Blood pressure profiles of pre-employed subjects in urban Sierra Leone

IN a survey of 298 clinic records of urban subjects undergoing routine medical examinations for employment; 19.4 per cent were found to be hypertensive; and in over half of these; the hypertension was moderate or severe i.e. Diastolic pressure of 105mm.Hg. or more; and/or systolic of 180mm. Hg.- or more. A further 21.5 per cent of subjects had borderline hypertension. Thus over 40 per cent of the study population were either hypertensive or had borderline hypertension. Of the hypertensive subjects; males were more affected than females; and blood pressure rose progressively with age. There was also a tendency towards higher blood pressures in obese subjects with body mass index (BMI) 27 kg/m2 and above. Males in the age group 40-49 years had the highest prevalence. The prevalence of hypertension in this selected group of urban subjects is high. An urban community survey of hypertension is required to determine the prevalence in the community as a whole

Electrodiagnosis of neuromuscular disorders in Sierra Leoneans: service utilisation and problems of sustainability

The indications for nerve conduction studies and electromyography on 642 patients were referred to the neurology unit over a ten year period are reviewed. Mononeuropathies; peripheral neuropathies and proximal nerve lesions were the main clinical indications for the investigations and diagnosis was substantially aided in mononeuropathies; peripheral neuropathies; traumatic nerve damage; myopathies and myasthenia gravis. Conversely; patients referred with unilateral sensory disturbances; movement disorders and burning feet syndrome did not benefit. Skilled manpower and the high recurring cost of the tests were the most serious limiting factors threatening the sustainability of the service. Discretionary referrals and involvement of non-specialized medical officers in the performance of tests will improve service delivery; but fiscal contribution from the health sector to complement cost recovery is vital to sustain and expand this service

Epilepsy pattern and clinic compliance in Sierra Leonean epileptics

Two hundred and twenty patients with epilepsy attending the neurologic clinic at Connaught Hospital were reviewed. Male predominance; greater prevalence of primary generalised seizures and low family history are consistent with reports from other African countries. Similarly the majority of patients had idiopathic epilepsy. Only 35 per cent of patients attented clinic for six months and 12 per cent for two years. Cultural attitudes; cost of medication and distance from clinic may contribute to the low level of clinic attendance. It is suggested that integrating the follow up and treatment of epileptics into primary health care programmes will make a greater impact on epilepsy control

Stroke in Sierra Leoneans

The clinical and laboratory data of eighty-seven Sierra Leoneans with clinical stroke are presented. Male predominance and younger age distribution are consistent with other African series. Hypertension was present in 60 per cent of cases and tended to be more severe in fatal cases. Hypercholesterolaemia was also common. A larger and more detailed longitudinal study is required to determine fully the role of these and other risk factors of this condition in the Sierra Leone