Prevalence of Hepatitis B Virus Infection in Nigeria; 2000-2013: A Systematic Review and Meta-Analysis

Vaccination against the hepatitis B virus (HBV) in the West African nation of Nigeria is lower than many Sub-Saharan African countries. In Nigeria; HBV is reported to be the most common cause of liver disease. However; the extent of HBV exposure among Nigerians at average risk is unknown. Our aim; therefore; was to accurately estimate the HBV prevalence for the country and the prevalence for specific subgroups. We used electronic databases to select systematic reviews and meta-analyses from 2000 to 2013. Forty-six studies were included (n = 34;376 persons). We used a random effects meta-analysis of cross-sectional and longitudinal studies to generate our estimates. The pooled prevalence of HBV in Nigeria was 13.6 (95 confidence interval [CI]: 11.5; 15.7). The pooled prevalence ( [95 CI]) among subgroups was: 14.0 (11.7; 16.3) for blood donors; 14.1 (9.6; 18.6) for pregnant women attending antenatal clinics; 11.5 (6.0; 17.0) for children; 14.0 (11.6; 16.5) among adults; and 16.0 (11.1; 20.9) for studies evaluating adults and children. HBV prevalence in Nigeria varied by screening method [ (95 CI)]: 12.3 (10.1; 14.4) by using enzyme-linked immunosorbent assay; 17.5 (12.4; 22.7) by immunochromatography; and 13.6 (11.5; 15.7) by HBV DNA polymerase chain reaction. HBV infection is hyperendemic in Nigeria and may be the highest in Sub-Sahara Africa. Our results suggest that large numbers of pregnant women and children were exposed to HBV from 2000 to 2013. Increased efforts to prevent new HBV infections are urgently needed in Nigeria

Lipid Profile in Sickle Cell Disease Patients with Chronic Kidney Disease

Background: Dyslipidaemia is reported to occur in patients with sickle cell disease as well as patients with chronic kidney disease irrespective of the haemoglobin genotype. This study aimed at evaluating lipid profile in subjects with sickle cell anaemia (HbSS); sickle cell trait (HbAS) and normal haemoglobin genotype (HbAA); and comparing the lipid parameters between sickle cell disease patients with and those without chronic kidney disease. Methods: A total of 66 patients with chronic kidney disease: 26 HbAA; 24 HbAS and 16 HbSS and 60 apparently healthy controls were recruited for the study. Lipoproteins; urea; creatinine; estimated glomerular filtration rate and electrolytes were determined using standard procedures in both patients and controls. Results: The mean total cholesterol; low density lipoproten cholesterol and high density lipoproten cholesterol in stable HbSS subjects were significantly lower (p

Relationship between duration of diagnosis and neuromusculoskeletal complications of middle-aged type 2 diabetes patients

Abstract. BACKGROUND: Patients with Type 2 Diabetes (T2D) often present with complications involving the neuromusculoskeletal system which creep in as the condition advances in years. Hence there is a need to further understand how the duration of diagnosis of diabetes (DD) relates to the neuromusculoskeletal complications in order to design timely preventive programmes. OBJECTIVE: To investigate the relationship between the duration of diabetes and neuromusculoskeletal complications in type 2 diabetes. METHODS: This was a cross-sectional survey involving 139 consenting T2D patients and 139 age and sex-matched nondiabetic individuals. The participants were assessed for the DD and selected neuromusculoskeletal complications including muscle weakness, ranges of motion (ROM), pain and foot ulceration. RESULTS: The mean DD was 7.82 ± 2.41 years. There were significant differences (p < 0.01) between the clinical variables of both groups. In the diabetic participants, significant inverse relationships (P<0.05) were obtained between the DDD and each of muscle strength {elbow flexors (r = -0.57), knee extensors (r = -0.63), handgrip (r = ­0.82)}; ROM {wrist extension (r = -0.64) and ankle planterflexion (r = -0.63)}. Significant and direct relationships were obtained between the DDD and each of pain (r = 0.62) and ulcerative grading (r = 0.81). CONCLUSIONS: Type 2 Diabetes patients have poorer neuromusculoskeletal variables and longer duration of diabetes is associated with reduced muscle strength, diminished ROM, gradual ulceration of skin of the feet and higher level of foot pain. Immediate therapeutic exercises against these complications soon after diagnosis of diabetes may help to decelerate their progression

Neuromusculoskeletal disorders in patients with Type 2 Diabetes Mellitus: outcome of a twelve-week therapeutic exercise programme

ABSTRACT. Background and Objectives:Usual line of management of diabetes patients is drug and diet with their physical needs usually receiving minimal attention. Among the physical needs, requiring attention is their neuromusculoskeletal disorders. This study was designed to investigate the effect of a twelve-week therapeutic exercise on neuromusculoskeletal disorders of Type 2 Diabetes (T2D) patients. Methods: Forty-three participants from the Diabetes Specialty Clinic ofAminu KanoTeaching Hospital, Kano completed the study. Selected neuromusculoskeletal disorders including pain, dermatological foot grades, disorders of ranges of motion and strength of selected joints and muscles were assessed before and after a period of twelve weeks of therapeutic exercises. Participants were followed up for another twelve weeks without therapeutic exercises. Results: Baseline assessment revealed poor neuromusculoskeletal status. Significant improvements (P<0.05) were obtained for pain, Severity of Dermatological Foot Grading, Muscle strength (One Repetition Maximum)and Range of Motions at the end of the exercises except that of right wrist extension (P>0.05). Conclusions: T2D patients presented with neuromusculoskeletal disorders at baseline. Therapeutic exercises however assisted in the improvement of these disorders but relapsed when exercises were suspended. Engagement in therapeutic exercises enhanced neuromusculoskeletal health, while withdrawal from the exercise contributed to a decline. T2D patients should be encouraged to participate in therapeutic exercises in order to promote their health and function

Rhinocerebral Mucormycosis in a Patient with Type 1 Diabetes Mellitus: Case Report

Background: Rhinocerebral mucormycosis is one of the severe forms of infections in persons with diabetes mellitus. Its occurrence is rare and is reported little in our environ- ment. We report a case of rhinocerebral mucormycosis in a patient with type 1 diabetes mellitus (DM) with the aim of drawing the attention of physicians to its existence in our nvironment and the need for aggressive management. Method: The case notes of a patient with type 1 DM presenting with features of rhinocerebral mucormycosis and the rele- vant literature of the subject was reviewed. Result: An eighteen-year old senior secondary school man with a one-year history of type 1 DM was admitted to the male medical ard of Aminu Kano Teaching Hospital (AKTH) with features of diabetic ketoacidosis (DKA); facial rashes involving the medial canthus of the right eye extending to the right para- nasal area and right nostril. The facial rashes which started initially as blisters later progressed to form ulcers with necroses. There was progressive deterioration in level of consciousness with a right hemiparesis. Magnetic resonance imaging (MRI) revealed multiple brain abscesses with dilatation and engorgement of the sphenoidal and maxillary sinuses. He was managed with broad-spectrum antibiotics; antifungals and wound debridement. He continued to deteriorate and died seven weeks later. Conlusion: Rhinocere- bral mucormycosis though rare; does occur especially in the setting of DM and requires an aggressive and a multidisciplinary approach to management

Prevalence of hypertension among teenage students in Kano, Nigeria

BACKGROUND: Hypertension has been reported among young people worldwide. It is known to track from youth to adulthood, which makes it a useful predictor of essential hypertension in adulthood. This study determined the prevalence of hypertension and associated cardiovascular risk factors among secondary school teenagers in Kano, Nigeria. METHODS: A questionnaire was administered on a cross section of 1000 teenage students to inquire about cardiovascular risk factors. Participants' blood pressure, height and weight were measured. Relevant investigations were done for those with raised blood pressure.RESULTS: The participants' ages ranged from 13 to 19 years with a mean of 15.91.62 years. Seventy of the students had systolic blood pressure 140mmHg and/or diastolic blood pressure 90mmHg giving a prevalence rate of hypertension of 7.2% [95% CI = 5.6-8.9%]. Specifically, 32 (6.7%) of the 476 males were hypertensive compared to 38 (7.7%) of the 492 female participants. This difference was not statistically significant (2 =1.6 df = 1 p > 0.05). The prevalence rate of hypertension rose from 4.3% (among the younger participants) to 11.8% among the oldest students. Of the 70, a majority (88.5%) had grade 1 hypertension, 10.0% had Grade 2 hypertension and 1.5% had Grade 3 hypertension. The hypertensives were about twice more likely to have a family history of hypertension compared to their normotensive counterparts. This difference was statistically significant [OR = 2.1, 95% CI = 1.12-3.83] (2 = 6.4 df = 1 p = 0.01). CONCLUSION: Hypertension exists among teenage students in Kano, Nigeria. Early detection can reduce risk of cardiovascular changes and end organ damage