Prevalence of echocardiographic left ventricular hypertrophy among hypertensives in a tertiary health institution in Nigeria

OBJECTIVE: Systemic hypertension remains an important risk factors for cardiovascular diseases and a major global public health problem. Left ventricular hypertrophy (LVH) is a recognized complication of hypertension and strongly predicts cardiovascular morbidity and mortality. In Nigeria, few studies evaluated the role of echocardiography in the diagnosis of LVHs among hypertensives. This study sets out to determine the prevalence of LVH among hypertensives as determined by echocardiography.MATERIAL AND METHODS: One hundred and seventy-eight hypertensives and eighty-nine age and sex-matched controls were recruited consecutively into the study. They all had echocardiography done to determine which among had LVH. The partition value for LVH for hypertensives was determined using the 97th percentile of the left ventricular mass for controls as a cutoff point. RESULTS:Echocardiographic determined the prevalence of LVH among hypertensives was 32.4%.CONCLUSION:The echocardiographic prevalence of LVH was 32.4% in the study population. This is a significant proportion among the study population considering the clinical impact of LVH among patients with hypertension.

Evidence Brief: Improving the Healthiness of Food Environments in the Caribbean

Caribbean countries have a number of issues in common regarding food security: these small open economies have limited agricultural resource bases; their food production is prone to disruption by natural disasters; there is a heavy reliance on imported commodities, as opposed to local food production; and trade liberalization has made relatively cheaper processed energy-dense foods, with high fat, sugar and sodium content, widely available on the domestic market. These factors combined, have resulted in unhealthy food choices and dietary practices among the population and a concomitant increase in the prevalence of obesity and diet-related non-communicable diseases. There is consensus among international agencies and the research community, that in order to promote healthier food environments, governments should launch a holistic response targeting seven areas: food composition; food labelling; food promotion; food provision; food retailing; food prices; and trade and foreign investments in food. The ability of Caribbean governments to implement these measures has, however, been constrained due to the challenges which they face in:1. coordinating decision - making across all State levels—a chieving a whole-of government response; 2. gaining broad participation from all sectors of society—the all-of-society approach; and 3. developing and enacting required legislation. These constraints have stymied implementation of a comprehensive and effective response to diet-related non-communicable disease...

Dialogue summary: improving the healthiness of food environments in the Caribbean

The evidence brief on Improving the Healthiness of Food Environments was used as the starting point for the deliberations during the stakeholder dialogue. The evidence brief recognized that the relationship between environmental factors and dietary choices was complex and multifaceted, however, it positioned four issues as the most important to understanding the problem in the Caribbean:Firstly, Caribbean States were identified as net food importing countries with heavy reliance on imports as the main source of food, and this resulted in wide availability and affordability of highly-processed unhealthy foods on the domestic market;Secondly, the surrounding environment faced by some groups, including children, urban populations and the poor made them more susceptible to poor dietary choices.Thirdly, the food choices made in response to macro and micro environmental influences led to a high prevalence of diet-related NCDs which placed heavy direct and indirect cost burdens on Caribbean countries;Finally, the brief noted that despite the range of cost-effective evidence-based policy interventions available to address the various issues related to unhealthy food environments, Caribbean countries faced a number of implementation challenges that constrained their ability to mount a comprehensive response.

Evidence brief: preventing interpersonal and self-directed violence and injuries in the Caribbean

The issue of violence and injuries and its status as a major public health problem has gained significant political traction both internationally and within the Caribbean region during the last two decades. Internationally, the momentum began to build across the Americas in 1993 with PAHO resolution CD37.R19 (Violence and Health)(1), and in 1996 when, at the 49th World Health Assembly, resolution 49.25 first helped to establish the issue of violence and injuries as a recognized global health priority. Specifically it urged member states to: 1) assess the problem of violence in their own jurisdictions; and 2) communicate the extent of their problems to the World Health Organization (WHO) with suggestions about solutions.(2) Building on these efforts, in 2002 WHO released the World Report on Violence and Health, which was the first comprehensive review of the problem of violence on a global scale, and helped to further raise the profile of the issue on the agendas of global institutions and several national governments.(3,4) The report also led to the development of the Global Status Report on Violence Prevention, which was published in 2014 with data from 133 countries (including five English-speaking Caribbean countries). (3-5)...

Picaduras por escorpión Tityus asthenes en Mutatá, Colombia: aspectos epidemiológicos, clínicos y toxinológicos / Tityus asthenes scorpion stings: epidemiological, clinical and toxicological aspects

Introducción. El escorpionismo afecta a países tropicales como Colombia.Objetivo. Determinar los indicadores ecológicos y epidemiológicos de las picaduras por Tityus asthenes en cuatro localidades de Mutatá, Colombia, y las características clínicas del envenenamiento y toxinológicas del veneno. Materiales y métodos. Es un estudio prospectivo/retrospectivo descriptivo y experimental; se visitaron aleatoriamente 324 de las 1.448 viviendas del municipio: 188 urbanas (58,0%) y 136 rurales (42,0%), con 1.593 habitantes. En 18 meses se estudiaron prospectivamente los pacientes picados por T. asthenes que ingresaron al hospital local y, retrospectivamente en encuestas domiciliarias, se determinó el subregistro. Se recolectaron escorpiones vivos y se realizaron experimentos con el veneno. Resultados. Hubo 12,9 más probabilidades de hallar ejemplares de T. asthenes en el área rural (OR=6,5; IC95% 3,9-10,8), en el intradomicilio y peridomicilio cercano a bosques y plantaciones agrarias altas (OR=13,0; IC95% 7,5-23,0). Se reportaron 80 picaduras ocurridas en los dos últimos años (prevalencia de 4,1%; IC95% 4,8-3,3); sólo 14 personas (17,5%) consultaron al hospital (subregistro de 82,5%). La prevalencia ponderada de infestación por escorpiones en las viviendas encuestadas fue de 26,9% (112 casas) (IC95% 30,8-22,9). El 50% de los accidentes ocurrió en la localidad de Caucheras: 10,6% de proporción de ataque. El envenenamiento sistémico fue más frecuente en niños (67%). La dosis letal 50 del veneno en ratones de 18 a 20 g, fue 121,6 μg (IC95% 103,7-139,6). Hubo reactividad inmunológica por Western blot de los antivenenos del Instituto Bioclón, México (Alacramyn®) y del Instituto Butantan, Brasil (Soro antiaracnídico®)...

Introduction. Scorpion stings are a public health problem in many countries. However, in Colombia, very few epidemiological, clinical or toxicological studies have been undertaken. Objective. Ecological and epidemiological aspects were related to the prevalence of scorpion stings by Tityus asthenes. The clinical features of envenomization were described in patients and in an experimental animal model. Materials and methods. The study was conducted in four localities of Mutatá and Urabá Counties in the province of Antioquia, Colombia. The sample consisted of 1,593 (929 urban, 664 rural) of the 5,305 exposed people, inhabitating 324 households (188 urban (58%); 136 rural (42%) of 1,448 houses total in the study area. An interview survey was performed in every selected family for a more realistic estimate of sting prevalence. Additionally, a prospective study was directed toward patients presenting scorpion stings at care at the local hospital over an 18-month period. Results. The probability was 12.9 times greater of finding T. asthenes inside or around houses in places near to forest and high agrarian plantations (odds ratio=13). Eighty scorpion stings were reported in the retrospective study (4.1% prevalence [95% CI 3.3-4.8%] ), but only 14 of the patients (17.5%) sought care in the local hospital (an 82.5% underreportage). Seventy percent of the stings occurred in rural places; 50% occurred in the locality of Caucheras, with an attack rate of 10.6%. The overall household infestation rate was 269% (95% CI 22.9-30.8%) and an area dispersion ratio of 100%. Signs of systemic envenomization occurred mainly in children (67%). The 50% lethal dose of T. asthenes venom was 121.6 μg for 18-20 g Swiss Webster rats (95% CI 103.7-139.6). Immunodetection of T. asthenes and Centruroides gracilis/C.margantatus venoms in the experimental animals was possible when were tested by Western blot against Alacramyn® (Instituto Bioclón, México) and Soro antiaracnídico®...

Estimativa do erro entre examinadores, usando metodologia da Organização Mundial da Saúde para levantamentos epdemiológicos de Saúde Bucal / Error estimate among examiners using the methodology of the World Health Organization for epidemiological studies in oral health

O autor objetiva estimar o erro entre examinadores, usando a metodologia da Organização Mundial da Saúde para levantamentos epidemiológicos de Saúde Bucal, através do exame de 30 escolares, de 14 a 16 anos, ambos os sexos, realizados por dois cirurgiões-dentistas, sem experiência neste tipo de pesquisa. O erro encontrado entre examinadores foi menor que 2 por cento. Para análise estatística foi utilizado o teste «t¼ de Student, com x=5 por cento. Os resultados indicam que não há erro estatisticamente significante, para x=5 por cento, na amostra examinada