optica in a young Nigerian woman with possible antiphospholipid syndrome: a case report. Journal of medical case reports. 2:1–4., Number 1: Springer Abstract
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Komolafe, MA, Sunmonu TA, Afolabi OT, Komolafe EO, Fabusiwa FO, Groce N, Kett M, Disu JO, Ajiboye JK, Olaniyan SO.  2012.  The social and economic impacts of epilepsy on women in Nigeria, 2012. Epilepsy and Behavior. 24(1) Abstract

Background: Persons with epilepsy in sub-Saharan Africa experience stigma and social marginalization. There is paucity of data on the social and economic impacts of epilepsy in these patients and in particular, groups like women. We sought to determine the social and economic impacts of epilepsy on Nigerian women and especially how it affects their treatment and outcomes. Methods: We carried out a cross-sectional survey of 63 women with epilepsy (WWE) and 69 controls matched for age, social status and site of care. A structured questionnaire was used to document information on demographic characteristics, education, employment status, economic status, health care use, personal safety and perceived stigma. The data were collated and analyzed with SPSS version 15. Results: Unemployment, fewer years of formal education, lower marriage rates and higher stigma scores were more frequent among WWE than controls. Physical and sexual abuse with transactional sex was also reported among WWE. We also noted poorer environmental and housing conditions and lower mean personal and household incomes among WWE compared to the control group. Conclusion: WWE in this sample from Nigeria have worse social and economic status when compared with women with other non-stigmatized chronic medical conditions. © 2011 Elsevier Inc.

Komolafe, M, Komolafe E, Fatoye F, Adetiloye V, Asaleye M, Famurewa O, Mosaku K, Amusa Y.  2008.  Profile Of Stroke In Nigerians: A Prospective Clinical Study, 2008/08/22. 26 Abstract

Background and purpose: Stroke is a leading cause of death and neurological disability in adults, and imposes a heavy emotional and financial burden on the family and society. We carried out this study to describe the epidemiological pattern of stroke at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife and also to describe the risk factors, the computerized tomography (CT) scan findings and the outcome of stroke in our practice setting. Methods: We prospectively studied one hundred and thirty five consecutive patients presenting to the neurology unit of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife over a six year period (2000- 2005). The socio-demographic and clinical data as well as the CT scan findings were collected. Statistical analysis was done using SPSS version 11.0. Results: The 135 patients comprised 76 male and 59 female with a mean age of 62+ 12years. The major risk factors were hypertension and diabetes mellitus. Cerebral infarction was the most common subtype of stroke seen. The case fatality rate was 15.6% and among the survivors the outcome was poor as only 3% made full recovery. Conclusion: Stroke is still a major problem and the major predisposing factor remains uncontrolled hypertension. The case fatality was very high and there is a risk of moderate to severe neurological disability among the survivors. The utilization of CT scan is sub-optimal even when it is available because of financial constraints. CT scan is recommended for all cases of stroke for definitive diagnosis and timely as well as accurate management.

Komolafe, MA, Fatusi OA, Alatise OI, Komolafe EO, Amusa YB, Adeolu AA, Durosinmi MA.  2009.  The role of human immunodeficiency virus infection in intranuclear facial paralysis, 2009. Journal of the National Medical Association. 101(4) Abstract

Background: This study describes the pattern of idiopathic intranuclear facial palsy (facial neuropathy) and highlights the role of human immunodeficiency virus (HIVJ/AIDS in its occurrence and management. Patients and Methods: This study conducted in lle-lfe, Nigeria, assessed individuals with idiopathic facial neuropathy seen at the neurology; maxillofacial surgery; and ear, nose and throat outpatient clinics between 1994 and 2006. Results: Eighty-eight patients with idiopathic facial neuropathy were seen during the 13-year study period. Forty-six (52.3%) were males, and the age range was 15 to 76 years, with a median of 35.5 years and interquartile range of 24.5 to 54 years. The right side was affected in 59.1%, compared with 40.9% on the left side. Twenty-six patients (29.5%) were HIV positive at presentation: 16 males, 10 females; mean age for HIV-positive patients was 29.15 ± 8.12 years and 44.39 ± 18.48 years for HIV-negative patients. There was a significant relationship among the status of the patients and the severity at presentation (p =.035), treatment given (p =.019), and the occurrence of flu-like symptoms (p =.004). Conclusion: A high index of suspicion of seroconversion is essential in patients presenting with idiopathic facial neuropathy since it has implications for management. Serological testing for HIV, especially in patients at risk and those with history of recent flu-like symptoms, is recommended.

Komolafe, MA, Sunmonu TA, Esan OA.  2008.  Tuberculous meningitis presenting with unusual clinical features in Nigerians: Two case reports, 2008. Cases Journal. 1(1) Abstract

Background: Tuberculous meningitis is common in developing countries and accounts for about 7.8% to 14% of all cases of tuberculosis in Nigeria. Case presentation: Case 1 was a 17-year-old woman who presented with a 3-week history of weakness of the right upper and lower limbs, a 6-hour history of inability to speak and irrational behaviour. She had no remarkable past medical history. Physical examination revealed pyrexia (temperature of 38.2C) and altered level of consciousness (Glasgow coma score = 7/15). The signs of meningeal irritation were present and she had anisocoria and right spastic hemiparesis. Other aspects of physical examination were normal. Laboratory investigations showed an elevated erythrocyte sedimentation rate, normal cerebrospinal fluid protein and reduced glucose. The brain computed tomography scan showed features in keeping with obstructive hydrocephalus and she was immediately commenced on antituberculous drugs, intravenous steroids and mannitol. She made a remarkable clinical recovery and was discharged home 6 weeks after admission. Case 2 was a 40-year-old man who presented with a 6-week history of headache and fever and a 2-week history of alteration in level of consciousness. There was no history of neck pain and/or stiffness, nausea or vomiting. He had no other remarkable past medical history. He had been placed on various intravenous antibiotics in private hospitals before presentation, with no clinical improvement. Physical examination showed a young man in a coma (Glasgow coma score = 4/15) and febrile (temperature of 38.5C) with signs of meningeal irritation. The brain stem reflexes were impaired and he had spastic quadriparesis. Further physical examination was essentially normal. The cerebrospinal fluid analysis showed features in keeping with meningeal inflammation and he had a raised erythrocyte sedimentation rate. The brain computed tomography scan showed features in keeping with obstructive hydrocephalus. He was placed on antituberculous drugs and intravenous steroids but despite this his clinical condition deteriorated and he died on the sixth day after admission. Conclusion: Late presentation of tuberculous meningitis is not rare in Nigerians and we report two cases of tuberculous meningitis that presented late to our health care facility. This report is intended to make clinicians aware of the unusual clinical presentations of tuberculous meningitis.

Komolafe, OO, Arawomo GAO, Idowu EO, Adedeji AA.  Submitted.  STATUS AND ECONOMIC IMPACT OF THE FISHERIES OF OSINMO RESERVOIR, EJIGBO, NIGERIA.. Ife Journal of Science. 16(2)komolafe_et_al_15.pdf
Komolafe, MA, Komolafe EO, Fatoye F, Adetiloye V, Asaleye C, Famurewa O, Mosaku S, Amusa Y.  2007.  Profile of stroke in Nigerians: A prospective clinical study, 2007. African Journal of Neurological Sciences. 26(1) Abstract

Background and purpose: Stroke is a leading cause of death and neurological disability in adults, and imposes a heavy emotional and financial burden on the family and society. We carried out this study to describe the epidemiological pattern of stroke at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife and also to describe the risk factors, the computerized tomography (CT) scan findings and the outcome of stroke in our practice setting. Methods: We prospectively studied one hundred and thirty five consecutive patients presenting to the neurology unit of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife over a six year period (2000- 2005). The socio-demographic and clinical data as well as the CT scan findings were collected. Statistical analysis was done using SPSS version 11.0. Results: The 135 patients comprised 76 male and 59 female with a mean age of 62+ 12years. The major risk factors were hypertension and diabetes mellitus. Cerebral infarction was the most common subtype of stroke seen. The case fatality rate was 15.6% and among the survivors the outcome was poor as only 3% made full recovery. Conclusion: Stroke is still a major problem and the major predisposing factor remains uncontrolled hypertension. The case fatality was very high and there is a risk of moderate to severe neurological disability among the survivors. The utilization of CT scan is sub-optimal even when it is available because of financial constraints. CT scan is recommended for all cases of stroke for definitive diagnosis and timely as well as accurate management.

Komolafe, MA, Ogunlade O, Komolafe EO.  2006.  Stroke mortality in a teaching hospital in south-west of Nigeria, 2006. African Journal of Neurological Sciences. 25(2) Abstract

Stroke, a major cause of morbidity and mortality is on the increase and with increasing mortality. Our retrospective review of all stroke admissions from 1990 - 2000 show that cerebrovascular disease accounted for 3.6% (293/8144) of all medical admissions; has a case fatality rate of 45% with the majority (61%) occurring in the first week; mean age of stroke deaths was 62 years (SD +/- 13); and severe as well as uncontrolled hypertension is the most important risk factor. Community based programmes aimed at early detection and treatment of hypertension in addition to screening for those with high risk factors should be put in place.

Komolafe, MA, Owagbemi OF, Alimi TI.  2018.  The distribution and pattern of neurological disease in a neurology clinic in Ile-Ife, Nigeria, 2018. Nigerian Journal of Clinical Practice. 21(11) Abstract

Background: Neurological disorders are common and contribute significantly to disease burden, disability-adjusted life years and death. Objective: To assess the distribution of neurological disease in patients presenting to our hospital. Methods: The records of the Adult Neurology Clinic in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun state, Nigeria were reviewed retrospectively for the years 2003-2005 and 2010-2014, and diagnoses as made by the Consultant were obtained and analyzed. Results: The total number of complaints was 1,524 and 86.4% of these were neurological in nature. Episodic and paroxysmal disorders (ICD-10) accounted for 54.1% of the diagnoses, and epilepsy and stroke were the most common of these. Of the 1,226 patients seen during the period, 91.4% had neurological disorders. The peak occurrence of these disorders was within the first three decades of life. Conclusion: Epilepsy and stroke are the commonest neurological disorders in the outpatient setting and there should be more studies in the community on their prevalence and impact.