A community-based study of hypertension and cardio-metabolic syndrome in semi-urban and rural communities in Nigeria

<p>Abstract</p> <p>Background</p> <p>The prevalence of cardio-metabolic syndrome (CMS) is increasing worldwide. In people of African descent, there is higher prevalence of hypertension and complications than other races. Bearing in mind these facts, we looked at the CMS in the general population and the population with hypertension. Using the new International Diabetes Federation (IDF) definitions of CMS, we studied its prevalence in semi-urban and rural communities in South-east Nigeria in relation to hypertension.</p> <p>Method</p> <p>This is a cross sectional population based study involving 1458 adults aged from 25 to 64 years. Diagnosis of CMS was based on the new IDF criteria using the anthropometric measurements for Europids as there is none yet for blacks. Hypertension was defined according to the WHO/ISH criteria.</p> <p>Results</p> <p>The overall prevalence of CMS was 18.0% in the semi-urban community as against 10.0% in the rural community increasing to 34.7% and 24.7% respectively in the population with hypertension. The prevalence of co-morbidities - hyperglycaemia, abdominal obesity, and hypertriglceridaemia were 13.9%, 41.1% and 23.9% while in the hypertensive populations they were 21.2%, 55.0% and 31.3% in the general population in both communities combined. Except for low HDL cholesterol, every other co-morbidity was higher in hypertensive population than the general population.</p> <p>Conclusion</p> <p>The high prevalence of CMS in the semi-urban population especially for the population with hypertension underscores the double burden of disease in developing countries. The lesson is while infections and infestations are being tackled in these countries the non-communicable diseases should not be neglected.</p

Renal disease in HIV infected patients at University of Benin Teaching Hospital in Nigeria

Background: HIV related renal disease is a common occurrence in patients with HIV infection. It is the third leading cause of end stage renal disease among African-American males between the ages of 20 and 64 years in USA. Renal function impairment has been reported at all stages of HIV infection. The aim of this study is to determine the relationship between severity of renal function impairment and CD4 cell count in HIV infected patients. Method: HIV patients presenting at University of Benin Teaching Hospital Benin, City Nigeria from 1st January to 30th June 2007 were randomly selected and screened for renal functional impairment (RFI). Those with RFI detected by glomerular filtration rate < 60ml/min/1.73m2 or urine protein creatinine ratio ³ 200 were stratified into mild, moderate and severe RFI. Forty patients from each stratum and forty HIV infected patients with normal renal functions were recruited as subjects and control respectively. Their clinical and laboratory parameters were evaluated. The data obtained were analysed using SPSS vs 15.0. Results: Of the HIV patients screened, 53.3% had renal functional impairment. of these, 40.2% had mild, 37.7% had moderate and 22.2% had severe impairment in their renal functions respectively Their mean age was 36.0±8.8 years. The CD4 cell count was found to be 309.75 ± 268.71/ul, 188.45 ± 173.12/ul, and 141.10±126.01/ul among subjects with mild, moderate and severe RFI respectively. The CD4 cell count in control group was 319.05 ± 248.41/ul. The difference was statistically significant. (p = <0.001). CD4 cell count had a significant positive correlation with GFR (r = 0.32, p = 0.042). However, there was a negative correlation between CD4 cell count and proteinuria but this was not statistically significant (r = 0.09, p = 0.173). Conclusion: Severity of RFI has a positive correlation with degree of immunosuppression in HIV infected patients

An audit of chronic kidney disease risk factors in type 2 diabetic patients in a tertiary hospital in Southern Nigeria

Background: Prevalence of diabetes mellitus (DM) is on the increase in Nigeria with diabetic nephropathy (DN) as one of the commonest causes of end stage renal disease among Nigerians. We determined the risk factors of chronic kidney disease (CKD) prevalent in type 2 diabetics.Methods: Type 2 diabetics attending the outpatient clinic of a tertiary health institution were recruited over a six week period and had their records reviewed.Results: A total of 144 type 2 diabetics were recruited. Fifty three (36.8%) were males while 91 (63.2%) were females. Mean age of all diabetics was 57.5± 11.5 years. The prevalence of obesity, metabolic syndrome, hypertension, dyslipidaemia, and poor glycaemic control were 38.8%, 70.8%, 67.4%, 64.6%, and 46.5% respectively. Central obesity, dyslipidaemia and metabolic syndrome were significantly more prevalent in female diabetics while hypertension and metabolic syndrome were more prevalent in elderly participants. Forty-four (30.6%) of the diabetics had CKD. Hypertension, dyslipidaemia and metabolic syndrome were more prevalent in diabetics with CKD, although only hypertension was significant.Conclusion: CKD risk factors were highly prevalent in type 2 diabetics in this study. Measures aimed at reducing these risks should be instituted to delay the onset and progression of CKD.Keywords: diabetes mellitus, chronic kidney disease, risk factor