Awareness of hypertension and its risk factors in Maiduguri, north eastern Nigeria

Objectives: To determine the level of awareness of hypertension and its risk factors in Gwange community of Maiduguri North-eastern Nigeria. Method: A community based cross sectional study in Gwange community of Maiduguri, a major city in North-eastern Nigeria. Participants were selected through a stratified randomize sample method. Demographic data including age, gender, marital status, highest educational qualification and occupation were recorded. Information on awareness of hypertension and level of awareness of risk factors for hypertension were also obtained. Blood pressure was taken once on the left arm using a standard mercury sphygmomanometer. Results: In all, 485(175 females) were included. The study showed a statistically significant higher level of awareness among young individuals with declining trend with aged (p=0.01). The study also recorded a statistically significant difference in the level of awareness of hypertension among individuals with different educational levels attained, with secondary and tertiary levels of education having higher awareness (p=0.00) and also a statistically significant difference in the awareness of hypertension among different occupational groups, with higher awareness among artisans and professionals. (p=0.00). The study found 13 (6.5%) hypertensives among 199 individuals who are not aware of the risk factors for hypertension, 38 (21.6%) hypertensives among 176 individuals who are aware of one risk factor for hypertension, 12 (23.5%) hypertensives among 51 individuals who are aware of two risk factors for hypertension, and 11 (26.8%) hypertensives among 41 individuals who are aware of three or more risk factors for hypertension. Conclusion: Awareness of hypertension among hypertensives is higher than in normotensives with statistically significant higher awareness of its risk factors. Awareness is also found to be higher among people of young age group, secondary and tertiary levels of education and also among artisans and professional. Special attention should be given to those leaving in remote villages and those least aware or treated in view of the consequences of hypertension on multiple organs and regular blood pressure check should be recommended to all individuals at risk

Risk factors for hepatitis C virus sero-positivity among haemodialysis patients receiving care at Kidney Centre in a tertiary health facility in Maiduguri, Nigeria

Hepatitis C virus (HCV) is an important health care problem in haemodialysis. Hepatitis C virus is both a cause and complication of kidney diseases. Yet there are limited information on antibody against HCV in patients on haemodialysis. The purpose of this study was to determine the prevalence of anti-HCV and the risk factors associated with HCV infection in a cohort of 100 participants on haemodialysis. They were consecutively recruited into the study, anti-HCV testing was made by the 3rd-generation ELISA System (C-100, C-33c, C-22). The prevalence of HCV antibody was 15%, risk factors associated with HCV antibody were history of blood transfusion and duration of session of haemodialysis; the risk increased with increased with the number of blood transfusion and seasons of haemodialysis. The observed high prevalence of HCV antibody among patients on haemodialysis reflect the quality of healthcare services and the standards of infection control practices in our haemodialysis units. Routine screening for HCV should be done before blood transfusion using third generation ELISA assays with high sensitivity and specificity. Safety measures should be taken in our haemodialysis units to prevent cross infection among patients and staffs. These safety measures include; discarding syringes, needles, gloves, bloodlines and dialysers after single use, and the use of sterile dressings on each patient visit

Seroprevalence and associated risk factors of hepatitis E virus infection among pregnant women attending Maiduguri teaching hospital, Nigeria

Background: Hepatitis E Virus (HEV) is a major public health problem in developing countries and often fatal among pregnant women in the third trimester. Objectives: The study investigated the sero-prevalence and risk factors of HEV infection among pregnant women attendee of University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. Methods: The cross-sectional study was carried out between 4th January 2016 to 30th May, 2016. One hundred and eighty blood samples from pregnant women who consented and enrolled for the study were analyzed for anti – HEV IgM using a quality assured commercial Enzyme Linked Immunosorbent Assay (ELISA) kit. Structured questionnaires were used to collate the sociodemographic characteristics and risk factor of study subjects. Results: Out of the 180 pregnant women sampled, the anti-HEV IgM seroprevalence of 13.3% was recorded.  The seroprevalence was significantly higher in the age range of 31 – 35 years (26.5%) and least in age range ≤ 20 years (4.9%) (p=0.009).  The highest seroprevalence was recorded in the third trimester 14.1% followed by second (p>0.05). After logistic regression, nature of toilet system, and source of water consumption were significant risk factors for active HEV infection (p˂0.05). Conclusion: Based on the 10.8 % pooled national prevalence of HEV infection in Nigeria, this study recorded a significantly high level of anti – HEV IgM seropositivity, an indication of recent and active HEV infection among pregnant women at the study area. Also, these infections are most among the pregnant women in their third trimester. HEV infection was related to personal, water and environmental hygiene

Tobacco abuse and its health effect

Tobacco smoking is still one of the most important risk factor for Respiratory and cardiovascular diseases and an estimated 90% of causes of lung cancer are attributable to Tobacco smocking and equally 90% of peripheral vascular disease in non-diabetic population is attributable to Tobacco smoking, despite the health effect there is disturbing figures of people who take up smoking habit daily and increase level of failed quit smoking attempts.Environment and genetics still plays major role, and various forms of tobacco is used worldwide and its health consequence has been highlighted. Monitoring tobacco use and prevention policies through effective tax laws is paramount to reduction of the tobacco health effects in our environments.Keywords: Tobacco abuse, cigarrete smoking, health effec

Limited emergence of resistance to integrase strand transfer inhibitors (INSTIs) in ART-experienced participants failing dolutegravir-based antiretroviral therapy: a cross-sectional analysis of a Northeast Nigerian cohort

Background Due to the high prevalence of resistance to NNRTI-based ART since 2018, consolidated recommendations from the WHO have indicated dolutegravir as the preferred drug of choice for HIV treatment globally. There is a paucity of resistance outcome data from HIV-1 non-B subtypes circulating across West Africa. Aims We characterized the mutational profiles of persons living with HIV from a cross-sectional cohort in North-East Nigeria failing a dolutegravir-based ART regimen. Methods WGS of plasma samples collected from 61 HIV-1-infected participants following virological failure of dolutegravir-based ART were sequenced using the Illumina platform. Sequencing was successfully completed for samples from 55 participants. Following quality control, 33 full genomes were analysed from participants with a median age of 40 years and median time on ART of 9 years. HIV-1 subtyping was performed using SNAPPy. Results Most participants had mutational profiles reflective of exposure to previous first- and second-line ART regimens comprised NRTIs and NNRTIs. More than half of participants had one or more drug resistance-associated mutations (DRMs) affecting susceptibility to NRTIs (17/33; 52%) and NNRTIs (24/33; 73%). Almost a quarter of participants (8/33; 24.4%) had one or more DRMs affecting tenofovir susceptibility. Only one participant, infected with HIV-1 subtype G, had evidence of DRMs affecting dolutegravir susceptibility—this was characterized by the T66A, G118R, E138K and R263K mutations. Conclusions This study found a low prevalence of resistance to dolutegravir; the data are therefore supportive of the continual rollout of dolutegravir as the primary first-line regimen for ART-naive participants and the preferred switch to second-line ART across the region. However, population-level, longer-term data collection on dolutegravir outcomes are required to further guide implementation and policy action across the region

Emergence and spread of two SARS-CoV-2 variants of interest in Nigeria.

Identifying the dissemination patterns and impacts of a virus of economic or health importance during a pandemic is crucial, as it informs the public on policies for containment in order to reduce the spread of the virus. In this study, we integrated genomic and travel data to investigate the emergence and spread of the SARS-CoV-2 B.1.1.318 and B.1.525 (Eta) variants of interest in Nigeria and the wider Africa region. By integrating travel data and phylogeographic reconstructions, we find that these two variants that arose during the second wave in Nigeria emerged from within Africa, with the B.1.525 from Nigeria, and then spread to other parts of the world. Data from this study show how regional connectivity of Nigeria drove the spread of these variants of interest to surrounding countries and those connected by air-traffic. Our findings demonstrate the power of genomic analysis when combined with mobility and epidemiological data to identify the drivers of transmission, as bidirectional transmission within and between African nations are grossly underestimated as seen in our import risk index estimates

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Prevalence of Anemia and Immunological Markers in HIV-Infected Patients on Highly Active Antiretroviral Therapy in Northeastern Nigeria

Background There are conflicting reports on the impact of highly active antiretroviral therapy (HAART) in resolving hematological complications. Whereas some studies have reported improvements in hemoglobin and other hematological parameters resulting in reduction in morbidity and mortality of HIV patients, others have reported no improvement in hematocrit values of HAART-treated HIV patients compared with HAART-naïve patients. Objective This current study was designed to assess the impact of HAART in resolving immunological and hematological complications in HIV patients by comparatively analyzing the results (immunological and hematological) of HAART-naive patients and those on HAART in our environment. Methods A total of 500 patients participated, consisting of 315 HAART-naive (119 males and 196 females) patients and 185 HAART-experienced (67 males and 118 females) patients. Hemoglobin (Hb), CD4+ T-cell count, total white blood count (WBC), lymphocyte percentage, plateletes, and plasma HIV RNA were determined. Results HAART-experienced patients were older than their HAART-naive counterparts. In HAART-naive patients, the incidence of anemia (packed cell volume [PCV] <30%) was 57.5%, leukopenia (WBC < 2.5), 6.1%, and thrombocytopenia < 150, 9.6%; it was, significantly higher compared with their counterparts on HAART (24.3%, 1.7%, and 1.2%, respectively). The use of HAART was not associated with severe anemia. Of HAART-naive patients, 57.5% had a CD4 count < 200 cells/μL in comparison with 20.4% of HAART-experienced patients ( P < 0.001). The mean viral load log10 was significantly higher in HAART-naive than in HAART-experienced patients ( P < 0.001). Total lymphocyte count < 1.0 was a significant predictor of <CD4 counts < 200 cells/μL in HAART-naïve patients, but this relationship was not observed in HAART-experienced patients. Conclusion HAART has the capability of reducing the incidence of anemia, other deranged hematological and immunological parameters associated with disease progression, and death in HIV-infected patients. Total lymphocyte count fails to predict CD4 count < 200 cells/μL in our cohort; thus, its use in the management and monitoring of HIV-infected patients in our settings is not reliable

Chronic Obstructive Pulmonary Disease as Measured By FEVl, FVC AND, FEVl/FVC Ratio Among Saw Mill Workers in Jos, Northern Nigeria

Background: The lung is organ most affected by occupation-related toxin inhalation after the skin. Exposure to wood dust is associated with serious health hazards, including chronic obstructive pulmonary disease (COPD). This study was conducted to determine the prevalence and severity of COPD among saw mill workers in an urban metropolis in North central Nigeria.Methodology: In this case-control study, we compared the prevalence of COPD amongst 200 healthy adults and 200 workers employed at four saw mills in Jos, North central Nigeria. In both subjects and control groups, we assessed ventilatory function using a vitalograph spirometer to measure FEVl, FVC, andFEVl/FVC ratio.Results: Amongst the control group, various respiratory symptoms were prevalent in 0-2% of subjects, while impaired FEVl and FVC values suggestive of an obstructive ventilatory defect was detected in 1%. Amongst study subjects, respiratory symptoms were prevalent in 22-80%, while impaired FEVl and FVC values was detected in 40%, of whom 35% had an obstructive defect and 5% had a restrictive defect.Conclusions: Respiratory symptoms and COPD are prevalent among saw mill workers in Northern Nigeria, where exposure to saw dust can be reduced by improved working conditions and better public awareness.Keywords: COPD; Spirometry; Sawmill workers; Nigeri