Prevalence and correlates of leisure-time physical activity among Nigerians

Background: Physical inactivity levels are rising in many countries with major implications for the prevalence of non-communicable diseases and the general health of the population worldwide. We conducted this study to examine leisure-time physical activity levels among African adults in an urban setting. Methods: We conducted a cross-sectional study among a random sample of 1,058 adults at a government worksite, in Abuja, an urban Nigerian city. We used log-binomial regression models to estimate the multivariable-adjusted associations of correlates of physical activity. Results: The mean age of the study population was 42 ± 9.3 years, 60% were men and 40% were women. The mean metabolic equivalent hours per week for all the participants was 6.8 ± 7.2. In univariate analysis comparing the lowest to highest tertiles of physical activity, the prevalence ratio (PR) and (95% confidence interval, CI) was 0.95 (0.81-1.11) p = 0.49, comparing women to men; compared to those aged <30 years the PR (95% CI) was 0.70 (0.57-0.86), 0.70 (0.58-0.85) and 0.78 (0.63-0.96) for age 30–39, 40–49 and ≥50 years respectively, p for trend = 0.03; compared to those who were normal weight, the PR was 0.93 (0.79-1.10) and 0.90 (0.74-1.09) for overweight and obese persons respectively, p = 0.26. The PR for age was attenuated to non-significant levels in multivariable analyses. Being married was a statistically significant correlate of higher physical activity levels, the PR comparing unmarried to married persons in multivariate analysis was 0.81 (0.67-0.97), p = 0.03. Conclusions: More than 80% of urban, professional Nigerian adults do not meet the WHO recommendations of physical activity. Urbanized Africans in this study population had low levels of leisure-time physical activity, independent of age, sex and body-mass index. This has major implications for the prevalence of non-communicable diseases in this population

Emerging breast cancer epidemic: evidence from Africa

Cancer is an increasingly important public health problem in developing countries, including Africa [1]. As public and professional awareness of the cancer problem has grown, so has interest in the pattern of disease presentation, its epidemiology and treatment outcome. To date, however, there has been limited research about breast cancer in Africa. In the absence of systematic population-based cancer registration, most information has come from small clinical and pathology case series and the bias inherent in these types of studies has influenced current understanding of the pattern and characteristics of breast cancer in Africa. In this communication, we review the evidence for an emerging epidemic of breast cancer in Africa, its risk factors and likely future course. We conclude that, despite limited data, rising incidence of breast cancer is being driven by increasing life expectancy, improved control of infectious diseases, and changing lifestyle, diet, physical activity and obstetric practices. We also review current beliefs about hormone receptor subtypes of breast cancer in Africa and suggest that this is probably not systematically different from the pattern in other populations after adjusting for factors such as age and that the reported differences are related to poor tissue handling and laboratory processing practices

Test-Retest Reliability of Self-Reported Sexual Behavior History in Urbanized Nigerian Women.

BACKGROUND: Studies assessing risk of sexual behavior and disease are often plagued by questions about the reliability of self-reported sexual behavior. In this study, we evaluated the reliability of self-reported sexual history among urbanized women in a prospective study of cervical HPV infections in Nigeria. METHODS: We examined test-retest reliability of sexual practices using questionnaires administered at study entry and at follow-up visits. We used the root mean squared approach to calculate within-person coefficient of variation (CVw) and calculated the intra-class correlation coefficient (ICC) using two way, mixed effects models for continuous variables and [Formula: see text] statistics for discrete variables. To evaluate the potential predictors of reliability, we used linear regression and log binomial regression models for the continuous and categorical variables, respectively. RESULTS: We found that self-reported sexual history was generally reliable, with overall ICC ranging from 0.7 to 0.9; however, the reliability varied by nature of sexual behavior evaluated. Frequency reports of non-vaginal sex (agreement = 63.9%, 95% CI: 47.5-77.6%) were more reliable than those of vaginal sex (agreement = 59.1%, 95% CI: 55.2-62.8%). Reports of time-invariant behaviors were also more reliable than frequency reports. The CVw for age at sexual debut was 10.7 (95% CI: 10.6-10.7) compared with the CVw for lifetime number of vaginal sex partners, which was 35.2 (95% CI: 35.1-35.3). The test-retest interval was an important predictor of reliability of responses, with longer intervals resulting in increased inconsistency (average change in unreliability for each 1 month increase = 0.04, 95% CI = 0.07-0.38, p = 0.005). CONCLUSION: Our findings suggest that overall, the self-reported sexual history among urbanized Nigeran women is reliable

Obesity epidemic has emerged among Nigerians

Background: Data from the WHO shows that the prevalence of overweight and obesity increased by ~20% between 2002 and 2010 in Nigeria. We conducted this study to examine the correlates of this fast growing epidemic. Methods: We conducted a cross-sectional study among a random sample of 1058 adults, who were visitors and staff of a government worksite in Abuja, an urban city in Nigeria. The study participants had varying socio-economic status and a wide range of occupations, including skilled labor and professionals. Log-binomial regression models were used to estimate the multivariable-adjusted associations of potential determinants with the prevalence of overweight and obesity. Result The mean age and body-mass index of the study population were 42 years ± (9.3) and 27 kg/m2 ± (4.8). The overall prevalence of overweight or obesity (body-mass index ≥ 25 kg/m2) was 64% (74% of the women and 57% of the men). For women compared to men, the prevalence ratio (PR) and (95% confidence interval, CI) was 1.24 (95% CI 1.08, 1.43, p = 0.004), for overweight, and 2.54 (95% CI 2.08, 3.10, p = <0.0001), for obesity. Individuals aged 40 – 49 years were more likely to be overweight or obese. The PR for overweight and obesity was 1.45 (95% CI 1.07, 1.97), p for age trend = 0.002 and 8.07(95% CI 3.01, 21.66, p for age trend = <0.0001) for those aged 40 – 49 years, compared with those aged <30 years. Compared with the individuals in the lower socio-economic status, the PR for obesity among those in the middle and high socio-economic statuses, were 1.39 (95% CI 1.13, 1.72) and 1.24 (95% CI 0.97, 1.59) respectively, p for trend = 0.003. Conclusion: About two-thirds of urban, professional, high socio-economic status Nigerian adults are either overweight or obese. The prevalence of overweight and obesity among this population of adult Nigerians, is as high as it is in the United Kingdom. Female gender and older age were independent predictors of overweight and obesity; while middle or high socio-economic status were independently associated with obesity

Vaginal microbiota diversity and paucity of Lactobacillus species are associated with persistent hrHPV infection in HIV negative but not in HIV positive women.

Funder: Maryland Department of Health and Mental Hygiene; doi: http://dx.doi.org/10.13039/100006671The vaginal microbiota is thought to play a role in modulating risk of high-risk human papillomavirus (hrHPV) infection. We examined the relationship between the vaginal microbiota and persistent hrHPV infection in HIV-negative and HIV-positive women. We used 16S-rRNA sequencing to characterize the vaginal microbiota of two serial samples taken six months apart from 211 Nigerian women (67%, 142/211 HIV-positive and 33%, 69/211 HIV-negative) and evaluated the association between the vaginal microbiota and persistent hrHPV infection using generalized estimating equation logistic regression models and linear discriminant analysis effect size (LEfSe) algorithm to identify phylotypic biomarkers of persistent hrHPV infection. The high diversity microbiota, Community State Type IV-B, was the most prevalent in both HIV-negative (38% at baseline, 30% at the follow-up visit) and HIV-positive (27% at baseline, 35% at the follow-up visit) women. The relationship between the vaginal microbiota and persistent hrHPV was modified by HIV status. In HIV-negative women, women with Lactobacillus dominant microbiota had lower odds (OR: 0.35, 95% CI 0.14-0.89, p = 0.03) of persistent hrHPV compared to women with Lactobacillus deficient microbiota. While among HIV-positive women, the odds of being persistently infected with hrHPV was higher in women with Lactobacillus dominant microbiota (OR: 1.25, 95% CI 0.73-2.14 p = 0.41). This difference in effect estimates by HIV was statistically significant (p = 0.02). A high diversity vaginal microbial community with paucity of Lactobacillus species was associated with persistent hrHPV infection in HIV-negative women but not in HIV-positive women

A Randomized Controlled Trial to Examine the Relationship Between Peer Mentoring for Physical Activity and Cardiometabolic Health

Background: Studies examining the effect of peer mentoring on physical activity levels have been conducted in mostly elderly and young populations, and the results have been inconsistent. This study examined the impact of one-on-one peer mentoring on physical activity and cardiometabolic parameters in urban adults. Methods: The study participants were 353 overweight or obese adults residing in Abuja, Nigeria. They were randomized into two groups, peer-mentored (n = 128) and a control (n = 225) group. All the participants received nutritional counseling and were invited to attend instructor-led physical activity sessions each week for six months. Differences in the frequency, duration, and intensity of physical activity and cardiometabolic parameters, including body fat, muscle mass and lipids, were evaluated within and between the groups with t and rank sum tests. Results: At the end of the study period, the average time spent on physical activity increased significantly by 14% (p = 0.006), and the average time spent on vigorous physical activity increased by 99% (p = 0.003) compared to baseline for participants in the peer-mentored group. For those in the control group, the average time spent on physical activity decreased significantly by 7% (p = 0.03), while the average time spent on vigorous physical activity increased by 30%, but this was not statistically significant (p = 0.34). In both groups, there were significant improvements in the total cholesterol, low- and high-density lipoproteins and triglycerides levels, at the end of the study period, compared to baseline. Conclusions: In these overweight or obese adults, we observed that peer mentoring was positively associated with increased physical activity. Peer mentoring also holds great promise for improving cardiometabolic health and promoting a healthy lifestyle in adults

Cancer burden among HIV-positive persons in Nigeria: preliminary findings from the Nigerian AIDS-cancer match study

Background: Although Nigeria has a large HIV epidemic, the impact of HIV on cancer in Nigerians is unknown. Methods: We conducted a registry linkage study using a probabilistic matching algorithm among a cohort of HIV positive persons registered at health facilities where the Institute of Human Virology Nigeria (IHVN) provides HIV prevention and treatment services. Their data was linked to data from 2009 to 2012 in the Abuja Cancer Registry. Match compatible files with first name, last name, sex, date of birth and unique HIV cohort identification numbers were provided by each registry and used for the linkage analysis. We describe demographic characteristics of the HIV clients and compute Standardized Incidence Ratios (SIRs) to evaluate the association of various cancers with HIV infection. Results: Between 2005 and 2012, 17,826 persons living with HIV (PLWA) were registered at IHVN. Their median age (Interquartile range (IQR)) was 33 (27–40) years; 41% (7246/17826) were men and 59% (10580/17826) were women. From 2009 to 2012, 2,029 clients with invasive cancers were registered at the Abuja Cancer Registry. The median age (IQR) of the cancer clients was 45 (35–68) years. Among PLWA, 39 cancer cases were identified, 69% (27/39) were incident cancers and 31% (12/39) were prevalent cancers. The SIR (95% CI) for the AIDS Defining Cancers were 5.7 (4.1, 7.2) and 2.0 (0.4, 3.5), for Kaposi Sarcoma and Cervical Cancer respectively. Conclusion: The risk of Kaposi Sarcoma but not Cervical Cancer or Non-Hodgkin’s Lymphoma, was significantly increased among HIV positive persons, compared to the general population in Nigeria

RPS19 and TYMS SNPs and Prevalent High Risk Human Papilloma Virus Infection in Nigerian Women

High risk HPV (hrHPV) infection is a necessary cause of cervical cancer but the host genetic determinants of infection are poorly understood. We enrolled 267 women who presented to our cervical cancer screening program in Abuja, Nigeria between April 2012 and August 2012. We collected information on demographic characteristics, risk factors of cervical cancer and obtained samples of blood and cervical exfoliated cells from all participants. We used Roche Linear Array HPV Genotyping Test® to characterize the prevalent HPV according to manufacturer's instruction; Sequenom Mass Array to test 21 SNPs in genes/regions previously associated with hrHPV and regression models to examine independent factors associated with HPV infection. We considered a p<0.05 as significant because this is a replication study. There were 65 women with and 202 women without hrHPV infection. Under the allelic model, we found significant association between two SNPs, rs2305809 on RPS19 and rs2342700 on TYMS, and prevalent hrHPV infection. Multivariate analysis of hrHPV risk adjusted for age, body mass index, smoking, age of menarche, age at sexual debut, lifetime total number of sexual partners and the total number of pregnancies as covariates, yielded a p-value of 0.071 and 0.010 for rs2305809 and rs2342700, respectively. Our findings in this unique population suggest that a number of genetic risk variants for hrHPV are shared with other population groups. Definitive studies with larger sample sizes and using genome wide approaches are needed to understand the genetic architecture of hrHPV risk in multiple populations