DIABETES RISK SCORE OF STAFF OF AN URBAN MISSION HOSPITAL IN NIGERIA

Background: Diabetes mellitus is a major global health problem which in hospital staff poses a major stress and can lead to migration away from health related posts. Certain features of health work e.g. long hours, shifts and uncertain break times increase the risk for hospital staff. It is critical to predict chronic conditions like diabetes mellitus that have a definable onset in adults so that morbidity and mortality can be mitigated through early recognition and treatment. Aims: To determine the diabetes risk score of health workers in an urban hospital and the associated risk factors. Methods and Materials: A correlational cross sectional survey of staff was conducted and diabetes risk was determined using a modified form of the Finnish Diabetes Risk Score questionnaire. Results and Conclusions: A total of 220 staff representing a response rate of 69.8% completed the study. The mean age was 41.6±9.88, Median duration of employment was 7.2years with a range of (0-37). Majority (66.4%) were in the 25-44 years age group, and most were female (66.4%) and married (70.5%). Mean BMI was 26.62±4.85. The mean Diabetes Risk score for the entire study group was 7.43±4.46 with a median score of 7 and a range of 0-19. About 40.5% had slightly elevated risk, 14.5% had moderate risk, and 5% had high risk. Female gender (AOR 0.17, 95% CI 0.09-0.33), and duration of employment (AOR 2.27, 95% CI 1.18-4.37) were significant predictors of higher diabetic risk score category. KEYWORDS: Type 2 Diabetes mellitus; Diabetes risk; Risk score; Health workforce

DIABETES RISK SCORE OF STAFF OF AN URBAN MISSION HOSPITAL IN NIGERIA

Background: Diabetes mellitus is a major global health problem which in hospital staff poses a major stress and can lead to migration away from health related posts. Certain features of health work e.g. long hours, shifts and uncertain break times increase the risk for hospital staff. It is critical to predict chronic conditions like diabetes mellitus that have a definable onset in adults so that morbidity and mortality can be mitigated through early recognition and treatment. Aims: To determine the diabetes risk score of health workers in an urban hospital and the associated risk factors. Methods and Materials: A correlational cross sectional survey of staff was conducted and diabetes risk was determined using a modified form of the Finnish Diabetes Risk Score questionnaire. Results and Conclusions: A total of 220 staff representing a response rate of 69.8% completed the study. The mean age was 41.6±9.88, Median duration of employment was 7.2years with a range of (0-37). Majority (66.4%) were in the 25-44 years age group, and most were female (66.4%) and married (70.5%). Mean BMI was 26.62±4.85. The mean Diabetes Risk score for the entire study group was 7.43±4.46 with a median score of 7 and a range of 0-19. About 40.5% had slightly elevated risk, 14.5% had moderate risk, and 5% had high risk. Female gender (AOR 0.17, 95% CI 0.09-0.33), and duration of employment (AOR 2.27, 95% CI 1.18-4.37) were significant predictors of higher diabetic risk score category. KEYWORDS: Type 2 Diabetes mellitus; Diabetes risk; Risk score; Health workforce

Evaluation of the environmental noise levels in Abuja Municipality using mobile phones

Background: Noise remains a nuisance which impacts negatively on the physical, social and psychological wellbeing of man. It aggravates chronic illnesses like hypertension and other cardiopulmonary diseases. Unfortunately, increased activities from industrialization and technological transfers/drifts have tumultuously led to increased noise pollution in most of our fast growing cities today and hence the need for concerted efforts in monitoring and regulating our environmental noise.Objectives: To assess the equivalent noise level (Leq) in Abuja municipality and promote a simple method for regular assessment of Leq within our environment.Methods: This is a cross-sectional community based study of the environmental Leq of Abuja municipality conducted between January 2014 and January 2016. The city was divided into 12 segments including residential, business and market areas via the Abuja Geographic Information System. The major markets were captured separately on a different scale. Measurements were taken with the mobile phone softwares having validated this withExtech 407730 digital sound level meter, serial no Z310135 . Leq(A) were measured at different points and hours of the day and night. The average Leq(A) were classified according to localities and compared with WHO standard safety levels.Results: LeqD ranged 71-92dB(A); 42-79dB(A) and 69-90dB(A) in business/ parks, residential and market places respectively. The Night measurements were similar 18dB(A)-56dB(A) and the day-night Leq(A)=77.2dB(A) and 90.4dB(A) for residential and business zones.Conclusion: The night noise levels are satisfactory but the day and daynight levels are above the recommended tolerable values by WHO and therefore urgently call for awareness and legislative regulations

Ten-year coronary artery disease risk in 1571 newly presenting hypertensive black subjects

Background: Although hypertension is highly prevalent in Nigeria, coronary artery disease (CAD) remains relatively uncommon. This may well change due to epidemiological transition. To ascertain the future role of CAD in Nigeria, we risk stratified every consecutive hypertensive subject referred to the Cardiology unit of the University of Abuja Teaching Hospital over 7 years. Hypothesis: A significant proportion of the study population will fall within the intermediate or high risk category. Methods: It is a prospective, observational study. 1571 hypertensive subjects were risk stratified according to the Framingham 10-year Risk Score. Results: 834(53.1%) of the subjects were female while 737(46.9%) were male. The mean age, mean body mass index and mean arterial pressure of the subjects were 50.9 ± 11.4 years, 28.1 ± 9.4 kg/m2 and 116.23 ± 13.1 mmHg respectively. According to Framingham criteria, 1263(80.4%) of the study population were low risk individuals, 286(18.2%) were medium risk, 22(1.4%) were high risk individuals. When the age of the subjects was hypothetically increased by an additional 10 years, the high risk group increased from 1.3% to 21.3%. Conclusions: According to the Framingham risk score, the majority of subjects with hypertension presenting to a large teaching hospital in Nigeria have a low risk of developing CAD in the near future, which contrasts with the risk profile seen in hypertensive subjects in Europe and North America. Nonetheless, approximately one in four subjects were classified as intermediate or high risk emphasizing the importance of lifestyle modification and the need to consider absolute risk stratification to guide management in countries undergoing epidemiological transition

Rationale and Design of the Diet, CKD, and Apolipoprotein L1 Study in Low-Income and Middle-Income Countries

IntroductionDiet, chronic kidney disease (CKD), and Apolipoprotein L1 (APOL1) (DCA) Study is examining the role of dietary factors in CKD progression and APOL1 nephropathy. We describe enrollment and retention efforts and highlight facilitators and barriers to enrollment and operational challenges, as well as accommodations made in the study protocol.MethodsThe DCA study is enrolling participants in 7 centers in West Africa. Participants who consented were invited to complete dietary recalls and 24-hour urine collections in year 1. We conducted focus groups and semistructured interviews among study personnel to identify facilitators and barriers to enrollment as well as retention and operational challenges in the execution of the study protocol. We analyzed emerging themes using content analyses.ResultsA total of 712 participants were enrolled in 18 months with 1256 24-hour urine and 1260 dietary recalls. Barriers to enrollment were the following: (i) a lack of understanding of research, (ii) the burden of research visits, and (iii) incorporating cultural and traditional nuances when designing research protocols. Factors facilitating enrollment were the following: (i) designing convenient research visits, (ii) building rapport and increased communication between the research team and participants, and (iii) cultural sensitivity - adapting research protocols for the populations involved. Offering home visits, providing free dietary counseling, reducing the volume of study blood collection, and reducing the frequency of visits were some changes made in the study protocol that increased participant satisfaction.ConclusionAdopting a participant-centered approach with accommodations in the protocol for cultural adaptability and incorporating participant feedback is vital for carrying out research in low-income and middle-income regions

Research capacity. Enabling the genomic revolution in Africa.

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