Body mass index, blood pressure, and cognitive impairment among type 2 diabetic patients in a primary care setting, North-Central Nigeria

The long-term effects of certain clinical factors on cognition cannot be overemphasized. The morbidity of Cognitive Impairment (CI) in patients with type 2 diabetes has been found to increase when associated with some clinical factors. The main objective of this study was to determine the relationship between CI and Body Mass Index (BMI) as well as CI and Blood Pressure (BP), among type 2 diabetic patients attending the primary care unit of a tertiary hospital. It was a descriptive hospital-based crosssectional study. Ethical approval was obtained from the Ethical Review Committee of the University of Ilorin Teaching Hospital (UITH) before the commencement of the study. Data was collected from 274 adult type 2 diabetic patients attending the Family Medicine clinics of the hospital, from March through May 2017. Interviewer-administered structured and semi-structured questionnaires were used to obtain information from the respondents. The Mini-Mental State Examination (MMSE) was used to assess CI among respondents. The BMI and BP of participants were obtained following standard procedure. Data was collated and analyzed using the Statistical Package for Social Sciences version 21 (SPSS- 21). The elderly constituted a higher proportion of participants 55.4%. Respondents were mainly females (70.8%), married (78.8%), and educated (78.1%). The clinical factor that had a statistically significant association with CI was the BMI of participants with a chi-square value (χ2) of 11.139 and a p-value of 0.048. Blood pressure had no statistically significant association with CI (χ2 of 5.181 and p-value of 0.159). CI is common in our clinics with a prevalence of 27% seen in this study. BMI had a statistically significant association with CI while BP was not. Hence, maintaining a normal weight may help in controlling CI. Physicians in primary care should routinely screen type 2 diabetic patients for CI as well as control risk factors for it.

Burden and spectrum of paediatric respiratory diseases at a referral hospital in North-Central Nigeria - A five year review

Introduction: Globally respiratory diseases, comprising a broad range of disease conditions due to infectious and non-infectious causes, are a major cause of childhood morbidity and mortality. Thus, identification of the burden of respiratory illness will ensure appropriate interventions towards reducing its attendant morbidity and mortality. The study was conducted to identify the burden, spectrum and outcome of respiratory diseases in hospitalized children at University of Ilorin Teaching Hospital, North-Central Nigeria. Methods: A retrospective descriptive cross-sectional study involving children admitted through the emergency paediatric unit over five years (January 2013-December 2017) was conducted. Data on demography, diagnosis, comorbidities and complications, duration of admission, and outcome were collected and analyzed using SPSS 20. Results: Of the total 7012 children admitted, 1939(27.7%) were due to respiratory diseases with a median age of 16 (interquartile range {IQR} 7-36) months. Males were 994(51.3%) and 945(48.7%) females. Infectious diseases were the most common cause of admission. Pneumonia (50.1%) and aspiration pneumonitis (5.1%) accounted for the highest admissions due to infective and non-infective respiratory diseases respectively. Overall, respiratory diseases accounted for 20.7% (119/574) of the overall mortality among all admissions while the all respiratory disease mortality was 6.1% (119/1939). The major contributors to mortality were pneumonia, aspiration pneumonitis and tuberculosis accounting for 81(68.1%), 12(10.1%) and nine (7.6%) deaths respectively. The median duration of hospital stay was four days [IQR: 2 to 6 days]. A significantly higher proportion of the deaths occurred with four days of admission and 82.4% of the deaths occurred among those aged less than five years. A higher number of females (70, 58.8%) died compared to males (49, 41.2%), p=0.05. Conclusion: Pneumonia and aspiration pneumonitis are major contributors to morbidity and mortality due to respiratory diseases for which interventions towards improving childhood health indices should be prioritized

An analysis of national data on care-seeking behaviour by parents of children with suspected pneumonia in Nigeria

Background. Pneumonia is responsible for 940 000 under-5 deaths annually. Most of these deaths result from delays in instituting effective treatment. Objectives. To determine care-seeking behaviour by parents of children with pneumonia and sociodemographic factors that influence decisions to seek appropriate care.Methods. The study was an analysis of the Nigeria Demographic and Health Survey 2013; which was a nationwide cross-sectional survey using a stratified cluster design of 40 680 households. All children under-5 living in the surveyed households with suspected pneumonia in the preceding 2 weeks were recruited along with their mothers. Sociodemographic characteristics of the parents and where they sought care for their child were obtained. Binomial logistic regression analysis was used to determine the contribution of various sociodemographic variables to the decision on seeking appropriate medical care.Results. Of the 28 950 children surveyed; 565 had suspected pneumonia; which equates to an occurrence rate of 19.5 per 1 000 children. About 36% of parents were judged to have sought appropriate care when their children had pneumonia. High paternal education; health decision-making by both husband and wife; and belonging to the higher quintiles on a wealth index were factors that positively influenced care-seeking behaviour. Conclusion. Care-seeking behaviour for pneumonia is poor. Paternal education and joint decision-making are key determinants of parents seeking appropriate care for their children with suspected pneumonia in Nigeria