ABSTRACT
Introduction: Short sleep duration is a salient issue because it is a major public health concern and has more wide-reaching problems among HIV/AIDS patients. Short sleep duration was said to be associated with lower CD4 count, higher viral load values, depression, high blood pressure, high body mass index and disease progression. It was also documented that patients receiving efavirenz had shorter duration of deep sleep. Incidentally there is paucity of data in Nigeria to support these claims hence the need to investigate. Methods: Four hundred HIV zero-positive patients were recruited at the HIV clinic of Kwara State Specialist Hospital, Sobi, Ilorin, after institutional ethical approval and informed consent was obtained. Blood pressure was measured. Classification of hypertension was made according to the seventh report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of high blood pressure (JNC-7). Body Mass Index was calculated as (kg/m2). The Patient Health Questionnaire (PHQ-9) was administered to the respondents to screen for depressive symptoms. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep duration. The respondents were categorized into four groups viz, sleeping more than 7 hours, 6-7 hours, 5-6 hours and less than 5 hours. Subjects with <5hrs are poor sleepers while those with >7hrs were good sleepers. Results: Four hundred HIV-infected patients were recruited with a mean age of 39yrs (SD 9). Eighty four (21%) were male, while 316 (79%) were female. The mean body mass index was 22.0 (SD 4.6), mean present CD4 count was 339.0 (SD 180.6). One hundred and eighty three respondents (45.8%) slept less than 5 hours, while 58 (14.5%) sleep more than 7hours. Short sleep was commoner in the age group 31-40 73(39.9%), among the female 145(79.2%) and those that were married 103(56.7%), and those with non-formal education 84(45.9%). Traders 80(43.7%) had highest number than other occupation. Short sleepers of less than 5 hours were prone to high blood pressure; higher body mass index and depression. This was statistically significant. The lower the CD4 count, the more the short sleep duration observed among the respondents. Patients receiving HAART containing efavirenz had shorter duration of deep sleep. Conclusion: Almost half of the respondents were poor sleepers with associated high blood pressure and increased body mass index (BMI). Both effects of the virus and antiretroviral drugs may cause short sleep duration. Health providers managing HIV positive patients, need to take complaints of short sleep duration seriously, because they can indicate an increased risk for low CD4 counts, high viral load, depression, high blood pressure and increase body mass index. There is the need for targeting efforts to improve short sleep duration for the majority of adults living with HIV/AIDS and tailoring appropriate interventions.
ABSTRACT
Background: Peripheral arterial disease (PAD) is rarely sought for and generally underdiagnosed even in diabetics in developing countries like Nigeria. PAD is easily detected and diagnosed by the ankle-brachial index; a simple and reliable test. Objectives: To determine the prevalence of PAD in diabetic subjects aged 50-89 years and the value of ankle-brachial index measurement in the detection of PAD. Method: A cross-sectional descriptive study of 219 diabetic subjects aged 50-89 years was carried out. The participants were administered a pre-tested questionnaire and measurement of ankle-brachial index (ABI) was done. The ankle-brachial index 0.90 was considered equivalent to peripheral arterial disease. Results: The overall prevalence of PAD was 52.5. The prevalence of symptomatic PAD was 28.7whilst that of asymptomatic PAD was 71.3. There were a number of associations with PAD which included; age (p 0.05); sex (p 0.05); and marital status (p 0.05). The use of the ankle-brachial index in the detection of PAD was clearly more reliable than the clinical methods like history of intermittent claudication and absence or presence of pedal pulses. Conclusion: The prevalence of PAD is relatively high in diabetic subjects in the southwestern region of Nigeria. Notable is the fact that a higher proportion was asymptomatic. Also the use of ABI is of great value in the detection of PAD as evidenced by a clearly more objective assessment of PAD compared to both intermittent claudication and absent pedal pulses
Subject(s)
Aged , Diabetes Mellitus , Nigeria , Peripheral Arterial Disease , PrevalenceABSTRACT
Background: In many developing countries obesity and obesity-related morbidity are now becoming a problem of increasing importance. Obesity is associated with a number of disease conditions, including hypertension, type 2 diabetes mellitus, cardiovascular diseases, cancer, gallstones, respiratory system problems and sleep apnoea. Objectives: The aim of this study was to determine the prevalence of hypertension and obesity, as classified according to waist circumference (WC), and further to determine whether there was any association between abdominal obesity and hypertension amongst adults attending the Baptist Medical Centre, Ogbomoso, Nigeria. Method: A cross-sectional descriptive study of 400 adults aged 18 years or older was conducted. Blood pressure and WC measurements were taken and participants completed a standardised questionnaire. Results: A group of 400 participants were randomly selected (221 women; 179 men), with a mean age of 48.7 ± 16.6 years. The overall prevalence of obesity as indicated by WC was 33.8%(men = 8.9%; women = 53.8%). Women were significantly more sedentary than men (50.8% for men vs 62.4% for women, p<0.05). Most of the obese participants' families also preferred high-energy foods (85.2%, p>0.05). Overall prevalence of hypertension amongst the study population was 50.5%, but without a significant difference between men and women (52.0% for men vs 49.3% for women, p>0.05). The prevalence of hypertension amongst the obese subset, however, was 60.0%. Conclusion: Prevalence of abdominal obesity was found to be particularly significant amongst women in this setting and was associated with hypertension, physical inactivity and the consumption of high-energy diets