Prevalence and control of hypertension in a Niger Delta semi urban community, Nigeria

Background: Hypertension is a public health problem worldwide, but the prevalence in Amassoma, Southern Ijaw Local Government Area is not known. Objective: To investigate the prevalence of hypertension in the locality and the extent of control in diagnosed cases. Methods: It is a prospective study involving interviewing. Four hundred adults aged 20 years and above selected through stratified random sampling across the various compounds called "AMA"; a unit of settlement comprising extended families of common ancestors. A self-developed, validated and pretested interviewer-administered questionnaire on demographics, predisposing factors, and medication history was used. In addition, measurement of respondents´ blood pressure, weight and height was carried out. The Body Mass Index calculated and the data were appropriately analysed. Results: The response rate of questionnaire distribution was 100.0% being interviewer administered alongside weight, height and blood pressure measurement. Majority of respondents were female. Almost half of respondents (46.5%) had their BMI above normal, 15.3% (61) of which falls within the obese region (>30.0kg/m2). The mean (SD) systolic blood pressure among males was 133.3 (3.2) mmHg and that of females was 127.4 (3.0) while the mean (SD) diastolic blood pressures were 86.2 (1.7) and 83.9 (2.4) for males and females respectively. Crude prevalence rate of hypertension in the community was 15.0% (60) out of which 13.8 % (55) were previously diagnosed. The hypertension was that of Stage I in 11.5% (46) and Stage II in 3.5% (14). Hypertension prevalence was slightly higher in males (18.8%) than that of the females (12.5%) (p= 0.0889), Relative Risk (RR)=1.500 [95%CI 0.9422:2.388]. The prevalence rate among 40 years and above was 41.6% (42/101) who also constituted 70.0% (42/60) of participants with hypertension in the survey and 10.5% (42/400) of the total. Of the previously diagnosed cases of hypertension, only 31% (17/55) were taking their drugs during the survey and only 12.7% (07/55) had regular adherence to medication and adequate BP control was achieved in 7.3% (04/55). Majority of the patients on drugs (21.8%) (12/55) were either taking methydopa as monotherapy or in combination with amiloride and hydrochlorothiazide. Other drugs being taken by patients include lisinopril, propranolol, amlodipine, atenolol, nifedipine and low dose aspirin. Conclusion: The prevalence of hypertension in the semi urban community is 15.0% with a prehypertension in another 23.5%. There was poor control of blood pressure among previously hypertensive patients.Antecedentes: La hipertensión es un problema de salud pública mundial, pero la prevalencia en Amassoma, Región del gobierno local de Southern Ijaw, es desconocida. Objetivo: Investigar la prevalencia de hipertensión en la localidad y el grado de control de los casos diagnosticados. Métodos: Estudio prospectivo que incluyó una entrevista. Se seleccionó a 400 adultos de 20 años o más mediante un muestreo aleatorio estratificado en los varios sectores llamados "AMA"; la unidad familiar comprendía las familias con los antepasados comunes. Se utilizó un cuestionario auto-desarrollado, validado y pre-testeado administrado por encuestador sobre demografía, factores predisponentes y medicación. Además, se realizó una medición de presión arterial, peso y altura de los respondedores. Se calculó el índice de masa corporal y se analizaron los datos pertinentemente. Resultados: La tasa de respuesta de la distribución del cuestionario fue del 100%, siendo el entrevistador quien midió peso, altura y presión arterial. La mayoría de los respondentes eran mujeres. Casi la mitad de los respondentes (46,5%) tenían un IMC por encima de lo normal, 15,3% (61) de ellos estaban en la zona de obesidad (>30,0 kg/m2). La media (DE) de la presión arterial sistólica entre hombres era de 133,3 (3,2) mmHg y en mujeres de 127,4 (3,0), mientras que la media (DE) de la presión arterial diastólica fue de 86,2 (1,7) y de 83,9 (2,4) para hombres y mujeres, respectivamente. La tasa de prevalencia cruda de hipertensión en la comunidad fue del 15,0% (60) de los que el 13,8% (55) habían sido previamente diagnosticados. La hipertensión era de estadio I en el 11,5% (46) y de estadio II en el 3,5% (14). La prevalencia de hipertensión fue ligeramente mayor en hombres (18,8%) que en mujeres (12,5%) (p=0,0889; riesgo relativo (RR)=1,500 [IC95%= 0,9422:2,388]. La tasa de prevalencia entre los de 40 años o más fue del 41,6% (42/101) que también constituían el 70,0% (42/60) de los participantes con hipertensión en el estudio y el 10,5% (42/100) del total. De los casos previamente diagnosticados de hipertensión, sólo el 31% (17/55) estaban tomando medicamentos regularmente durante la encuesta y sólo el 12,7% cumplían regularmente la medicación y se alcanzó el control adecuado de la presión arterial en el 7,3% (4/55). La mayoría de los pacientes medicados (21,8%) (12/55) estaban o con metildopa en monoterapia o en combinación de amiloride and hydrochlorothiazide. Otros medicamentos utilizados incluían lisinopriolo, propranolol, amlodipina, atenolol, nifedipina y bajas dosis de aspirina. Conclusión: La prevalencia de hipertensión en el área semi-urbana es del 15,0% con una prehipertensión en otro 23,5%. Había in pobre control de la presión arterial entre los pacientes previamente diagnosticados

Development of an Efficient Chamber for Green-Drying Moringa Oleifera Leaves

The Moringa oleifera (M. oleifera) leaves are very nutritious leaves, rich in protein, vitamins and minerals. The leaves are also used for varied applications such as nutritional and medicinal purposes. This potential presents M. oleifera as a leaf with economic cum health prospects especially to agrarian communities. To sustain these potential benefits of M. oleifera, a means of processing them has to be developed and this process must not in any way reduce the nutritional value of the leaves. Drying under room condition is a usual process practice for M. oleifera, this is quite remote and would not encourage large scale production which could determine the economic feasibility. However, several efforts have been reported for processing M. oleifera, yet the balance between drying and retention of nutritional content is yet to be established for mechanized drying process. Therefore, there is the need to develop a mechanized chamber for green-drying M. oleifera. In this work, development of an efficient drying chamber was addressed using indigenous materials. The machine was designed, constructed and tested using fresh M. oleifera leaves. The machine is electrically-controlled via a switch and a thermocouple that will cut off the heater chamber when the required temperature is reached. To test the effectiveness of the dryer, M. oleifera leaves were dried using the designed dryer and the same quality dried using the room method. The method was able to dry M. oleifera leaves about three (3) hours compared to four (4) to seven (7) hours using the room method. The two samples were then sent to a laboratory for analysis. For nutrients like crude fibre of the sample dried using the new design yielded 7.4% crude fibre which is very close to 7.5% nutritional crude fibre content with room drying method. The drying chamber presented in this study showed efficient greendrying performance of M. oleifera with high nutritional content retention. The drying chamber presented in this work has the potential to benefit medium-scale production of M. oleiferawith nutritional components.Keywords: Nutritional leaves, drying, processing, chamber, minerals, medium-scale productio

Complications of Transverse Distal Penile Island Flap: Urethroplasty of Complex Anterior Urethral Stricture

PURPOSE: To report the complications of transverse distal penile island flap urethroplasty for urethral reconstruction in adult patients with long/ multiple segments anterior urethral stricture. MATERIALS AND METHODS: This prospective study was carried out on 55 patients with complex anterior urethral stricture to study complications of transverse distal penile island flap urethroplasty in two teaching hospitals between June 2002 and December 2008. Pre-, intra- and postoperativeinformation were collected on a pro forma to generate data, which was analyzed. RESULTS: The patients’ mean age was 43.83 years (range, 19 to 73 years). The leading etiology of the stricture was urethral inflammation (76.4%) with the commonest complication being infection: wound infection in 9.1%, urosepsis in 3.6%, and epididymo-orchitis in 1.8% of the subjects. CONCLUSION: Transverse distal penile island flap urethroplasty has a remarkable outcome in treatment of a long/multiple segment urethral stricture with few manageable complications

A comparative study of the relevance of digital rectal examination, transrectal ultrasound, and prostate-specific antigen in the diagnostic evaluation of patients with advanced carcinoma of the prostate in a resource poor environment

Aims: To compare the diagnostic yield of digital rectal examination (DRE), transrectal ultrasound (TRUS) scan, and prostate-specific antigen (PSA) in diagnostic evaluation of advanced carcinoma of the prostate (CAP). Subjects and Methods: A comparative study of sensitivity and specificity of DRE, TRUS, and PSA in the evaluation of advanced CAP. This was done over a 3-year period (January 2010 to December 2012) in a tertiary health institution in Sub-Saharan Africa. All patients presenting with symptoms of prostatic enlargement were recruited, DRE, TRUS, and PSA findings were compared to the histological diagnosis. Statistical Analysis Used: SPSS version 16.0. Results: One hundred and eight cases were analyzed. Histological diagnosis revealed that 52 (48.1%) were CAP whereas 56 (51.9%) were benign. All the patients presented with lower urinary tract symptoms. Surprisingly, some patients with advanced CAP had PSA values in the normal range (0-4 ng/ml) while some with the benign disease also had PSA values above 50 ng/ml. PSA was noted to have the highest sensitivity but lowest specificity. Conclusions: Limitations of PSA are not only seen in screening for early disease, but also in the diagnosis of advanced CAP, and no value of PSA can be considered safe to declare a patient CAP free

Rhizobacterial inoculation in combination with mineral fertilizer improves maize growth and yield in poor ferruginous soil in Central Benin

The use of biotechnological approaches to increase soil fertility and productivity allows to obtain sustainable agriculture with lesser use of chemical fertilizers. The present study aimed to determine whether the inoculation of Bacillus panthothenicus, Bacillus thuringiensis, Pseudomonas putida, Pseudomonas syringae, or Serratia marcescens combined with reduced doses of NPK (nitrogen, phosphorus, potassium) fertilizer can improve the growth and yield of maize on poor ferruginous soils under field conditions in central Benin. For this purpose, maize seeds of the EVDT 97 STR C1 variety were inoculated with 10 ml suspension of five plant growth-promoting rhizobacteria (PGPR) strains, and the plots were fertilized at seeding with the recommended doses (0, 25, 50, 100%) of 200 kg/ha of NPK and 100 kg of urea for corn cultivation. The study was conducted in a completely randomized design with 3 replicates. The results showed that except for P. syringae , which induced the highest fresh aerial biomass (94.51%) and dry aerial biomass (63.63%), all other parameters were positively improved with inoculation associated with reduced doses of NPK + urea. The best height, leaf area, fresh underground biomass, and grain yield were recorded in response to the application of P. syringae + 50% NPK + urea, with an increase of 26.82, 32.23, 107.57, and 30.64%, respectively, compared to those of the control. The inoculation of seeds with P. syringae + 50% NPK + urea can be considered to be an environmentally sustainable strategy for maize cultivation

Experimental evidence of deep infiltration under sandy flats and gullies in the Sahel

International audienceDespite the strong reduction in rainfall observed after 1968, the water table of some endorheic areas in the Sahel has been found to be rising over the last several decades. It has been previously demonstrated that this is due to land use changes which have led to a severe increase in runoff and erosion. In such areas, the excess in runoff causes a strong increase in the number of ponds, their sizes and thus, their duration. Ponds have been identified as the main zones of deep infiltration of water. The aim of this study was to investigate whether other areas of the Sahelian region could also be defined as deep infiltration ones as well, and then, whether they were contributing to aquifer recharge. Soil water content was surveyed for five consecutive years (2004-2008) by implementing a set of measurement devices at different depths. The hydrologic water balance was monitored at stream flow gauge stations located upstream and downstream of two small endorheic catchments. A temporal increase in runoff and erosion induced by the soil degradation following the replacement of bush vegetation by cultivated crops and fallow land areas was observed. This process led to the appearance of extended bare soil areas due to both aeolian and hydric erosion, triggering a strong reduction in soil infiltrability under millet fields and fallow lands as well as in the soil water holding capacity. It also resulted in the formation of a great number of gullies and sand sediment deposits in the endorheic areas. Measurements showed that sandy deposits correspond in fact to large areas of deep infiltration: tens of thousands of cubic meters of water infiltrated catchments of less than 1 km2. Runoff decreased by up to 50% in the sandy deposit areas, while infiltration (close to 1300 mm h-1) was observed up to depths of 10 m. These factors would raise the water table and significantly modify the surface and sub-surface components of the water cycle

Spatio-temporal variability of hydrological regimes around the boundaries between Sahelian and Sudanian areas of West Africa : a synthesis

Abundant information is available on West African drought and its hydrological and environmental impacts. Land-use and climatic changes have greatly modified the conditions of Sudanian and Sahelian hydrology, impacting the regime and discharge of the main rivers. Human pressure on the environment (significant increase in crops and disappearance of natural bushes and landscapes, for example) has led to severe soil crusting and desertification throughout Sahelian regions. Despite recent increases in rainfall, the drought has not ended, resulting in two different hydrological evolutions. In the Sudanian areas, stream flows have been reduced, sometimes as much as twice the rainfall reduction rate. In the Sahelian regions, runoff coefficients have increased to such a degree that discharges are increasing, in spite of the reduced rainfall. The main goal of this paper is to synthesize the recent advances in the Sahelian and Sudano-Sahelian West African hydrology. The other objectives are two fold: First, to discuss the "Sahelian Paradox" (the increase in runoff in most of the Sahel during the drought, at least during the 1968-1995 period, as described in the 1980s) and paradox of groundwater highlighted in the square degree of Niamey (the rise in water table levels in some endorheic areas during the same drought, evidenced in the 1990s), and second, to attempt to define the application of their respective geographical areas. The land-use changes act as a general factor of hydrological evolution of soils and basins, while some spatial factors explain the great variability in the response to environmental evolution, such as endorheism, geological context, latitudinal climate gradient, and local hydrodynamic behaviour of environment. This paper is literature-based, and incorporates current research advances in the field, as well as a prospective focused on resources and socio-economic impacts