Type 2 Diabetes Mellitus in Ambulatory Adult Nigerians: Prevalence and Associated Family Biosocial Factors in a Primary Care Clinic in Eastern Nigeria: A Cross-sectional Study.

Background: Type 2 diabetes mellitus is a multi-factoral medical condition that aggregates in the family and has implications for family health. Research analyses of determinants of type 2 diabetes mellitus have demonstrated the interactions and clustering of family biosocial factors in its epidemiology. Aim: To determine the prevalence of type 2 diabetes mellitus and describe the associated family biosocial factors in ambulatory adult type 2 diabetic Nigerians in a primary care clinic in Southeastern Nigeria. Study Design: This was a cross-sectional study. Seven hundred and fifty patients were screened for diabetes mellitus and thirty five of them who had diabetes mellitus were age and sex matched with thirty five non-diabetic, non-hypertensive patients for the determination of the association with family biosocial factors. Place and Duration of Study: The study was carried out at a primary care clinic in Umuahia, South-eastern Nigeria in May 2011. Methodology: Data on family biosocial factors were obtained using pretested, structured and interviewer-administered questionnaire. Diabetes mellitus was defined using American Diabetes Association criterion. Results: The prevalence of type 2 diabetes mellitus was 4.7%. Eleven (1.5%) of the diabetic patients were newly diagnosed in the hospital. There were fourteen (40.0%) males and twenty one (60.0%) females with sex ratio of 1:1.5. The age ranged from 28-82 years with mean age of 47±11.2 years. The middle aged adults were predominantly affected. Family biosocial factors significantly associated with type 2 diabetes were family history of hypertension (P=.006) and diabetes mellitus (P=.048). A significantly higher proportion of the diabetic patients had family history of hypertension compared to the non-diabetic and non-hypertensive subjects. The diabetic patients were one and half times more likely to have family history of hypertension compared to their non-diabetic and non-hypertensive counterparts. Conclusion: The study has shown the prevalence of type 2 diabetes mellitus with predilection for middle aged adult Nigerians. The associated family biosocial factors were family history of hypertension and diabetes mellitus. Screening adult Nigerians with family history of hypertension and diabetes mellitus for diabetes mellitus is recommended in primary care setting for familycentred preventive care.

Studies on the distribution of clinically diagnosed pulmonary tuberculosis in Ebonyi State, Nigeria

A study was conducted between January; 2005 to December; 2006 to ascertain the prevalence of pulmonary tuberculosis among patients who attended chest clinics in some randomly selected hospitals; Clinics and Health Centers in Ebonyi State; Nigeria. Investigations were carried out using the two popular diagnostic criteria for pulmonary tuberculosis namely the specific Ziehl Neelsen (ZN) methods and chest X-ray. A total of 962 patients with clinical signs and symptoms of tuberculosis were studied. Out of this figure; 559 (58.1) had pulmonary tuberculosis with 1:1 male/female ratio. There was no significant difference between ZN sputum smear positive and chest x-ray in the diagnosis of pulmonary tuberculosis in the studied population at 95confidence level. The possible reasons for the high prevalence of pulmonary tuberculosis may be attributed to increase in the incidence of HIV/AIDS; high rate of poverty; emergence of drug-resistant strains of Mycobacteria and to a lesser extent; smoking and diabetes

Epidemiology, therapeutic agents and cost of management of paediatric malaria in a Nigerian tertiary hospital.

BACKGROUND AND OBJECTIVES: Malaria is the most widespread parasitic disease in sub-Saharan Africa with associated high morbidity and mortality especially among the highly predisposed population of pregnant women and children of age five years and below. Living in malaria endemic regions of the world has become associated with health and economic hazards placing financial and productive burden on affected households. METHODS: A prospective study of children treated for malaria and other associated illnesses at a Nigeria tertiary health institution between May and October 2003 was undertaken. The various malaria-associated diseases treated were determined from their provisional diagnosis, hospital records and causative agents confirmed from their diagnostic laboratory results. Cost of treatment was determined from the patients' guardian and confirmed from relevant hospital departments. Common drugs for malaria treatment, their costs, relative effectiveness and frequency of use were determined through a completed questionnaire by health officers and patients' guidance. RESULTS: Of 5356 paediatric patients suspected of having malaria, 5100 (95.2%) were confirmed positive for malaria parasites microscopically. Of these, 4119 (80.8%) were aged 0 - 6 years, with children aged 1 to 3 years being mostly affected. Eight hundred and twenty (16.1%) of them were in-patients spending an average of six days on hospital bed. Over 22 million naira (dollar 0.22 m) was spent on the treatment of malaria with drugs accounting for the major cost (66.81%). About 33.7% of the patients had malaria complicated with other diseases. INTERPRETATION AND CONCLUSION: The effectiveness of common therapeutic agents used for malaria treatment, their costs and associated side effects is discussed. Recommendations are made for appropriate care and government subsidy for paediatric malaria management in sub-Saharan Africa.