Medical causes of death in a teaching hospital in South‑Eastern Nigeria: A 16 year review

Background: Most developing regions of the world are undergoing gradual epidemiological transition resulting in high burden of both communicable and noncommunicable diseases. This affects the pattern of death in this region.Objective: The objective of this study is to determine the causes of death in the medical wards of the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, South‑East Nigeria from 1995 to 2010.Materials and Methods: Data were collected retrospectively from January 1995 to December 2010.Statistical Analysis Used: Statistical Package for Social Sciences (SPSS Inc. Chicago, IL, USA) version 17.0 was used. Simple descriptive statistics were done. Student’s t‑test was used to compare means of continuous variables, while Chi‑square test was used to test significance of differences between two proportions.Results: The mortality rate was 22.8% (6250/27,514) admissions. The male to female ratio was 1.7:1. Infections (20.2%) were the most common cause of death. However, chronic kidney disease was the single most common disease entity causing death (12.3%). Other important causes of death in order of prevalence were cerebrovascular accident (10.5%), acquired immune deficiency syndrome and tuberculosis either alone or as co‑infection (10.3%), heart failure (8.8%), chronic liver disease (7.0%), septicemia (6.5%), respiratory failure (5.3%), diabetes mellitus (4.6%), cardiac arrhythmias (2.9%), and primary liver cell carcinoma (2.7%). There were few deaths from tetanus, malaria, typhoid fever, and coronary artery disease.Conclusion: Mortality is high in our medical wards and reflects the emerging trend of mixed disease spectrum comprising communicable and noncommunicable diseases.Keywords: Chronic kidney disease, infections, medical wards, mortality, Nigeri

Pattern of cancer deaths in the medical wards of a teaching hospital in South East Nigeria

Background: Cancers are emerging public health problems in developing countries like Nigeria. The epidemiological shift and aging population make cancers a challenge.Objective: We set out to describe the pattern of death due to cancer in our medical ward. The hospital is one of the premier hospitals covering the South East zone of Nigeria.Materials and Methods: We retrospectively reviewed the case notes and death certificates of all who died of cancer in our adult medical wards for 16 years (January 1995 to December 2010).Statistical Analysis Used: Statistical Package for Social Sciences (SPSS Inc. Chicago, IL) version 17.0 was used.Results: Twenty seven thousand, five hundred and fourteen patients were admitted into the medical wards. Six thousand, two hundred and fifty died. Out of the 6250 deaths, cancers accounted for 7.6%. Male to Female ratio was 2.4:1. The mean age at death was 43.7 ± 17.4 years. The mean age at death in both sexes was similar (42.9 ± 17.5 for men and 45.7 ± 17.0 years for women), P = 0.109. Primary liver cell carcinoma was the most common cause of death among men (40.8%), while cancer of hematopoietic organ was the most common in women (48.7%). The overall fatality rate was 1.7% (477/27 514) of medical admissions. Younger and middle age groups were most commonly affected in both sexes. Conclusion: Since the most productive age groups were affected, governments in developing countries should as a matter of urgency put in place adequate cancer preventive and curative services.Keywords: Cancer, mortality, medical wards, South East NigeriaNigerian Journal of Clinical Practice • Oct-Dec 2013 • Vol 16 • Issue

Hepatitis C Virus Infection In Nigerianswith Diabetesmellitus

Background/Aims: Studies from mainly Caucasian populations have shown epidemiological evidence of an association between diabetes mellitus and Hepatitis C virus (HCV) infection. The aim of this study was to determine whether any such association exists in a black African population with diabetes mellitus. Method: This was a cross sectional study of consecutive diabetic patients seen at the diabetes clinic of the University of Nigeria Teaching Hospital Enugu, Nigeria between September 1, 2004 and April 30, 2005. Patients who underwent upper gastrointestinal endoscopy during the same period for dyspeptic symptoms were used as controls after matching for age and sex. Structured questionnaire on risk factors for HCV infection was administered to the participants. Blood test for HCV antibodies was carried out on the diabetic patients as well as the control subjects. Results: Out of 191 diabetic patients, 27(14.1%) were HCV antibody positive compared to the control group in which 5 out of 134 (3.7%) subjects had HCV antibodies (p = 0.0046). Conclusion: Hepatitis C virus infection is more common in Nigerian patients with diabetes mellitus than in control subjects. The nature of the association between diabetes mellitus and HCV infection remains to be elucidated. Keywords: Hepatitis C virus, Diabetes MellitusNigerian Journal of Clinical Practice Vol. 11 (2) 2008: pp. 94-9