Sero-prevalence of human T-lymphotrophic virus 1/2 among HIV-1 infected individuals in Ilorin, Nigeria

Background: HTLV­1 or 2 co­infection in individuals infected with HIV­1 can lead to increased morbidity. The shared routes of transmission of HTLV with HIV­1 may increase the prevalence of HTLV among HIV­1 infected population and subsequently affect patient's management. Methods: Sera were collected from 144 HIV­1 infected individuals attending the highly active anti­retroviral therapy (HAART) clinic of the University of Ilorin Teaching Hospital between the months of May and August 2016. Sera were tested for anti­HTLV IgM and IgG antibodies to HTLV­1&2 using the sandwich enzyme­linked immunosorbent assay. Results: Out of the 144 participants tested, 47 (32.6%) and 37 (25.7%) were positive for HTLV IgG and IgM respectively. Twenty­one participants (14.6%) had both IgG and IgM antibodies to HTLV­1&2. Ten individuals were anti­retroviral drug naïve out of which, four and six were positive to anti­HTLV IgG and IgM respectively. Conclusion: Findings from this study revealed that there is high sero­prevalence of HTLV IgG and IgM antibodies among HIV­1 sero­positive individuals in Ilorin. The high rate of co­infection supports routine screening for HTLV­1/2 co-infection among HIV­1 infected individuals in Ilorin, Nigeria so that the purpose of HAART treatment and monitoring of patients to prevent progression to AIDS will not be aborted

Secondhand Smoke Exposure among Nonsmoking Adults in two Nigerian Cities

Background: Tobacco control policy can only succeed if the burdens of smoking are known. The objective of this study was to determine the prevalence and correlates of secondhand smoke (SHS) exposure among nonsmoking adults in two Nigerian cities. Materials and Methods: We carried out a cross-sectional study from October 2009 to April 2010 among adult population of two Nigerian cities: Enugu and Ilorin. A semi-structured questionnaire was administered by interviewers to obtain socio-demographic information; and information regarding pattern of SHS exposure; wareness of tobacco control policy and the harmful effects of SHS. SHS exposure was defined as regular exposure to tobacco smoke in the previous 30 days in a nonsmoking adult. Results: Of the 585 nonsmoking adults that completed the study; 38.8had regular exposure to SHS; mostly; in public places (24.4). More men were exposed at public places when compared with women (27.0vs. 19.5). The strongest factor associated with exposure to SHS in women was having a smoking spouse [prevalence rate (PR) ratio-7.76; 95confidence interval (CI); 3.08-9.42]; and in men; it was lack of home smoking restriction (PR ratio-6.35; 95CI; 4.51-8.93). Among men; SHS exposure at any location was associated with lack of secondary school education; residing in slum apartment (house with many households); living with a smoking family member (non-spouse); lack of home smoking restriction; and alcohol intake. Among women; SHS exposure at any location was associated with having a smoking spouse; residing in slum apartment and lack of home smoking restriction. Seventy-two percent of respondents were aware of the harmful effects of SHS on their health. Lack of awareness of the harmful effects was significantly associated with increasing age (r= +0.45; P = 0.01); lack of secondary school education (rof the employees reported availability of outdoor smoking area at their workplaces. Conclusion: Our results show that prevalence of SHS exposure was the highest in public places. These findings underscore the need for enactment of comprehensive smoke-free legislation and implementation of educational strategies to reduce SHS exposure in homes

Sickle Cell Chronic Lung Disease among Young Adult Nigerians

BACKGROUND: Sickle cell chronic lung disease (SCLD) is often underappreciated by health care providers because its exact prevalence and methods of diagnosis have not been well studied. OBJECTIVE: To describe the pattern of SCLD among young adult Nigerians with sickle cell anaemia (SCA). METHODS: Ninety (43 males and 47 females) patients with SCA who were selected by balloting and 90 (54 males and 36 females) healthy subjects with normal adult haemoglobin were studied. Their ventilatory function test (spirometry and peak expiratory flow rates); radiological and electocardiographic parameters were obtained and analyzed for SCLD. RESULTS: Seventeen (18.9) of the patients had SCLD. Majority (94.1) of them were in stage1 disease; 5.9in stage two; and none in the more advanced stages3 and 4. The number of patients with SCLD increased with increasing age. SCLD was associated with more than five previous hospital admissions (82.4; OR=10.02; CI=4.51-22.22) and presence of symptoms suggesting previous acute chest syndrome (dyspnoea in 58.8; OR=33.33; CI=7.39-150.30; chest pain in 94.1; OR=81.33; CI= 9.83-672.85; cough in 47.1; OR=64.00; CI=7.15-572.60). CONCLUSION: SCLD may not be a rare event in Nigeria. Therefore efforts should be made to diagnose it in the early asymptomatic stage so as to offer effective intervention therapy to halt progression to the more disabling advanced stages

Management of asthma in sub-Saharan Africa: the Nigerian perspective

Asthma is a very common respiratory disorder with rising prevalence rates worldwide. The advances in our understanding of its pathogenesis and introduction of new medications in its management have not been of much benefit to most patients in Africa. This is due to various complex and interrelated reasons such as lack of proven diagnostic and monitoring facilities; inadequate knowledge of current management of asthma by doctors; poor compliance by patients; use of traditional medicines of unproven efficacy; fake/ substandard drugs; and lack of locally designed guidelines based on local resources. The solutions to these problems require the full participation of all. Governments need to provide the appropriate environment for the care-givers and patients; on the other hand the care-givers need to update themselves on the current management of asthma; while the patients need to take the treatment of their illness seriously and also develop a strong management partnership with their care-givers

Sickle cell chronic pulmonary disease among Africans: the need for increased recognition and treatment

The pulmonary complications of sickle cell disease (SCD) among adults are expected to increase since more of them are expected to survive into adulthood with improved healthcare delivery systems. Such complications; especially the chronic ones; which are usually collectively referred to as SCCLD (sickle cell chronic lung disease); are often under-appreciated by healthcare providers in sub-Saharan Africa. However; results of recent work in Nigeria show that SCCLD might not be as uncommon as previously thought. It is very important to detect SCCLD at an early stage; which is usually asymptomatic; the late stages are not usually responsive to conventional treatment. In Africa; outline spirometry can be used as a screening test for asymptomatic SCCLD in the follow-up of SCD. Patients with asymptomatic SCCLD should be offered measures that can prevent further deterioration of their condition; while those with more advanced symptomatic disease are treated symptomatically