Prevalence and correlates of chronic kidney disease among civil servants in Bayelsa state, Nigeria

Introduction: Chronic kidney disease (CKD) has become a public health problem with rising incidence and prevalence world-wide. Despite the fact that Sub-Saharan Africa, including Nigeria appears to be badly hit by this epidemic, there is a paucity of data on CKD prevalence in these regions and where data exists, they are mostly hospital-based.Objectives: The present study was carried out to determine the prevalence and correlates of CKD in an urban civil service population in Bayelsa State, Nigeria.Materials and Methods: A total of 179 civil servants in the Bayelsa State secretariat were screened for CKD during the World Kidney Day on March 2012. CKD was defined as estimated glomerular filtration rate <60 ml/min/1.73 m2 body surface area and/or proteinuria. Socio-demographic data was obtained using interviewer.administered semi-structured questionnaire while anthropometric measurements were taken. Blood pressure (BP), urinalysis, serum urea and creatinine were also assessed.Results: The prevalence of CKD in the study was 7.8%. Age >50 years was associated with CKD in univariate analysis but none of age, gender, body mass index, BP or hyperglycemia independently predicted it.Conclusion: The prevalence of CKD among Nigerian civil servants was fairly high and was associated with advancing age. Routine screening for CKD in this population is recommended.Key words: Bayelsa, civil servants, kidney disease, Nigeria, prevalenc

A Multi-Center Randomised Controlled Trial of Gatifloxacin versus Azithromycin for the Treatment of Uncomplicated Typhoid Fever in Children and Adults in Vietnam

BACKGROUND: Drug resistant typhoid fever is a major clinical problem globally. Many of the first line antibiotics, including the older generation fluoroquinolones, ciprofloxacin and ofloxacin, are failing. OBJECTIVES: We performed a randomised controlled trial to compare the efficacy and safety of gatifloxacin (10 mg/kg/day) versus azithromycin (20 mg/kg/day) as a once daily oral dose for 7 days for the treatment of uncomplicated typhoid fever in children and adults in Vietnam. METHODS: An open-label multi-centre randomised trial with pre-specified per protocol analysis and intention to treat analysis was conducted. The primary outcome was fever clearance time, the secondary outcome was overall treatment failure (clinical or microbiological failure, development of typhoid fever-related complications, relapse or faecal carriage of S. typhi). PRINCIPAL FINDINGS: We enrolled 358 children and adults with suspected typhoid fever. There was no death in the study. 287 patients had blood culture confirmed typhoid fever, 145 patients received gatifloxacin and 142 patients received azithromycin. The median FCT was 106 hours in both treatment arms (95% Confidence Interval [CI]; 94-118 hours for gatifloxacin versus 88-112 hours for azithromycin), (logrank test p = 0.984, HR [95% CI] = 1.0 [0.80-1.26]). Overall treatment failure occurred in 13/145 (9%) patients in the gatifloxacin group and 13/140 (9.3%) patients in the azithromycin group, (logrank test p = 0.854, HR [95% CI] = 0.93 [0.43-2.0]). 96% (254/263) of the Salmonella enterica serovar Typhi isolates were resistant to nalidixic acid and 58% (153/263) were multidrug resistant. CONCLUSIONS: Both antibiotics showed an excellent efficacy and safety profile. Both gatifloxacin and azithromycin can be recommended for the treatment of typhoid fever particularly in regions with high rates of multidrug and nalidixic acid resistance. The cost of a 7-day treatment course of gatifloxacin is approximately one third of the cost of azithromycin in Vietnam. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN67946944

Age, Sex and Atherogenic Risk in Type 2 Diabetes Mellitus and Non-Diabetes Mellitus patients.

The objective of this study was to assess the degree of atherogenic risk in type 2 DM and non-DM patients and to relate age and sex with atherogenic risk of the patients. A total of 192 participants, consisting of one hundred (100) type 2 diabetes mellitus patients and ninety-two (92) healthy controls were randomly selected and studied. A researcher administered questionnaire documented their ages, sex, occupation and addresses. Their weight, height and blood pressure of the participants were measured and their fasting blood samples obtained for plasma glucose and lipid profile were assayed using standardizedmethods. The diabetics had higher mean Triglyceride (TG), Low density cholesterol (LDL-c) and Total Cholesterol (TC) as follows: 119.0±52.5, 137.5±61.3 and 202.9±55.6 mg/dl when compared to the non-diabetics with the mean values of 92.45±39.7, 73.2±39.8 and 149.7±38.9 mg/dl respectively (p=0.001). The atherogenic risk increased with age with the peak mean values of 151.1±13.1 and 214.2±14.0)mg/dl for LDL-c and TC respectively (p=0.001) at age group >65years. The mean values of TC and LDL-c were higher in males than in females as follows: 203.79±59.4 and 141.23±55.4 mg/dl for the males and 202.2±53.1 and 134.6±48.3 mg/dl for females respectively p>0.05. It is our hope that these findings will assist the physicians to focus more on age and sex in the interpretation of the degree of atherogenic risk in DM and non-DM patients so as to enhance intensive preventive and control measures against cardiovascular complications.Keywords: Age, Sex, Atherogenic risk, Type 2 DM and non-DM

Health status and measurement of some liver function parameters of staff in Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State

Background: A good health program is necessary to optimize health care opportunities so as to make appropriate adjustments for optimal service delivery by our health workers in all health sectors.Aim: To determine some hepatic function parameters as a correlate of health status amongst staff of Niger Delta University Teaching Hospital,Okolobiri.Methodology: This was a cross-sectional study carried out among  hospital staff from 1st July to 30th August 2012.The participants blood samples were analyzed for total protein, albumin, Aspartate transaminase (AST), Alanine Transaminase (ALT), Gamma-glutamyl Transferase (GGT) and Total Bilirubin (T-Bil) using automated piccolo analyzer.Results: A total of 100 staff were studied, comprising 53(53%) of males and 47(47%) of females. The mean ages of the staff were 37.1± 10.7years. The plasma albumin levels of between 36-50g/L was found in 90% of staff, 48% had total protein of between 62-80g/L,77% had AST level of between 11-38IU, 84% had ALT level of between 10-47IU,81% of staff had GGT of 5-65IU while 89% had total bilirubin of between 0.2-1.6mg/dl. The mean values of AST, ALT, GGT and total bilirubin were significantly higher in males (p<0.05) than females whereas albumin and total protein though higher in males than females were not statistically significant.Conclusion: Majority of the staff were of good health status and had hepatic profile similar to those of other studies. Keywords: Liver Function test parameters, Health status, Medical screenin

Measuring Glycosylated Haemoglobin (HBA1C): A Comparison of Boronate Affinity Chromatographic Method and Spectrophotometric Methods

Context: Glycosylated haemoglobin (HbA1c) is an important marker for long term assessment of glycaemic state in patients with diabetes. Different methods are used for its measurement. In this study we compared two widely used methods of measuring HbA1c. Aims and Objectives: To compare two widely used method of measuring HbA1c with the view of find which of the method is more accurate, more stable, and more suited for use in this environment.Methods: A total of fifty known diabetic patients attending the diabetic clinic at the University Of Benin Teaching Hospital were recruited for this study. About 3ml of blood was collected from each patient and dispensed into EDTA bottle. The specimens were first analyzed using the boronate affinity chromatographic method, thereafter the specimen was analyzed using the spectrophotometric method. Results: The mean HbA1c value for boronate affinity chromatographic method was found to be higher than that of the spectrophotometric method (9.4%EF%BF%BD0.6% and 9.1%EF%BF%BD0.6%) but this difference was not statistically significant. The same difference was also observed in the mean HbA1c value for both males and females, Conclusion: The boronate chromatographic method which is automated was found to be more reliable, faster and easier to use than the spectrophotometric method