Factors associated with undernutrition and overweight in elderly patients presenting at a primary care clinic in Nigeria

Background: Undernutrition and overweight are commonly overlooked health problems of the elderly, often due to the implicit assumption that undernutrition is a rare occurrence in old age and overweight is an invariable consequence of ageing. Method: A cross-sectional descriptive study of 500 patients aged 60 years and above who presented consecutively at the general outpatient department, University College Hospital, Ibadan, between September and October 2009, was undertaken. The main outcome measures were prevalence of nutritional problems (undernutrition and overweight), healthcare utilisation pattern and morbidities. The Mini Nutritional Assessment (MNA) tool was used to assess undernutrition, while body mass index was used to assess body weight. Results: The prevalence of undernutrition and overweight was 7.8% and 54.1%, respectively. Previous hospital admission (p < 0.001) and chronic morbidities like hypertension (p < 0.001), osteoarthritis (p < 0.001) and psychosomatic disease (p < 0.001) were significantly associated with undernutrition, but not with overweight. Logistic regression analysis showed that previous hospital admission (OR = 2.105, 95% CI 1.479-2.996) and hypertension (OR = 0.122, 95% CI 0.048-0.306) were the most important factors contributing to the development of undernutrition. Conclusion: Nutritional problems were prevalent among the elderly in this setting. Co-morbidities in the elderly constitute risk factors to be addressed in order to reduce the occurrence of nutritional problems. Health workers should always assess the elderly for nutritional problems, together with other morbidities with which they may present, and institute appropriate management

Prognosis of Non Traumatic Coma: The Role of some Socio-Economic Factors on its Outcome in Ibadan; Nigeria

Background : Coma occurring in the course of an illness; irrespective of cause; traditionally implies a poor prognosis and many factors may determine its outcome. These factors must be identified and possibly stratified in their order of importance. This research seeks to identify these factors and how they influenced the outcome of non-traumatic coma in our environment. Methods : Two hundred consecutive patients; aged 18-79 years who met the inclusion criteria; the Glasgow coma scale (GCS) score of 8; history and physical findings suggestive of medical illness; no head trauma or sedation; were recruited into the study from August 2004 to March 2005 at the University College Hospital (UCH); Ibadan; after obtaining institutional ethical clearance and consent from patients' guardians. Detailed history of illness including the bio-data and time to present to the hospital and treatments given were noted. Thereafter; the clinical course of the patients was monitored daily for a maximum of 28 days during which the support of the family and/ or the hospital social welfare was evaluated. Results : During the 8-month period of the study; 76(152) of the patients died while 24(48) survived. The following factors were associated with high mortality rate: inability to confirm diagnosis (100); poor family support (97.1); delay in making a diagnosis within 24 h (85.4); poor family understanding of disease (84.1); need for intensive care admission and management (83.3); poor hospital social welfare support (82.4); presentation to UCH after 6 h of coma (76.7); and referral from private health facilities (75.7). Others include substance abuse (100) and seropositivity to HIV (96) and hepatitis B surface antigen (92) antibodies; among others. Conclusion : This study has demonstrated that socio-economic factors such as gender; occupation; risky lifestyle behaviors; late presentation or referral to hospital; late diagnosis and treatment; and poor family support contributed to poor outcome of nontraumatic coma. It is hoped that improvement; modification; or correction of these factors may improve coma outcome

Detection of HTLV-I antibodies and DNA in blood sample of a patient with myelopathy in Nigeria

Descrevemos um caso de infecçäo por HTLV-I associado a mielopatia, em mulher de 50 anos, na Nigeria. A paciente apresentou fraqueza progressiva dos membros inferiores e posteriormente incapacidade para andar. A presença de anticorpo HTLV-I no plasma coletado da paciente foi repetidamente detectada pelos ensaios imunoenzimaticos (Abbott HTLV-I EIA e Coulter SELECT-HTLV I/II) e confirmada pela tecnica de Western Blot. Adicionalmente amplificou-se o DNA do HTLV-I a partir do DNA genomico isolado das celulas mononucleares do sangue periferico da paciente através da técnica de PCR. Este achado e significativo sendo o primeiro relato de associaçäo de HTLV-I com mielopatia, na Nigeria