Arterial blood pressure in adult Nigerians with sickle cell anemia

SummaryAim and objectiveThis study was aimed at comparing the arterial blood pressures in steady state adult sickle cell patients with those of age- and sex-matched healthy controls.MethodsA descriptive cross-sectional study of 62 sickle cell anemia patients and 62 age- and sex-matched healthy controls was carried out in the adult outpatient sickle cell clinics and the cardiac center of the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria. Brachial blood pressures were measured in the right arm in all subjects.ResultsSignificant increase in pulse rate was found in the study subjects (87.68±8.91bpm) compared with the controls (72.13±6.79bpm) (p<0.05). The mean systolic blood pressure was comparable in the two groups. However, the patients had significantly lower diastolic blood pressure, lower mean arterial blood pressure, as well as a higher pulse pressure than the control subjects. Significant correlations were found between blood pressure indices and hematocrit, body mass index, frequency of crisis, and body surface area.ConclusionRelatively lower arterial blood pressure is a significant finding in patients with sickle cell anemia. Hematocrit, frequency of crisis, body mass index, and body surface area are significant determinants of blood pressure indices in sickle cell anemia

COMPARATIVE ASSESSMENT OF DIFFERENT DIAGNOSTIC TECHNIQUES IN THE IDENTIFICATION OF MYCOBACTERIUM TUBERCULOSIS IN SUSPECTED CASES OF TUBERCULOSIS

Statement of the Problem: Tuberculosis remains a serious public-health threat in developing countries though it has been eradicated in some advanced countries. This disease constitutes a significant threat to global health, being the second highest cause of morbidity and mortality resulting from infectious agents. Prompt diagnosis of active TB facilitates timely therapeutic intervention and minimizes community transmission. Aim: This study aimed at determining a ‘Point of Care’ diagnostic tool for pulmonary tuberculosis (PTB) by comparing the efficiency of four different PTB diagnostic tools for different age groups. Methodology: Zeihl Nelson (ZN) staining, culture, Gene xpert (GX) and Lipoarabinomanan (LAM) assay were employed in this study The culture method was used for confirmation. Sputum and urine samples were collected from each of 100 patients symptomatically diagnosed of PTB. Findings: Fifty-seven percent of the population was male while 43% were female. Mycobacterium tuberculosis was isolated from 9 (9%) of 100 patients. Similarly, GX detected Mycobacterium tuberculosis in 9 (9%) of the patients while the rate of detection using LAM was 10% and with ZN it was 7%. Gene xpert produced no true or false positive and negative result, LAM had one false positive result and ZN had two false negative results. The maximum time frame to generate result was 25 minutes for LAM, two hours for Gene xpert, eight weeks for culture and two days for ZN. Two positive isolates were observed at the same frequency for age group 21-30 and 31- 40 while age groups 1-10, 10-20, 41-50, 50-60 and above has 1 positive result each. Gene xpert had 98.11% sensitivity while LAM had 96.23% and ZN had 86.79%. The choice of ‘Point of Care’ diagnostic tool is of great concern to clinicians and the general public. Conclusion &amp; Significance: This study identified LAM assay as suitable ‘Point of Care’ diagnostic and an add-on tool for PTB diagnosis because of its relatively high sensitivity and short maximum time frame to generate result compare to other three diagnostic techniques. &nbsp; &nbsp; &nbsp

Profile of Cardiovascular Risk Factors among Priests in a Nigerian Rural Community

Objective: Cardiovascular disease (CVD) is reaching near epidemic proportions inAfrica.Achieving significant reduction in the CVD burden requires aggressive population-based lifestyle-related risk  factorsmodification. No studies have been done in this developing country on the cardiovascular risk factor profile among priests. The authors thus set out to evaluate the CV risk factor profile among priests in the rural diocesan setting ofOji River in Enugu State, Nigeria. Methods: All the available serving priests of the diocese were recruited for the study. Their biodata, demographic and clinical characteristics were recorded under standard conditions and their lifestyle habits were evaluated. Laboratory investigations of blood glucose, serum electrolyte, urea, creatinine and cholesterol were carried out. Results: Fifty priests were studied, with mean age 45.5 (± 9.1) years. Fourteen percent of them were hypertensive and 16% were obese. Eighty percent either checked their blood pressures irregularly or never at all,while only 40%were regularly on their  antihypertensive medications. Only 40% regularly engaged in any formof exercisewhile 18%admitted taking extra table salt at meals. Eighteen percent were inclined to rejecting/denying the fact of their hypertensive status “by faith”. The mean values of all the biochemical parameters were within the normal range. Conclusion: This study has shown low level of modifiable and unmodifiable cardiovascular risk factors, with a poor level of observance of lifestyle habits among the study population. It also shows a higher prevalence of hypertension in this rural setting among priests than for the rest of the country of study.Niger Med J. Vol. 48, No. 4, Oct. – Dec., 2007: 79 – 84.Keywords: Cardiovascular Risk Factors, Priests, Nigeria

Electocardiographic findings in adult Nigerians with sickle cell anaemia

 Background: Cardiovascular system abnormalities are common causes of morbidity and mortality in sickle cell anaemia.Objectives: The study aims at determining the pattern of electrocardiographic changes in adult Nigerian sickle cell anaemia patients.Methods: A descriptive cross sectional study was done on sixty sickle cell anaemia patients seen at the adult sickle cell clinic of University of Nigeria Teaching Hospital (UNTH) Enugu, and sixty age and sex matched normal controls. All the subjects had clinical evaluation as well as electrocardiographic examination.Results: The mean heart rate, P-wave duration, P-wave dispersion, PR interval, QRS duration, QRS dispersion, QTc interval and QTc dispersion were significantly higher in the patients than in the control group. Electrocardiographic abnormalities identified by this study were: left ventricular hypertrophy (75%; 1.7%), left atrial enlargement (40%; 0%), biventricular hypertrophy (11%; 0), ST-segment elevation (10%; 0%) and increased P-wave and QTc dispersions. ST segment elevation was found more in patients with moderate and severe anaemia (P= 0.02, Spearman correlation r= 0.342; P= 0.007),Conclusion: Sickle cell anaemia is associated with significant electrocardiographic abnormalities. Further prospective studies are recommended to evaluate the prognostic significance of the electrocardiographic intervals dispersion on the long term disease outcome in sickle cell anaemia.Key words: electrocardiographic findings, adult, sickle cell

Beliefs of Health Care Providers, Lay Health Care Providers and Lay Persons in Nigeria Regarding Hypertension. A Systematic Mixed Studies Review

<div><p>Background</p><p>Hypertension is a major health risk factor for mortality globally, resulting in about 13% of deaths worldwide. In Nigeria, the high burden of hypertension remains an issue for urgent attention. The control of hypertension, among other factors, is strongly determined by personal beliefs about the illness and recommended treatment.</p><p>Objective</p><p>The aim of this review is to systematically synthesize available data from all types of studies on beliefs of the Nigerian populace about hypertension</p><p>Methods</p><p>We searched the following electronic databases; Medline, EMBase, PsycInfo, AMED from their inception till date for all relevant articles. A modified Kleinman’s explanatory model for hypertension was used as a framework for extraction of data on beliefs about hypertension.</p><p>Results</p><p>The search yielded a total of 3,794 hits from which 16 relevant studies (2 qualitative, 11 quantitative and 3 mixed methods studies) met the inclusion criteria for the review. Overall, most health care providers (HCPs) believe that stress is a major cause of hypertension. Furthermore, reported cut-off point for uncomplicated hypertension differed widely among HCPs. Lay Health Care Providers such as Patent Medicine Vendors’ beliefs about hypertension seem to be relatively similar to health care professionals in areas of risk factors for hypertension, course of hypertension and methods of treatment. Among Lay persons, misconception about hypertension was quite high. Although some Nigerians believed that life style habits such as alcohol intake, exercise levels, cigarette smoking were risk factors for developing hypertension, there was discordance between belief and practice of control of risk factors. However, beliefs across numerous ethnic groups and settings (urban/rural) in Nigeria have not been explored.</p><p>Conclusion</p><p>In order to achieve control of hypertension in Nigeria, interventions should be informed, among other factors, by adequate knowledge of beliefs regarding hypertension across the numerous ethnic groups in Nigeria, settings (rural/urban), age and sex.</p></div