Acute Pulmonary Thromboembolism: A Retrospective Study in a Nigerian Private Tertiary Hospital

Background: Pulmonary embolism (PE) is a disease associated with high morbidity and mortality in the more technically advanced western world. However, in Africa and Nigeria in particular, the burden of PE is largely poorly defined as few data are available. Objectives: To characterize the clinical profile, management and outcomes in PE patients confirmed with Computerized Tomography Pulmonary Angiography (CTPA). Methods: A retrospective study was conducted at Babcock University Teaching Hospital, Ilishan-Remo, Nigeria. The medical records of PE patients confirmed by CTPA and admitted to the intensive care unit of the hospital spanning July 2016 to June 2020 were retrieved for analysis. Results: Thirty-one patients with the age range of 26 to 93 years were included and the mean age was 55.5±18.5 years. Breathlessness was the most prevalent presenting symptom. In the majority of patients (48.4%), the risk factors were not known. However, the most common risk factor and co-morbidity was pregnancy (16.1%). The in-hospital mortality rate was 9.7%. Conclusion: The clinical characteristics of PE in this cohort were similar to those described in the literature. The high mortality rate in this study also underscores the need for large population studies in black Africans

May measurement month 2018: an analysis of blood pressure screening results from Nigeria.

Hypertension remains the dominant cardiovascular risk factor worldwide. May Measurement Month (MMM) is an annual global programme of the International Society of Hypertension aimed at screening for undetected hypertension in the general population. We report the outcome of MMM 2018 in Nigeria. An opportunistic screening of adults aged at least 18 years was conducted in the six geopolitical zones of Nigeria in the month of May, 2018. Screening for hypertension was done by trained volunteers with the use of validated digital and mercury sphygmomanometers following the MMM protocol. Hypertension was defined as blood pressure (BP) ≥140/90 mmHg or the use of BP-lowering medication. There were 6398 participants (53.0% female) with a mean (SD) age of 41.7 (15.0) years. Hypertension was present in 36.4% of the participants with 51.1% of the hypertensives aware of their status, 41.8% on medication, of whom 43.1% were controlled. Overall, only 18.0% of all hypertensive participants had their BP under control. The proportion with hypertension is high, and awareness, treatment, and control rates are low. Concerted efforts are needed to improve awareness and treatment of hypertension in Nigeria in order to reduce the high rate of complications associated with uncontrolled BP

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially