Screening for diabetes mellitus and humanimmunodefiency virus infection in personswith tuberculosis

Introduction. Nigeria is a country saddled with a high tubercu- losis (TB) and human immunodeficiency virus (HIV) burden but the possible combination of these communicable diseases with diabetes mellitus (DM) has been overlooked. We undertook to determine the burden of HIV and DM in persons with TB by docu- menting the prevalence rates of these disorders. Methods. This is a cross-sectional Study that was conducted within 54TB/DOT centers in Lagos State. A total of 3,376 persons with TB who were on antiTB drugs were screened for HIV and DM using standardized tests. Statistical analysis was performed using Students t test and chi square. Results. The frequency of occurrence of DM in TB and that of HIV in TB were comparable (4.8% Vs 3.5%). The Study subjects with DM were older, had higher waist circumference measure- ments and had higher proportions of hypertension compared to the subjects without DM. The combination of HIV and DM in TB was found in (0.3%). We also noted that DM in TB and HIV in TB occurred more frequently in the third and fourth decades of life. Conclusion. This study demonstrated the potential co existence of HIV, DM and Tuberculosis. It is therefore important that these two diseases are sought for in patients with TB considering the changing epidemiology of these diseases particularly in develop- ing countries like Nigeria

Prevalence and factors associated with hypertension among rural community dwellers in a local government area, South West Nigeria

Background: Many African countries including Nigeria are said to be at various stages of an epidemiological transition from communicable to non-communicable diseases (NCD). Objective: This study determined the current pattern and correlates of hypertension among adults in some rural communities in South West Nigeria. Methods: It was a descriptive cross-sectional study of 1012 individuals across 16 rural communities. The respondents\u2019 blood pressure, weight, height and waist circumference were measured. Bivariate and multivariate analyses were done. Results: Among the participants, 461 (45.6%) had hypertension out of whom 217 (47.1%) and 244 (52.9%) had stage 1 and stage 2 hypertension respectively. The systolic, diastolic and mean arterial blood pressures increased with age. The significant predictors of hypertension were; increasing age (p<0.001), higher waist circumference (p = 0.01) and overweight / obesity (p = 0.03). While systolic blood pressure (SBP) had the strongest correlation with age, waist circumference (WC) was the strongest correlate of diastolic blood pressure (DBP). Conclusion: Despite being a rural population, there was a high prevalence of hypertension in the study area

Factors influencing quality of life and predictors of low quality of life scores in patients on treatment for pulmonary tuberculosis: a cross sectional study.

There is paucity of information on the quality of life of patients with pulmonary tuberculosis in Nigeria. This study assessed the factors influencing their quality of life and the independent predictors of low quality of life scores. Two hundred and sixty consecutive patients with pulmonary tuberculosis seen at the Lagos University Teaching Hospital were evaluated for health related quality of life using the World Health Organization Quality of life instrument (WHOQoL-BREF). Sociodemographic characteristics of the patients were related to the various domains of quality of life and a multivariate logistic regression analysis was performed to identify the independent predictors of low quality of life scores in the patients. The mean age of the patients was 36.7±12 years. Sex, age and marital status of patients were found to influence quality of life scores. The independent predictors of low quality of life scores were low monthly income, duration of the illness, concomitant illnesses, unemployment, advancing age and male gender. Several socio demographic and economic factors influenced the quality of life of patients with tuberculosis and are predictive of poor scores. It is important to consider these factors when treating patients with tuberculosis to optimise outcome of care

Cooking Fuels in Lagos, Nigeria: Factors Associated with Household Choice of Kerosene or Liquefied Petroleum Gas (LPG).

Cooking with dirty-burning fuels is associated with health risk from household air pollution. We assessed the prevalence of and factors associated with the use of cooking fuels, and attitudes and barriers towards use of liquefied petroleum gas (LPG). This was a cross-sectional, population-based survey conducted in 519 households in Lagos, Nigeria. We used a structured questionnaire to obtain information regarding choice of household cooking fuel and the attitudes towards the use of LPG. Kerosene was the most frequently used cooking fuel ( = 475, 91.5%; primary use = 364, 70.1%) followed by charcoal ( = 159, 30.6%; primary use = 88, 17%) and LPG ( = 86, 16.6%; primary use = 63, 12.1%). Higher level of education, higher income and younger age were associated with LPG vs. kerosene use. Fuel expenditure on LPG was significantly lower than for kerosene ( N (Naira) 2169.0 ± 1507.0 vs. N 2581.6 ± 1407.5). Over 90% of non-LPG users were willing to switch to LPG but cited safety issues and high cost as potential barriers to switching. Our findings suggest that misinformation and beliefs regarding benefits, safety and cost of LPG are important barriers to LPG use. An educational intervention program could be a cost-effective approach to improve LPG adoption and should be formally addressed through a well-designed community-based intervention study

Prevalence of pulmonary hypertension in sickle cell anaemia patients of a tertiary hospital in Nigeria

Background: Sickle cell disease (SCD) is an inherited haemoglobinopathy characterised by recurrent organ hypoxia-reperfusion cycles which may result in repeated organ damage including the lungs and heart. In SCD, pulmonary hypertension is a known complication that may precede or complicate acute chest syndrome which is often fatal. This study seeks to know the prevalence of pulmonary hypertension and its relationship with clinical and laboratory parameters in sickle cell disease patients attending a tertiary hospital in Lagos. Materials and Methods: This was a case - control study involving patients with sickle cell disease recruited from adult sickle cell clinic of Lagos State University Teaching Hospital, Ikeja and HbAA controls matched for age and sex from a tertiary educational institution in Lagos. Both the patients and controls were subjected to echocardiography and pulmonary hypertension was deduced from their cardiac tricuspid regurgitant jet velocity. Other parameters measured were age, body mass index, full blood count, red cell indices, foetal haemoglobin, chest X-ray, liver function tests, lactate dehydrogenase and pulmonary function tests. Consenting patients were 56 HbSS in steady state and 28 HbAA controls matched for age and sex. Data was analysed using SPSS version 16.0. Results: The mean age of patients was 22 ± 6 years. In two 2 of 56 (3.6%) of the participants with sickle cell disease, the pulmonary artery pressure was > 25mmHg and there was significant difference in the mean of the pulmonary artery pressure of the control and that of the patients (P-value 0.013). Also, using the appropriate correlation tests, there was significant relationship between the pulmonary artery pressure and lactate dehydrogenase, aspartate transferase and haematocrit in patients with sickle cell disease. Conclusion: Sickle cell disease is an independent cause of pulmonary artery hypertension. Variation in cardiovascular reactions to recurrent hyperhaemolysis and hyperdynamic state in sickle cell disease may explain differences in the development of cardiac complications. Exploration of these reactions may reveal other therapeutic measures to prevent complications in sickle cell disease. Clinical assessment of adult patients with sickle cell disease should include echocardiography

Unrecognized respiratory morbidity among adolescents and young adults in Nigeria: Implications for future health outcomes

Background: Lung function impairment is a major determinant of morbidity and mortality. Unrecognized respiratory morbidity may be a missed opportunity to improve future health outcomes. Aim: The aim of this study was to investigate the prevalence of respiratory symptoms and the relationship to spirometry abnormalities and respiratory diagnosis among medical students in Lagos, Nigeria. Methods: This was a cross‑sectional study among students aged 16–35 years. We assessed frequency of respiratory symptoms, previous respiratory diagnosis, and spirometry abnormalities. The relationship between respiratory symptoms, spirometry pattern, and previous respiratory diagnosis was determined using the Chi‑square test and stepwise forward logistic regression analysis. Results: Of 640 participants, 464 (72.5%) performed good quality spirometry tests. Two hundred and forty‑four (52.6%) had at least one respiratory symptom. Preexisting conditions were only identified in 60 (12.9%): 49 (7.7%) asthma, 29 (4.5%) allergic rhinitis, 16 (2.5%) treated tuberculosis, and 8 (1.3%) bronchitis/chronic obstructive pulmonary disease. Using the Global Lung Function Initiative (GLI) lung function predicted values, obstructive (8.4%) and restrictive abnormalities (25.4%) were common. An obstructive pattern was associated with previous diagnosis of asthma, but there was no significant association for the restrictive spirometry pattern. Conclusions: Among otherwise healthy students, respiratory symptoms and lung function abnormalities are common. The vast majority are without a formal diagnosis. Asthma accounted for the majority of obstructive spirometry pattern seen, but the restrictive abnormalities based on GLI equations remain unexplained. Further research is required to determine the cause of these abnormalities and long‑term implications in apparently healthy young individuals