Prevalence of Hypertension in Akwa Ibom State, South-South Nigeria: Rural versus Urban Communities Study

Recent studies have shown an increasing trend in the prevalence of hypertension in rural communities compared to that of the urban communities. This study was therefore carried out to determine the prevalence of hypertension and its predictors (if any) in both urban and rural communities of Akwa Ibom State of Nigeria. Subjects and Method. This was a cross-sectional study of urban and rural communities of Akwa Ibom State for the prevalence of hypertension and its predictors. Two urban cities and two rural communities were randomly selected from the three senatorial districts of the state. Hypertension was defined based on the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of Hypertension. Results. Nine hundred and seventy-eight (978) participants were recruited from rural areas and five hundred and ninety (590) from urban centers. The rural populace had higher systolic, diastolic, and mean arterial blood pressure than the urban populace (P<0.001, < 0.002, < 0.001, resp.). The prevalence of hypertension was significantly higher in the rural populace than in the urban populace [44.3% (95% CI 41.1–47.4%) versus 28.6% (95% CI 24.9–32.3%)]. Age, BMI, and proteinuria were independent predictors of hypertension occurrence. Conclusion. There is an epidemiologic change in the prevalence of hypertension in the rural communities of Nigeria

Prevalence of Hypertension in Akwa Ibom State, South-South Nigeria: Rural versus Urban Communities Study

Recent studies have shown an increasing trend in the prevalence of hypertension in rural communities compared to that of the urban communities. This study was therefore carried out to determine the prevalence of hypertension and its predictors (if any) in both urban and rural communities of Akwa Ibom State of Nigeria. Subjects and Method. This was a cross-sectional study of urban and rural communities of Akwa Ibom State for the prevalence of hypertension and its predictors. Two urban cities and two rural communities were randomly selected from the three senatorial districts of the state. Hypertension was defined based on the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of Hypertension. Results. Nine hundred and seventy-eight (978) participants were recruited from rural areas and five hundred and ninety (590) from urban centers. The rural populace had higher systolic, diastolic, and mean arterial blood pressure than the urban populace ( &lt; 0.001, &lt; 0.002, &lt; 0.001, resp.). The prevalence of hypertension was significantly higher in the rural populace than in the urban populace [44.3% (95% CI 41.1-47.4%) versus 28.6% (95% CI 24.9-32.3%)]. Age, BMI, and proteinuria were independent predictors of hypertension occurrence. Conclusion. There is an epidemiologic change in the prevalence of hypertension in the rural communities of Nigeria

Demographics, cost, and sustainability of haemodialysis among end-stage kidney disease patients in Southern Nigeria: A single-center study

Context: Access to chronic hemodialysis for patients with end‑stage kidney disease has improved over the years. However, it is unclear if thisbhas resulted in lower cost and improved dialysis vintage. Aim: We aimed to assess the demographics, cost implication, and sustainability of maintenance hemodialysis in our cohort of end‑stage kidney disease (ESKD) patients. Methods: Retrospective descriptive study of ESKD patients on maintenance HD from 2014 to 2018 using hemodialysis records. Time‑to‑HD discontinuation and reasons for discontinuation were recorded. Using Kaplan–Meier graphs, the time‑to‑dialysis discontinuation experience of the cohort was shown. Log‑rank test was used to compare the experience between both genders. Univariable and multivariable Cox proportional hazard models were built to identify independent associations with time‑to‑dialysis discontinuation. Results: Over the 5‑year period, 702 individuals initiated HD, males were older than females, the complete cohort contributed 65,714 person‑days to the study and the median time‑to‑HD discontinuation was 10 days (interquartile range, 2–42). Females had a shorter time to HD discontinuation (8 days [1–32 days]) compared to males (11 days [2–48 days]). Only 28.5%, 15.3% and 8.3% of the patients had HD beyond 30, 90, and 180 days, respectively. About 128 (18.2%) had thrice‑weekly HD. Most sustained the treatment for the 1st week. Majority (98.4%) of the patients were presumed dead, while 4 (0.65%) were still alive and 6 (0.98%) had renal transplantation. All patients who discontinued dialysis did so for financial reasons. Multivariable Cox proportional hazards model showed that individuals who could afford dialysis more than once a week had reduced hazard of dialysis discontinuation. Conclusion: Most patients cannot sustain HD beyond a few weeks for financial reasons. Several cost containment strategies need to be deployed to bring down the cost of care

The prevalence of acute kidney injury in women with hypertensive disorders of pregnancy in Africa: a systematic review and meta-analysis

Background: Hypertensive disorder of pregnancy (HDP) is a leading and preventable cause of pregnancy-related acute kidney injury globally. This systematic review and meta-analysis determined the prevalence of AKI in cases of HDP in Africa. Methods: A systematic search of PubMed and African Journals Online (AJOL) was undertaken to identify articles with relevant data published between 1991 and 2022. The pooled prevalence of AKI in women with HDP was determined using meta-analytic techniques. Results: Eighteen eligible articles were included in the systematic review and meta-analysis. The studies included reported on 8 703 pregnant women with HDP with a median age of 27.7 years. Most of the studies were crosssectional and had medium or poor methodological quality. The overall prevalence of AKI was 6.0% (95% CI 3.4–9.3%, I2 = 96.7%; p-value for heterogeneity &lt;0.001). There was no difference in AKI prevalence by African subregion. There was a higher prevalence of AKI in the post-RIFLE era compared to the pre-RIFLE era [7.1% (4.3–10.5%) versus 1.6% (0.5–3.2%); p &lt; 0.001]. The pooled AKI prevalence was higher in the studies that used established AKI consensus criteria than those where criteria were not used [19.6% (10.7–30.3%) versus 4.8 (2.4–8.0%); p = 0.001]. Conclusion: The pooled prevalence of AKI in HDP in Africa was 6.0%. Using consensus AKI definition criteria improves the sensitivity of AKI detection in HDP. The early involvement of nephrologists, as part of a multidisciplinary team taking care of women with HDP, may enhance early AKI detection and reduce the likelihood of renal complications