The prevalence and Predictors of generalised obesity in a rural farming community in the Niger Delta Region of Nigeria

Background: Obesity, an independent risk factor for cardiovascular diseases has become a global epidemic even in the developing nations of the world. Epidemiologic transition with rapid urbanisation is important variable implicated in the rising prevalence of obesity. The prevalence of this major risk factor for cardiovascular disorders like hypertension, heart failure, coronary artery disease etc has not been richly studied in the rural setting of the Nigerian Niger Delta regiondespite the increasing urbanisation taking place in same region. The aim of this research therefore is to determine the prevalence and predictors of obesity in a rural farming community of the Niger Delta region of NigeriaMethods: A cross sectional study involving 388 subjects aged 15 years and above. Demographic social and relevant medical information and social information were obtained using a questionnaire administered by face-to-face interview. Anthropometric (height, weight, waist circumference, Waist-Hip-Ratio) and blood pressure measurements were done. Blood samples were taken for fasting blood sugar.Results: The overall mean age of the study subjects was 40.88±16.52. The mean age for males was 40.66±17.23 and that for females was 40.98±16.17. The male to female ratio was 1:2.1. The prevalence of generalised obesity in this study was 3.4% .The females had a higher prevalence than the males (p= 0.02). The prevalence of obesity found to be highest in the 50 to 59 years age group. Pearson and Spearman’ rho correlation analysis of BMI with other parameters revealed that educational status, waist circumference, and hypertension had significant association while logistic regression confirmed these variables as well as physical inactivity as predictors of obesity.Conclusion: The prevalence of obesity in this rural community is 3.4% and educational status, waist circumference and hypertension are important predictors.Keywords: Prevalence, Predictors, generalised obesity, rural, Niger Delt

Pattern of cardiovascular disease admissions in the medical wards of the University of Port Harcourt Teaching Hospital: a retrospective review

Background: Cardiovascular disease as a leading contributor to global disease burden has shown an increase in its prevalence since the 19th century and was responsible for the global mortality of 17.5 million individuals in the year 2005. This has been linked to increasing urbanization and westernization of life style particularly in the sub-Saharan Africa. Hence, a study on the pattern and trend of cardiovascular disease admission in Port Harcourt an urban and a cosmopolitan city in Nigeria becomes important as such knowledge will influence Health care policy making and budgeting. This study is aimed at determining the frequency and the pattern of cardiovascular disease admissions in University of Port Harcourt Teaching Hospital.Method: A retrospective study of adult patients with diagnosis of cardiovascular disorders admitted into the medical wards of UPTH between January 2013 and December 2014 was carried out using the ward admission and discharge register.Results: A total of 1989 patients were admitted into the medical ward over the period of this study. Patients with cardiovascular disorders were 629 constituting 31.6% of the total admission. 346(55.01%) of the study population were females with males constituting 44.99%. The ages ranged between 20 and 94 years with a mean of 56.04 for males and 55.12 for females. The pattern of CVD observed in this study were heart failure (43.1%), cerebrovascular accident (CVA) (24.3%), diabetes and its complications (15.6%), uncontrolled hypertension (14.8%), acute MI (1.6%), symptomatic bradycardia ( 0.3%), acute pericarditis (0.2%) and ventricular tachycardia (0.2%). The death rate was found to be 12.2%.Conclusion: Heart failure and cerebrovascular accident are major causes of cardiovascular admissions in the medical wards of University of Port Teaching Hospital. Early detection, appropriate management as well as patient education will go a long way to reduce the morbidity and mortality caused by this rising trend.Keywords: Cardiovascular disease, pattern, medical admissions, UPT

Article Prevalence of Hyperuricaemia in a Rural Population of Nigerian Niger Delta Region

INTRODUCTION: Hyperuricemia is a cardiovascular disease risk factor that has been poorly researched into in Africa and its prevalence is largely unknown in the rural areas in Nigeria and in the Niger Delta region of Nigeria in particular.METHODS: A cross-sectional rural survey involving 500 subjects aged 15 years and above. Demographic and social data were obtained using a questionnaire. Anthropometric (height, weight, waist circumference) and blood pressure measurements were taken. Blood samples were taken for blood uric acid, glucose and lipid check.RESULTS: The mean age of the study subjects was 41.32±17.0 (males, 42.84±17.8; females, 40.62±16.6) with a range of 15 years to 95 years. The male to female ratio was 1:2.3. The mean serum uric acid was337.58±94.59 mmol/l with a significant higher mean for females (males 333.20±88.70, females 339.56±97.21, p<0.001). Hyperuricemia was found in 86 subject giving a prevalence of 17.2 % with higher prevalence inmales (males 25%, females 13.7%; x2 = 7.75, p= 0.006). Correlational analysis of serum uric acid with other parameters revealed that waist circumference, total cholesterol, low-density lipoprotein and gender hadsignificant association with uric acid. Male gender was found to be a significant predictor for hyperuricaemia following a logistic regression.CONCLUSION: The prevalence of hyperuricemia is high in this rural community of study. There is need for more research considering the cardiovascular and otherimplications of hyperuricaemia.KEY WORDS: Hyperuricaemia, prevalence, Rural, Niger Delta, Nigeri

Childhood hypertension and family history of hypertension in primary school children in Port Harcourt

Objective: To determine the relationship between childhood hypertension and family history of hypertension in primary school children in Port Harcourt.Methods: A stratified multi-staged sampling technique was used torecruit pupils between 6-12 years of age, from thirteen primary schoolslocated in three school districts. Data was collected using a pretestedquestionnaire completed by parents / guardians. The average of three blood pressure measurements, weight and height were taken for each pupil, using standardized techniques. Hypertension was defined as average systolic and / or diastolic blood pressure greater than or equalto the 95th percentile for age, gender and height using the standard bloodpressure charts. Family history of hypertension was defined as eitherparent indicating on the submitted questionnaire that they were hypertensive (diagnosed by a physician and/or on antihypertensive drugs)or had a family history of hypertension.Results: A total of 1302 pupils with 717 (55.1%) females and 585(44.9%) males were studied, giving a female to male ratio of 1.2:1. Themean age of pupils studied was 8.82±1.91 years. Sixty one (4.7%)of the pupils examined had hypertension. Of the 1302 pupils, 316(24.3%) had a family history of hypertension. The mean systolic(p<0.001) and diastolic (p=0.220) blood pressures were higher in childrenwith a family history of hypertension than in those without. Ofthe pupils that had a family history of hypertension, 7.9% had  hypertension, while 3.7% of those that did not have a family history, werefound to be hypertensive (p=0.001).Conclusion: A family history of hypertension was associated with a higher prevalence of childhood hypertension than was seen in children without a family history of hypertension.Key words: Childhood Hypertension, Family history

Prevalence of enuresis among primary school children in Port Harcourt

Background: Enuresis is a common problem among children and adolescents. It can lead to important psychosocial disturbances. Knowledge of the prevalence and types of enuresis in a community would guide early intervention. Objectives: To determine the prevalence of enuresis among primary school children aged 6-12years in Port Harcourt (PHC) and the types of enuresis among these children. Methods: A cross sectional study of enuresis among school children in 13 primary schools in three school districts in PHC was performed. Pretested questionnaires completed by parents/guardians and augmented by history obtained from the children were used to collect data from 922 school children. Descriptive statistics and chi-square test were used for data analysis. Results: A total of 922 school children, consisting of 463 (50.2%) males and 459 (49.8%) females were studied. The response rate was 82.2%. The overall prevalence of enuresis was 23.2%. Enuresis was notably more common in boys (male: female ratio 1.4:1), and the prevalence rates decreased with increasing age. Of all enuretic children, 92.1% had nocturnal enuresis, 0.9% had diurnal and 7.0% had nocturnal-diurnal enuresis. Conclusion: Enuresis is a common problem among school children in PHC, is more common in males. The predominant type is the primary nocturnal enuresis. Key Words:  Prevalence, Enuresis, Primary school-children, Port-Harcour

Prevalence of head lice infestation in Primary School children in Port Harcourt

Background: Head lice infestation affects mainly school-aged children and prevalence varies from region to region. Head lice infestation is of public health concern and screening is integrated into the School Health Programme.Objective: To determine the prevalence of head lice infestation in primary school – aged children in Port Harcourt, Nigeria.Design: Cross-sectional descriptive study.Subjects: A stratified multi-staged sampling technique was used to recruit pupils between six and 12 years of age, from thirteen primary schools located in three School Districts in the area. The heads of the pupils were inspected for head lice and nits with the aid of a battery operated Robi lice comb, magnifying glass and a torch as light source.Results: A total of 1350 pupils were studied, 743 (55%) females and 607 (45%) males giving a female to male ratio of 1.2:1. Ten (0.7%) of the pupils had head lice infestation while five (0.4%) had evidence of past head lice infestation. The number of infested pupils among the younger age group (six to nine years) was seven (0.8%) and is higher, though not statistically significant, than that in the older age group (ten to twelve years) which was three (0.6%) (p = 0.453). No male was found to be infested while ten (1.3%) females were infested and the observed gender difference was statistically significant (p = 0.002).Conclusion: Head lice infestation still exists in Primary School children in Nigeria, therefore, screening for head lice infestation should still remain a part of the School Health Programme

Trend of HIV-seropositivity among children in a tertiary health institution in the Niger Delta Region of Nigeria

The objective of the study was to investigate the recent trends and magnitude of pediatric HIV-infection in the Niger Delta of Nigeria. It is a descriptive study of 1,559 consecutively recruited children (0-16 years), in whom laboratory requests for HIV screening were made, and seen in the Pediatrics Department of the University of Port Harcourt Teaching Hospital between January 1999 to December 2004 were evaluated for HIV –infection. The overall prevalence obtained was 25.8%. HIV-1 constituted the predominant viral serotype (97.6%) compared to HIV-2 (2.4%). The peak HIV seropositivity occurred in pediatrics 6-8 years. There was no statistically significant difference in prevalence rate based on gender (OR = 1, p = 0.98). Children with clinical diagnosis of bronchopneumonia, neonatal sepsis, septicemia and pulmonary tuberculosis had higher prevalence of HIV seropositivity. There is a trend of increasing HIV prevalence from 1999 to 2004 (χ2 for trend= 6.23, p = 0.39). History of previous blood transfusion was not significantly associated with HIV positivity (OR = 0.94, p = 0.94). This study shows that, in spite of the anti HIV campaign, there is a high prevalence of HIV among children attending tertiary health institution in the Niger Delta of Nigeria and the trend is increasing over the last 5 years. This calls for a re-intensified effort on health education and risk control programme, provision of antiretroviral regimen to prevent mother-to-child transmission of HIV, provision of supportive environment for voluntary counseling and confidential testing of pregnant women coupled with the provision of pediatric antiretroviral therapy to reduce HIV-related mortality and morbidity of HIV-infected Nigerian children. African Journal of Health Sciences Vol. 13 (1-2) 2008: pp. 80-8

The prevalence and correlations of electrocardiographic-left ventricular hypertrophy in a rural community in Africa.

INTRODUCTION: Left ventricular hypertrophy (LVH) is a major and independent risk factor for cardiovascular morbidity and mortality irrespective of aetiology. Patients with ECG -LVH from any cause are at a greater risk for major cardiovascular complications including heart failure, cardiac arrhythmias, death following myocardial infarction, decreased left ventricular ejection fraction, sudden cardiac death, aortic root dilation, and stroke. Although echocardiography has become the gold standard for LVH detection in clinical practice, electrocardiography ECG remains widely used due to its simplicity and accessibility. This study is to determine the prevalence and correlations of ECG-LVH among adult population of a rural farming community in Rivers State, Nigeria.METHODS: A cross-sectional survey involving 539 adults. A questionnaire was administered to elicit socio-demographic data, prior knowledge of blood pressure/blood sugar status and family history of hypertension and diabetes. Anthropometric and blood pressure measurements were done in a standardized manner. Blood samples were taken for blood glucose and uric acid. Twelve lead surface electrocardiograms were recorded on all the subjects using a portable ECG machine. Data obtained was analysed using SPSS version 17. LVH was determined using Sokolow-Lyon voltage criteria Mv= SV1+RV5 (or V6 if larger).RESULTS: The prevalence of ECG-LVH by the Sokolow-Lyon criterion was 16.4% with a significantly higher prevalence in males than females (20.4 % versus 8.2%, p=0.001). There was high prevalence rate in the middle age and the elderly age group with the lowest rate seen in the young age group of 18-29 years in both sexes. The male gender, hypertension including both systolic and diastolic blood pressure and cigarette smoking were significantly correlated with LVH.CONCLUSION: The prevalence of ECG-LVH in this rural community of the study is high. The male gender, hypertension including both systolic and diastolic blood pressure and cigarette smoking are important variables found to be significantly correlated with the development of LVH in this study. This therefore calls for urgent need to tackle these modifiable risk factors amongst others elicited in this study while developing a more comprehensive health package for our rural dwellers.KEY WORDS: Prevalence, correlations, electrocardiographic-left ventricular hypertrophy, rural community

Clustering of cardiovascular disease risk factors in a rural adult population in Nigeria

Background: Cardiovascular disease (CVD) is responsible for one third of global deaths and is the leading contributor to global disease burden. A non-communicable disease survey done in Nigeria helped determine the prevalence of major CVD risk factors in the country and showed a rising trend in the prevalence. This study aims to determine the proportion of adults in a rural farming community in the Niger Delta region of Nigeria with clustering of the following CVD risk factors: hypertension, diabetes, obesity, dyslipidaemia, hyperuricaemia, ECG-LVH, smoking, heavy alcohol consumption and physical inactivity.Methods: Descriptive cross-sectional survey carried out in a rural farming community in the Niger Delta region of Nigeria. Stratified sampling method was used to recruit study subjects aged 18 years and above and a total of 500 subjects completed the survey. Socio-demographic information, anthropometric, blood pressure and ECG measurements were obtained. Venous samples were collected and analyzed.Results: Five hundred subjects participated. There were 156 males and 344 females with male to female ratio of 1:2.3. The overall mean age was 41.32±17.0 with range of 18 years to 95 years. The mean age for males was 42.84±17.8 and females 40.62±16.6. Overall, 38.2%, of subjects had 2 or more risk factors. Additionally, 42.1% of males and 31.4% of females had ≥2 of these risk factors. Multivariate logistic regression showed higher clustering of risk factors with increasing age, male gender, Government staff and higher educational attainment.Conclusions: Clustering of CVD risk factors is high in this rural community of Nigeria and requires integrated approach to its prevention, detection and treatment

Sociocultural issues and causes of cerebral palsy in Port Harcourt, Nigeria

Background: Cerebral palsy (CP) is a common neurological disorder of childhood with significant neurological complications and associated comorbidities. The aim of this study was to determine the socio- cultural characteristics and causes of CP in children who presented to the Paediatric neurology clinic in Port Harcourt, Nigeria. Method: Hospital records of 834 children with CP who presented between 1 June 2008 and 1 June .2010 were reviewed Demographic data were extracted and a validated socio-economic classification of parents was used. Data was analyzed using SPSS version 15 software. Results: of the 2,288 patients with neurological disorders seen. 834 had cerebral palsy giving a prevalence of 36.45%. Theirages ranged from 5 months to 13 years. Socio-economic stratification of the patients showed concentration in the lower socioeconomic groups IV (35.73%) andV(56.35%). Majority of the children 668 (80.09%) had spastic CP. Eighty seven (10.43%) had hypotonic and 57 (6.83%) extrapyramidal types, the mixed type 22 (2.64%) was the least common. Asphyxia (27.94%), kernicterus (26.26%) and Central Nerves System infections (15.95%) were the leading identified causes. Co-morbidities such as seizures, microcephaly and speech and auditory deficits were present in majority of the subjects. Seizures and microcephaly were commoner among CP cases associated with asphyxia than those associated with kernicterus. Conclusion: Cerebral palsy was commoner amongst those in low socio-economic status with perinatal problems. Improved perinatal care will reduce the burden of CP. Continuing training of health workers and traditional birth attendants are essential.Keywords: Cerebral palsy, Social cultural issues, Port Harcourt