Prevalence of non-communicable diseases among HIV positive patients on antiretroviral therapy at a tertiary health facility in Makurdi, north-central, Nigeria

Human immunodeficiency virus (HIV) treatment program has grown exponentially in Nigeria largely due to improved Antiretroviral therapy (ART) regimen which has changed the course of HIV/AIDs by enabling patients to live longer, raising concern of the co-existence of HIV with other chronic illnesses, notably non communicable diseases (NCDs). This study determined the prevalence of hypertension and diabetes mellitus among HIV positive patients in a tertiary institution in Makurdi, North-central Nigeria.Methods: A cross-sectional study was conducted at the ART clinic among clients ≥ aged 21 years old living with HIV /or enrolled between October 2022, and March 30, 2023. The clients' information was extracted from the register using a Proforma and all the clients who had attended their follow up clinic visit within the study period were included in the study. Data was analyzed using SPSS version 21.0. Categorical data were presented as frequencies and percentages. Results: Among the 491 patients, 404 (82.3%) had HIV only and 87 (17.7%) had HIV and at least one comorbidity, namely DM and/or HTN. Hypertension was the most prevalent comorbidity affecting 15.5% of the patients while 1.0% of them were diabetic. The middle aged (30-49) patients, females (63.2%) had the highest prevalence of comorbidities and some of those with normal weight (35.6%) also had the highest prevalence of NCDs.Conclusion: Non-communicable diseases are common among people living with HIV. There is need to encourage early diagnosis and treatment of non-communicable diseases in HIV positive patients in Nigeria.

Mort in utero tardive: fréquence, facteurs associés et méthodes de déclenchement du travail à Kisangani, République Démocratique du Congo / Late fetal death: frequency, associated factors and methods of labor induction in Kisangani, Democratic Republic of Congo

La mort fœtale tardive fait référence à la mort in utéro (MIU) de survenue spontanée à partir de 22 semaines d'aménorrhée (SA), mais avant tout début du travail d'accouchement, ce qui constitue une tragédie pour la mère, les membres de la famille et du personnel soignant. La présente étude a déterminé l'ampleur, les facteurs associés et les méthodes de déclenchement artificiel du travail d'accouchement sur MIU. Méthodes : Il s'est agi d'une étude transversale descriptive, multicentrique menée dans 3 hôpitaux de Kisangani, pendant une période de 3 ans. La collecte des données était rétrospective, des cas de MIU à partir de 28 SA. Résultats : La fréquence de MIU tardive était de 6,48%. Les principaux facteurs associés étaient l'infection urinaire (35,4%), le paludisme sur grossesse (27,5%) et l'hypertension artérielle gravidique (27,5%). Le taux de participation aux consultations prénatales (CPN) n'était que de 63,5 %. Les méthodes de déclenchement artificiel du travail d'accouchement utilisées étaient le Misoprostol (42,7%), l'ocytocine (17,7%) soit les deux combinées (25%). La césarienne était indiquée à un taux de 26,4%. Conclusion : la fréquence de MIU tardive est élevée à Kisangani. L'infection urinaire, le paludisme et l'hypertension artérielle en constituaient les principaux facteurs associés. Le Misoprostol était la méthode de déclenchement du travail les plus utilisées. Un suivi régulier des CPN pourrait réduire le taux de MIU.

Postnatal foot length in the estimation of gestational age in relation to intrauterine growth pattern among Nigerian neonates

Objectives: To determine the relationship between postnatal foot lengths and estimated gestational age (EGA) in relation to intrauterine growth patterns determined at birth among Nigerian neonates. Design: Hospital-based, cross-sectional. Setting: Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. Participants: 260 neonates with EGA 30- 42 weeks within 48 hours of life. Interventions: Postnatal foot lengths (FL) were measured with Vernier digital calliper in millimetres. The intra-uterine growth pattern was determined using the Lubchenco chart. Pearson correlation and regression analysis tests were performed. Main outcome measures: Postnatal foot length in relation to Intra-Uterine Growth Pattern. Results: The mean postnatal FL had a strong positive correlation with the EGA from 30 through 42 weeks (r = 0.855, p < 0.001). The overall mean foot length for preterm neonates was 65.44 (6.92) mm, while that of term neonates was 77.92 (4.24) mm. The linear regression equation was generated as: EGA = 9.43 + (0.37 × FL), p < 0.001. The EGA as measured by FL had the highest positive correlation with Small for Gestational Age (SGA) intra-uterine-growth pattern, followed by Appropriate for Gestational Age (AGA) and least by Large for Gestational Age (LGA) respectively (r = 0.936> 0.861 > 0.666). Conclusion: The postnatal foot length correlated well with estimated gestational age, and the correlation was best among SGA infants

Awareness of Stroke among University Employees in Kigali, Rwanda: A Cross Sectional Study

Background Awareness of stroke is important for appropriate and timely stroke prevention and management. Objective To assess the level of awareness about the risk factors, signs, and appropriate responses for stroke among university employees in Rwanda. Methods We employed a quantitative descriptive cross-sectional approach. We involved 92 participants, and a self-administered questionnaire to collect data. We computed descriptive statistics and used the Chi-Square test to assess any differences in stroke awareness. Results We found that 12% and 15.2% of the participants were not aware of any risk factor and warning sign of stroke respectively. Regarding the reaction in case a warning sign of stroke was noticed, 9.8% of the participants indicated that they would do nothing or advise the victim to take rest at home. The limited awareness was significantly higher in the administrative than academic employees for both risk factors (p=0.002) and warning signs (p=0.006), but not for the appropriate responses to stroke (p=0.426). Conclusion A significant proportion of the participants were not aware of any stroke risk factor, warning sign and appropriate responses. It is important to conduct further similar studies and implement stroke education interventions in university communities

Quality of care for patients with hypertension in selected Health Centres in Rwamagana District, Rwanda

Background Hypertension is the main risk factor for cardiovascular diseases and its prevalence is high in Rwanda. Rwanda has integrated the management of hypertension in health centres (HCs). However, little is known about the quality of hypertension care in HCs in Rwanda. Study objective To examine the quality of care for patients with hypertension and associated outcome of hypertension control in Health Centres. Methods A cross-sectional study design was used, and data were collected from a convenience sample of 202 patients. A self-reported questionnaire and blood pressure measurement were taken. Data were analysed using descriptive, bivariate, and hierarchical logistic regression analyses. Results A total of 166 (82.2%) patients participated in the study. Of these, 130 (78.3%) were females. Mean age was 57.8 (SD =14.0). The quality of hypertension care process was high with mean score of 5.86 over 7 (SD = 1.4). However, only 30.1% (n = 50/166) had well-controlled hypertension. Comorbidity (OR = 2.3; 95% CI:1.0- 5.1, p =.039) and the quality of care (OR = 1.6; 95% CI: 1.1- 2.4, p = .024) were associated with higher odds of having hypertension control. Conclusion Tailored patient-centred primary care interventions that consider comorbidity could contribute to hypertension control in primary HCs in Rwanda.

Investigating the mechanism of antihypertensive actions of medicinal plants using some animal models

As the search for, and development of new drugs continues, drug companies engage in the large-scale pharmacological screening of medicinal plants. This creates the need to elucidate the mechanism of action of medicinal plants found to possess biological activity as a means of deriving their full therapeutic potential. This research was carried out to investigate the mechanism of the antihypertensive action of Vernonia amygdalina, Ocimum gratissimum, and Pterocarpus erinaceus using animal models. The dried 70% ethanolic extracts of the plants were prepared at varying concentrations ranging from 0.4 mg/mL to 50 mg/mL. These extracts were administered at varying doses alone and in the presence of selected antagonists like prazocin in anesthetized cat in-vivo and to rabbit jejunum and spontaneously beating guinea pig right atrium. Adrenaline and atropine were used as control drugs.The effects of these plants extracts were demonstrated on the Finkleman preparation and they were found to induce relaxation of the rabbit jejunum. They also reduced both the rate and force of contraction of spontaneously beating guinea pig's right atrium. The cardiovascular effects of the extracts were investigated on cat blood pressure. The effect of atropine tested in the presence of V. amygdalina and O. gratissimum showed a change in the pattern of induced fall in blood pressure but does block the fall in blood pressure induced by the extracts. While the exact mechanism of the antihypertensive action of these extracts has not been fully determined, the result of this research work proposes that the mechanism could either be blocking calcium channels or have direct activity on lowering blood pressure. It is therefore recommended that further studies be conducted on the extracts to better understand the mechanism of antihypertensive actions of these plants.

Ethnobotanical survey of plants used for the managememnt of hypertension in Zango Kataf, Kaduna state, Nigeria

Zango Kataf is home to a diverse range of medicinal plant species among which are herbs used for the management of high blood pressure. This study was conducted to document the antihypertensive plants used by indigenes of Zango Kataf , Kaduna State, Nigeria. Seventeen (17) herbal healers were interviewed (using a semi structure questionnaire) in order to gather information about their knowledge of plants used for the treatment of hypertension. A total of twenty-three (23) antihypertensive plants (Zingiber officinale, Carica papaya, Lycopersicon esculentum, Anacardium occidentale, Annona senegalensis, Moringa oleifera, Newbouldia laevis, Vernonia amygdalina, Vitex doniana, Cymbopogon citratus, Terminalia catappa, Sesamum indicum, Hibiscus sabdariffa, Piliostigma reticulatum, Nelsonia canescens, Hibiscus cannabinus, Allium sativum, Aloe vera, Pavetta crassipes, Ocimum basilicum, Ocimum gratissimum, Persea americana and Eucalyptus globulus) used for the treatment of hypertension were identified. The identified plant species belong to 21 families. Most of the ethnomedicinal plant parts used were leaves. It was concluded that herbal healers in Zango Kataf Local Government area of Kaduna State hold medicinal knowledge of plants used for the treatment of hypertension.

Profil glucido-lipidique et risque cardiovasculaire chez les diabétiques de type 2 / Carbohydrate and lipid profile associated with cardiovascular risk in type 2 diabetics

Introduction-Le diabète est un véritable problème de santé publique du fait de ses nombreuses complications potentielles, notamment cardiovasculaires. Notre objectif était de décrire le profil clinico-biologique chez une population de diabé tique type 2 et d'étudier la relation entre l'équilibre glycémique et les anomalies lipidiques avec les complications micro et macroangiopathiques. Matériels et méthodes -Nous avons mené une étude rétrospective portant sur 341 pa tients diabétiques type 2.Les données ont été analysées par le logiciel IBM® SPSS statis tics 20.0. Seules, les associations significatives (p ≤ 5%) étaient retenues. Résultats - quatre-vingt deux pourcent et demi des patients ont un taux d'HbA1c ≥7 %. Plus de 60 % ont une dyslipidémie. Cinquante deux pourcent des patients ont un taux du LDLc ≤ 1 g/l, et 64,4 % ont un taux du Non-HDLc >1g/l. Environ 66 % des patients ont une hypertension artérielle. quarante pourcent des patients ont présenté une macroangio pathie et 66,8 % une microangiopathie (p=0,0001). L'analyse par régression logistique, a montré que l'HbA1c est le paramètre biologique le plus associé aux complications macroangiopathiques (p=0,008), alors que pour les complications micro-angiopathiques, l'HTA était le seul facteur associé (p = 0,03). Pour la cardiopathie ischémique, la dyslipi démie et l'HTA étaient les facteurs les plus associés. Conclusion -Notre étude a montré une fréquence élevée des complications micro et macroangiopathiques et des anomalies lipidiques, ainsi qu'un très mauvais équilibre glycémique. L'HbA1c, la dyslipidémie et l'HTA sont les facteurs les plus associés au risque cardiovasculaire.

Background-Diabetes is a real health public problem because of its many potential complications, particularly the cardiovascular ones.The aim of this work was to describe the clinical and biological profile in type 2 diabetic population, then to study the relationship between glycemic control and lipid abnormalities with micro and macro vascular complications. Methods - It was about a retrospective study of 341 type 2 diabetes patients' with an average age of 60.1 ± 11.71 years.The IBM® SPSS statistics 20.0 software was used for analyzing data. Only significant associations (p ≤ 5%) were retained. Results -An HbA1c level ≥7% was observed in 82,5% of patients, More than 60% have dyslipidemia. 52,8% of them have an LDLc level ≤ 1 g/l, and 64,4% have a Non-HDLc level >1g/l. Sixty-six percent of patients have high blood pressure. The macrovascular disorders were observed on 30,9% of patients and microvascular ones on 66,8% of them (p = 0.0001).The logistic regression analysis showed that HbA1c was the most significant biological parameter (p=0,008). while for micro-vascular complications, high blood pressure was the only associated factor (p = 0.03). For ischemic heart disease, dyslipidemia and high blood pressure were the most associated factors. Conclusion - this study showed a high frequency of micro and macrovascular complications, lipid abnormalities and a very poor glycemic control. The elevation of HbA1c level, the high blood pressure and dyslipidemia are the most associated factors with a high cardiovascular risk.

Screening for neurocognitive deficits in adult populations reliant on toxic cassava as the main source of food

Context and objective. Chronic dietary reliance on improperly processed cyanogenic toxic cassava is widespread in sub-Saharan Africa. The objective of the present study was to screen for neurocognition impairments and daily-life functioning in adults with dietary dependency on cyanogenic cassava as the main source of food. Methods. A cross-sectional design enrolled heads of households (in couples) in the rural district of Kahemba, Democratic Republic of Congo. Participants were screened for neurocognitive impairments using the Community Screening Interview for Dementia (CSID). Detailed neuropsychiatric evaluations were performed and disease entities classified according to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) criteria when applicable. Cassava cyanogenic exposure was ascertained by urinary concentrations of thiocyanate (SCN). Regression models were used to identify predictors of CSID performance at the 0.05 significance level. Results. For hundred and six households (203 couples, mean age 38.4 ± 11. 4 years) were involved. One hundred thirty-six subjects (33.5 %) [69 women and 67 men, mean age 39 ± 14.4 years)] and 13 (3.2 %) [7 women and 6 men, mean age: 32 ± 2.6 years] fulfilled the criteria for mild cognitive impairment (MCI) and Major Neurocognitive disorder (MNCD), respectively. The overall mean urinary concentration of SCN was 949.5+518.3 mol/l after adjusting Context and objective. Chronic dietary reliance on improperly processed cyanogenic toxic cassava is widespread in sub-Saharan Africa. The objective of the present study was to screen for neurocognition impairments and daily-life functioning in adults with dietary dependency on cyanogenic cassava as the main source of food. Methods. A cross-sectional design enrolled heads of households (in couples) in the rural district of Kahemba, Democratic Republic of Congo. Participants were screened for neurocognitive impairments using the Community Screening Interview for Dementia (CSID). Detailed neuropsychiatric evaluations were performed, and disease entities classified according to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) criteria when applicable. Cassava cyanogenic exposure was ascertained by urinary concentrations of thiocyanate (SCN). Regression models were used to identify predictors of CSID performance at the 0.05 significance level. Results. For hundred and six households (203 couples, mean age 38.4 ± 11. 4 years) were involved. One hundred thirty-six subjects (33.5 %) [69 women and 67 men, mean age 39 ± 14.4 years)] and 13 (3.2 %) [7 women and 6 men, mean age: 32 ± 2.6 years] fulfilled the criteria for mild cognitive impairment (MCI) and Major Neurocognitive disorder (MNCD), respectively. The overall mean urinary concentration of SCN was . for age, gender, nutritional status, and history of konzo, neurocognition domain-specific deficits were independently associated with either hypertension or USCN (350mol / l incremental increase in excretion Functional impairments in daily-life activities increased as subjects poorly performed at the CSID screening (Spearman r = - .2, p < 0.01). Conclusion. Neurocognitive deficits in adults are common in Congolese adults relying on cyanogenic cassava as the main source of food. Our study findings warrant further studies to elucidate the overall lifespan brain/behavioral burden and mechanisms of cassava toxicity among adults with dietary dependency on cyanogenic cassava as the main source of food

Association between angiotensinogen M235T gene polymorphism and risk of hypertension: A case control study among Ethiopian patients

Background: Hypertension is a major public health problem in both developing and developed nations because it is highly prevalent and is associated with complications. Numerous enviromnental and genetic variables are linked to the occurrence of the disease. It may be influenced by the renin-angiotensin-aldosterone system, M'hich preserves bodily homeostasis. The angiotensinogen gene 11235T polymorphisms that has an effect on the activity of the renin-angiotensin-aldosterone system are related to the high hvpertension risk. The aim of this study was to find out the association between angiotensinogen Nf235T gene polymorphism and the risk of developing hypertenMon. Methods: A total of 306 samples - 153 patients Il'ith hvpertension and 153 age- and ser-matched healthy controls were selected using a simple random sampling technique. Clinical and biochemical variables were measured to assess the associated riskfactors. Blood samples from the patients and matched controls were used to isolate deoxyribonucleic acid. The AGT 11235T genotypes u:ere identified using polymerase chain reaction and analyzed by agarose gel electrophoresis. Logistic regression with a 95% confidence interval (CI) was employed to assess the risk correlations ofAGT gene M235Tpolymorphisms with hypertension. Results: Our analysis showed that the AGT-TT genotype (odds ratio [OR] = 3.11, 95% CL = 1.67­5.79, P< 0.001) and T allele (OR = 2.18, 95% CL = 1.56­3.04, P< 0.001) are considerably higher in hypertensive patients than in healthy controls. Our study also identified the clinical risk factors for hypertension, such as, total cholesterol, triglycerol, low density lipoprotein-cholesterol, and high density lipoprotein-cholesterol Inels, which were significantly higher in patients compared to controls (P< 0.001). Conclusion: The A GT M235T genes of the TT genotype and the T allele are associated with an increased risk of hypertension among the Ethiopian patients. A population-based epidemiological study is needed corroborate the association between AGT and HTN

Hypertension and associated factors among patients attending HIV clinic at KorleBu Teaching Hospita

Objectives: This study determined the prevalence of hypertension and its associated factors among patients attending the HIV clinic at the Korle-Bu Teaching Hospital (KBTH). Design: A hospital-based cross-sectional study was conducted at KBTH. The prevalence of hypertension was estimated among study participants, and socio-demographic, lifestyle, anthropometric, metabolic and HIV/ART-related factors associated with hypertension were determined by logistic regression modelling. Setting: Study participants were recruited from the HIV clinic at the KBTH. Participants: A total of 311 Persons Living with HIV were recruited as study participants Interventions: Simple random sampling technique was used to recruit study participants. A questionnaire adapted from the WHO STEPwise approach to chronic disease risk-factor surveillance was used to collect study participants' data. Results: The prevalence of hypertension was 36.7%, and the factors associated with hypertension were increasing age, positive family history of hypertension, minimal exercising, current BMI ≥25.0 kg/m2 , total cholesterol level ≥5.17 mmol/L, exposure to anti-retroviral therapy (ART) and increasing duration of ART exposure. Conclusions: This study shows a high prevalence of hypertension among patients attending the HIV clinic at KBTH,associated with exposure to ART and increasing duration of this exposure. Blood pressure monitoring should move from routine to a more purposeful screening of patients for hypertension. Patients with the identified risk factors should be encouraged to have regular blood pressure measurements at home and not only when they visit the HIV clinic.

Association between anthropometry and cardiovascular risk in patients attending a diabetic clinic

Background Obesity is a well-documented risk factor for cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM), with increasing evidence to suggest visceral adiposity as a greater risk factor for CVD than body mass index (BMI). Objectives To determine a relationship between hypertension (HPT) and anthropometry in people living with diabetes (PLWD) in an HIV endemic area. Methods This was a retrospective study analysing data captured from standardised clinic sheets from the DM clinic at the Harry Gwala Regional Hospital, Pietermaritzburg, South Africa, from January 1, 2019 to December 31, 2019. Results Data from 957 PLWD were used for the study, the majority of whom had T2DM (811; 86.2%). Approximately one-sixth of the cohort had HIV infection (146; 15.3%). There was no significant difference in HPT prevalence between the HIV-uninfected (77.9%) and PLWD who had HIV (PLWDHIV) (78.1%). Multivariate analysis revealed females with increased waist circumference (WC) and waist-to-height ratio (WTHR) were 57.8 (95% CI 3.04­1096.33) (p = 0.007) and 87.2 (95% CI 4.88­1558.28) (p = 0.002) times more likely to be hypertensive respectively. By contrast, only BMI in males was associated with HPT with a AOR 5.294 (95% CI 1.54 - 18.22) (p = 0.008). HIV status was non-contributory to anthropometry in predicting HPT in PLWD. Conclusion Our study found that anthropometric indices are not all equal predictors of HPT. The authors advocate for local guidance on gender-specific cut-offs on anthropometry in PLWD.

Spatial factors for COVID-19 associated community deaths in an urban area of Lusaka, Zambia: an observational study

We retrospectively analyzed spatial factors for coronavirus disease 2019 (COVID-19)-associated community deaths i.e., brought-in-dead (BID) in Lusaka, Zambia, between March and July 2020. A total of 127 cases of BID with geocoordinate data of their houses were identified during the study period. Median interquartile range (IQR) of the age of these cases was 49 (34-70) years old, and 47 cases (37.0%) were elderly individuals over 60 years old. Seventy-five cases (75%) of BID were identified in July 2020, when the total number of cases and deaths was largest in Zambia. Among those whose information regarding their underlying medical condition was available, hypertension was most common (22.9%, 8/35). Among Lusaka's 94 townships, the numbers (median, IQR) of cases were significantly larger in those characterized as unplanned residential areas compared to planned areas (1.0, 0.0-4.0 vs 0.0, 0.0-1.0; p=0.030). The proportion of individuals who require more than 30 minutes to obtain water was correlated with a larger number of BID cases per 105 population in each township (rho=0.28, p=0.006). The number of BID cases was larger in unplanned residential areas, which highlighted the importance of targeted public health interventions specifically to those areas to reduce the total number of COVID-19 associated community deaths in Lusaka. Brought-in-dead surveillance might be beneficial in monitoring epidemic conditions of COVID-19 in such high-risk areas. Furthermore, inadequate access to water, sanitation, and hygiene (WASH) might be associated with such distinct geographical distributions of COVID-19 associated community deaths in Lusaka, Zambia.

Sodium, potassium food intake and global cardiovascular risks in Togo

Objectives. To assess urinary sodium/potassium intake and identify its links with global cardiovascular risk (RCVG) according to the WHOPEN approach to WHO/ISH (International High Blood Pressure Society). Methods. It was a cross-sectional and analytical study that took place from July 6, 2020, to September 17, 2021, in Togo, in the Aneho, Notse and Dapaong localities. It focused on 400 adults selected by sampling. The analysis of two urine samples was done. Cardiovascular risk scores were determined from specific graphs that take into account age, gender, systolic blood pressure, diabetes status and smoking behavior. Results. Among the 400 respondents, 49% lived in rural areas. The average age was 41 (30; 51) years. The average sodium and potassium intakes were respectively 3.2 g (1.04-5.99) or 7.95 g of salt and 1.4 g (1.89-5.62) per day. The risk of excessive sodium intake was 2.39 times higher in urban areas than in rural ones (p=0.049). Residing in rural areas was associated with high potassium intakes compared to urban ones (OR=3,2 IC [1.89-5.62]). Thirteen percent (13%) of respondents were likely to develop at least a deadly or non-deadly cardiovascular disease in the next 10 years 'time, of whom 5% present a high risk. Excessive sodium intake increases by 2.10 times the risk of a deadly cardiovascular disease occurrence. Conclusions. Sodium intakes are high while potassium intakes are low with a subsequent global cardiovascular risk (GCVR) in the three cities. Sodium intakes were associated with VCVR. It is necessary to take steps to reduce excessive sodium intake and improve potassium intake.

Maladies non transmissibles et comorbidités chez les séniors dans le service de medécine interne du CHU de Bouaké / Non-Communicable Diseases and Comorbidities in Seniors in the Internal Medicine Department of the University Hospital of Bouake

. Les maladies non transmissibles chez le sujet âgé sont négligées en Afrique car l'espérance de vie n'était aussi élevée qu'aujourd'hui. Quel en était donc le panorama, il y a 10 ans ? Objectif : Améliorer les connaissances des maladies non transmissibles et des comorbidités chez les sujets âgés. Méthodes. Il s'agissait d'une étude transversale, rétrospective à visée descriptive du 1er janvier 2009 au 31 décembre 2013 dans le service de Médecine Interne du Centre Hospitalier Universitaire de Bouaké (CHU). Elle portait sur 151 patients hypertendus âgés de 65 ans et plus. Résultats. L'âge moyen était de 75 ans avec des extrêmes de 65 ans et 93 ans. Le sex-ratio était de 1,07. Les comorbidités étaient marquées principalement par le diabète (47%). Les motifs d'hospitalisation étaient dominés par les signes neurologiques (70%). L'hypertension artérielle (HTA) systolique isolée représentait 48% et l'HTA de grade III 23%. Ses principales complications étaient les accidents vasculaires cérébraux (AVC) (62%) et les cardiopathies (32%). Ces AVC étaient surtout ischémiques (78%). L'HTA était associée à d'autres facteurs de risque cardiovasculaire (78%) notamment la pression pulsée (52%) et le diabète (47%). Les Inhibiteurs de l'enzyme de conversion (IEC) étaient les plus prescrits (64%). La mortalité était de 23%. Conclusion. Les facteurs de risque cardiovasculaire constituent depuis plus de 10 ans à Bouaké, la morbidité mais surtout la mortalité des séniors, du fait de la gravité de leurs complications.

Day and night blood pressure variability among older persons in South­Western Nigeria

Background: Hypertension is the largest contributor to the global burden of disease. Emerging risk factors for cardiovascular disease include blood pressure variability (BPV), but evidence on BPV is lacking among older Nigerians. We reported BPV in a cohort of older persons at the University College Hospital (UCH), Ibadan. Methods: We conducted a retrospective cohort study of respondents aged >50 years within the Ibadan Ambulatory Blood Pressure Registry at the UCH, Ibadan, Nigeria. Socio-demographic characteristics, lifestyle habits and anthropometric measurements were obtained. Results: Among 639 respondents, 332 (52.0%) were female. The blood pressure (BP) variables were strongly associated with age. Compared with younger age groups, mean diastolic BP (DBP) was less at an older age, whereas mean pulse pressure was greater. During the wake-up and sleep periods, mean DBP and mean arterial BP were less with each increasing age category, whereas mean pulse pressure was larger with each increasing age category. BP dipping, systolic, diastolic and mean arterial BP decreased with age. Overall, timed BPV increased significantly with increasing age. The prevalence of white­coat hypertension was greater among older participants than younger participants. Most respondents in the 50­59 years' age group were non-dippers (55.8%), whereas 33.7% of older respondents were reverse-dippers. Conclusion: Older persons experienced a greater abnormal circadian blood variation and greater BPV than younger people. In Nigeria, follow­up data are needed to determine the prognostic significance of these data in this population

Correlates of hypertension among persons living with HIV at Livingstone Central Hospital: A cross sectional study

Background: Persons living with HIV (PLWH) are more likely to develop hypertension and cardiovascular disease than the HIV-negative population. The new hypertension guidelines by the American Heart Association (AHA) and the American College of Cardiology (ACC) lowered the definition of hypertension from systolic and diastolic blood pressure (BP) of ≥ 140/90mmHg to ≥ 130/80, respectively. This study was aimed at determining the prevalence and factors associated with hypertension in PLWH in Livingstone using the new hypertension diagnostic criteria. Methods: This was a cross-sectional study. We recruited 226 antiretroviral treated PLWH attending routine visits. Socio-demographic, health and clinical data including BP readings were collected. Interviewer-structured questionnaires adapted from the World Health Organization Stepwise approach to Surveillance ( WHO STEPs) and the international physical activity questionnaire (IPAQ) were used to collect data. Statistical evaluations were employed to elucidate relationships between hypertension and all response variables. Results: The prevalence of hypertension using the old and new guidelines was 16% and 42%, respectively. Factors significantly associated with increased and reduced odds of developing hypertension after adjustments in multivariate logistic regression were age, body mass index (BMI), employment status, fasting blood sugar (FBS) and table salt consumption, respectively (p<0.05 for all). Using the new AHA/ACC criteria for hypertension shifted the prevalence from 16% (old criteria) to 42%.Conclusion: The prevalence of hypertension in PLH in Livingstone was 42% and the major risk factors associated with hypertension in PLWH were increasing age, BMI and FBS. We recommend the inclusion of FBS in routine measurements in PLWH. The AHA/ ACC new guidelines should be reenforced in low-cost settings to increase the treatment of hypertension among PLWH.

Choix thérapeutiques des hypertendus et diabétiques en milieu rural: Une étude mixte dans deux zones de santé de l'Est de la République Démocratique du Congo / Therapeutic choices of hypertensive and diabetics in rural areas: A mixed study in two health zones in the East of the Democratic Republic of Congo

Background: One third of patients in the Democratic Republic of Congo (DRC) do not use the formal health system to access healthcare. Aim: In this manuscript we analyse the therapeutic decisions of hypertensive and diabetic patients in rural eastern DRC and the reasons for these decisions. Setting: The study was conduct in two health zones (HZ) in South Kivu (Bagira and Walungu), DRC. Methods: A mixed-methods convergent study was conducted from November 2018 to December 2018. Quantitative data were collected using a questionnaire and qualitative data were collected using focus groups. The quantitative data were analysed using descriptive statistics and a Fischer exact test, while the qualitative data were analysed using thematic analysis. Results: Out of 382 subjects declaring a chronic pathology, hypertensives and diabetics represented 21.5% and 7.9%, respectively. Health facilities were the first therapeutic choice of the chronically affected persons. The alternative therapeutic choices found were the use of prayer rooms, consultation with traditional healers and self-medication. Poverty, ignorance, the pharmaceutical business, and the socio-cultural dimension of the disease are the main causes of alternative therapeutic choices for hypertensives and diabetics. Conclusion: To ensure appropriate care for patients with chronic diseases in rural areas, it is important to establish a bridge of regulated collaboration between the formal and informal health sector.

Time to Diabetic Retinopathy and Its Risk Factors among Diabetes Mellitus Patients in Jimma University Medical Center, Jimma, Southwest Ethiopia

Diabetic retinopathy is a complication of diabetes, caused by high blood sugar levels damaging the eye. Globally, diabetic retinopathy affects more than 103.12 million people. Diabetic retinopathy is among the leading causes of vision loss at the global level, including in Ethiopia. Therefore, the study aimed to assess the time to develop diabetic retinopathy and identify factors associated with diabetic retinopathy among diabetes patients. METHODS: A retrospective study was conducted from September 1, 2021, to January 30, 2022. Data was collected using semi structured questionnaire. The Cox proportional hazard model were used to determine the median time to develop diabetic retinopathy and identify predictors of diabetic retinopathy. Data was analyzed using R software. RESULTS: A total of 373 diabetes patients were included in this study. The prevalence of diabetic retinopathy was 41.3%. The median time was 41 months, ranging from 39 to 73 months. Elder age (HR=3.17, 95%CI: 1.53, 6.58), being male (HR=2.34, 95%CI: 1.35,6.15), previous family history of diabetes (HR=4.16, 95%CI: 2.19, 8.37), longer duration of diabetes (HR=2.86, 95%CI: 1.41, 5.31) received only insulin therapy (HR=3.91, 95%CI: 1.36, 7.94), and high systolic blood pressure (HR=2.32; 95%CI: 1.12, 4.39) were statistically significant factors related to development of diabetes retinopathy. CONCLUSIONS: More than half of diabetic patinets in this study were developed retinopathy diabetes within a few months of being diagnosed. As a result, we advocate that the best way to preserve our vision from diabetic retinopathy is to maintain our diabetes under control, and the high-risk population receive early screening for diabetes

Impact of adapted physical activity on blood pressure and hypertension control in the militaries of Kinshasa Garrison, Democratic Republic of Congo: A randomized controlled trial

Context and objective. Major handicap for operational conditioning of troops, hypertension requires innovative approaches for its prevention and management. The present study aimed to evaluate the impact of adapted physical activity (APA) on BP level of sedentary soldiers from Kinshasa garrison and the rate of hypertension control in those with high BP. Methods. Open, parallel randomized controlled trial carried out at Camp Lt-Colonel Kokolo (CVEC) from June 2016 to October 2017) in sedentary soldiers (57.6 %, hypertensives) allocated for 8 weeks to APA (n=119) or control (n=110). The randomization procedure used permuted blocks of four consecutive participants. The outcomes were baseline-adjusted betweengroup difference in BP level (all participants), in rate of BP control among hypertensives. Results. At the last available visit in 226 participants (119 vs 107), the baseline-adjusted BP difference between active and control group by intentionto-treat was 5.1 (95 % CI 1.2 -10.8)/3.0 (0.1-6.9) mmHg lower in the active group. The effect of APA was also significant across pre-specified categories of participants based on age, officers' rank, and hypertension status. Among 129 analyzed drug treated hypertensives (68 vs 61), the rate of BP control remained unchanged in the control group (43.8 to 44.3%) but increased (43.5% to 85.3 %) in the active group yielding a baseline-adjusted between group difference of 40.7 (32.2; 49.2) %. The probability to achieve hypertension control was greater (HR: 3.38 [95% CI: 1.48- 4.84] in the active group. PP analysis of 122 soldiers (80 vs 42) with data at all scheduled visits yielded confirmatory results for BP reduction and for hypertension control by APA. The changes in BP were positively correlated with concomitant reductions in heart rate. Conclusion. Exercise training induced a significant BP reduction in sedentary militaries and improved the control rate among those with drug treated hypertension