Relationship between body mass index, waist circumference, waist hip ratio and erosive gastroesophageal reflux disease in a tertiary centre in Nigeria: A case control study

Background: Gastro-oesophageal reflux disease (GERD) is a condition that develops when the reflux of stomach content causes troublesome symptoms with or without mucosa damage and or complications. GERD is believed to be evolving among blacks.Objectives: The objective of this study was to look at the relationship of GERD to body mass index (BMI), waist circumference (WC), hip circumference (HC) and waist hip ratio (WHR) among patients with distal oesophageal erosive GERD and controls.Methods: A case control study among patients with dyspepsia that had diagnostic upper gastrointestinal endoscopy. Patients with erosive GERD were grouped into cases while those without GERD were controls. GERD was graded using the Los Angeles classification. BMI, WC, HC and WHR were measured among cases and controls. Obesity was defined as BMI ≥ 30 kg/m2 or WC ≥ 88 cm or ≥WHR 0.85 in females and BMI ≥ 30 kg/m2 or WHR ≥ 0.9 or WC ≥102 cm for males. Data were analysed using descriptive and inferential statistics.Results: A total of 160 subjects (80 cases and 80 controls) were analysed. Mean (SD) age for cases was 51.1 (±12.4) years and 50.1 (±13.7) years for controls. When cases with GERD were compared with controls; males were less likely to be obese, BMI < 30 kg/m2, have normal WC, HC and WHR while females were more likely to be obese, BMI ≥ 30 kg/m2 and have increased WC, and HC, (p < 0.05).Conclusion: Central obesity is a risk factor for distal oesophageal erosive GERD among female Nigerians but not among males.Keywords: Gastro esophageal reflux, Central obesity, Dyspepsia, Nigeri

Factors Associated with the Survival Outcome of Hepatocellular Carcinoma Patients on Supportive Care in a Tertiary Hospital in South-West Nigeria

Background: Hepatocellular carcinoma (HCC) is a primary liver cancer. This study assessed the factors associated with the survival outcome of HCC on supportive care. Methods: This was a prospective cohort study carried out from January 2010 to June 2016 on cases of HCC recruited into a cancer data registry. Clinical, laboratory and survival outcomes were obtained. Data obtained were analyzed using descriptive and inferential statistics. Results: A total of 149 cases were analyzed: 120 (80.5%) males and 29 (19.5%) females. Age range was 18-87years, with mean (SD) being 45.0 (14.3) years. Identifiable aetiological factors were hepatitis B and C viruses, alcohol and herbal preparations in 94% while no risk factor was identified in 6%. Some risks co-occurred in multiples in 71.2% of cases. The overall median survival was 20 days, and general survival was 59.1% at two weeks, 33.6 % at one month, and only 7.3% surviving beyond thirty one days to two years. The survival of cases, according to the Child-Pugh (CTP) class, was CTP A: 36 days (ranged 4 to 730 days), CTP class B: 22 days (ranged 1 to 210 days) and CTP class C: 14 days (ranged 2 to 660 days). Higher proportion of young cases was HBsAg positive. Factors significantly associated with survival outcome included older age, female sex, abdominal pain, jaundice, elevated creatinine, bilirubin, AST, ALT, white cell count and hyponatreamia. Conclusion: Overall survival outcome among cases of HCC was poor. It is necessary to prevent HBV, reduce alcohol use, detect and treat HCC early

Helicobacter pylori patient isolates from South Africa and Nigeria differ in virulence factor pathogenicity profile and associated gastric disease outcome

Helicobacter pylori is a gram-negative, spiral-shaped bacterial pathogen and the causative agent for gastritis, peptic ulcer disease and classified as a WHO class I carcinogen. While the prevalence of H. pylori infections in Africa is among the highest in the world, the incidence of gastric cancer is comparably low. Little is known about other symptoms related to the H. pylori infection in Africa and the association with certain phenotypes of bacterial virulence. We established a network of study sites in Nigeria (NG) and South Africa (ZA) to gain an overview on the epidemiological situation. In total 220 isolates from 114 patients were analyzed and 118 different patient isolates examined for the presence of the virulence factors cagA, vacA, dupA, their phylogenetic origin and their resistance against the commonly used antibiotics amoxicillin, clarithromycin, metronidazole and tetracycline. We report that H. pylori isolates from Nigeria and South Africa differ significantly in their phylogenetic profiles and in their expression of virulence factors. VacA mosaicism is intensive, resulting in m1-m2 vacA chimeras and frequent s1m1 and s1m2 vacA subtypes in hpAfrica2 strains. Gastric lesions were diagnosed more frequent in Nigerian versus South African patients and H. pylori isolates that are resistant against one or multiple antibiotics occur frequently in both countries

Helicobacter pylori strains from a Nigerian cohort show divergent antibiotic resistance rates and a uniform pathogenicity profile

Antibiotic resistance in Helicobacter pylori is a factor preventing its successful eradication. Particularly in developing countries, resistance against commonly used antibiotics is widespread. Here, we present an epidemiological study from Nigeria with 111 isolates. We analyzed the associated disease outcome, and performed a detailed characterization of these isolated strains with respect to their antibiotic susceptibility and their virulence characteristics. Furthermore, statistical analysis was performed on microbiological data as well as patient information and the results of the gastroenterological examination. We found that the variability concerning the production of virulence factors between strains was minimal, with 96.4% of isolates being CagA-positive and 92.8% producing detectable VacA levels. In addition, high frequency of bacterial resistance was observed for metronidazole (99.1%), followed by amoxicillin (33.3%), clarithromycin (14.4%) and tetracycline (4.5%). In conclusion, this study indicated that the infection rate of H. pylori infection within the cohort in the present study was surprisingly low (36.6%). Furthermore, an average gastric pathology was observed by histological grading and bacterial isolates showed a uniform pathogenicity profile while indicating divergent antibiotic resistance rates

Occult Hepatitis B Virus Infection in Nigerian Blood Donors and Hepatitis B Virus Transmission Risks

Background: Occult hepatitis B virus infection (OBI) characterized by the absence of detectable HBsAg remains a potential threat in blood safety. We investigated the actual prevalence, viral factors and genotype of OBI infections in Nigerian blood donors. Methods: Serum collected from two blood banks were reconfirmed as HBsAg seronegative by ELISA. Forty HBsAg positive samples were employed as controls. HBV-DNA was amplified from all donors and viral loads were determined using quantitative real-time PCR. Antibodies to the HBV core, surface and HBe antigen (anti-HBc,anti-HBs,HBeAg) were measured. The PreS/S and PreC/C regions of the HBV genome were sequenced. Results: Of the 429 blood donors, 72(17%) were confirmed as OBI by DNA detection in different reference labs and excluded the concern of possible contamination. Of the 72 OBI samples, 48(67%) were positive for anti-HBc, 25(35%) positive for anti-HBs, and 2(3%) positive for HBeAg. Of the 72 OBI samples, 31(43%) were seropositive for either anti-HBc, anti-HBs or HBeAg, 21 (30%) positive for both anti-HBc and anti-HBs,one positive for both anti-HBc and HBeAg. None of the OBI samples were positive for all three serological markers. The viral load wa