Assessment of Right Ventricular Systolic Function using Tricuspid Annular Plane Systolic Excursion (TAPSE) among HIV Patients on HAART and Its Relationship with Viral Load and CD4 Cell Count.

BACKGROUND: The introduction of highly active antiretroviral therapy (HAART) has decreased the morbidity and mortality associated with HIV infection; however, this survival advantage is not free from complications. HIV patients are more likely to develop cardiovascular disease compared with the general population, and right ventricular systolic dysfunction is said to be associated with worse outcomes. We, therefore, sought to assess right ventricular systolic function using tricuspid annular plain systolic excursion (TAPSE) among HIV patients on HAART and its relationship with viral load and CD4 cell count. METHODS: The study was a cross-sectional conducted among HIV patients receiving HAART at the Federal Medical Centre, Nguru, Yobe State, Northeastern Nigeria. Right ventricular systolic function was assessed using tricuspid annular plane systolic excursion. RESULTS: One hundred and seven (107) subjects were recruited into the study comprising thirty-seven (34.6%) males and seventy (65.4%) females. The mean CD4 cell count and viral load of the studied patients were 612.65 ± 347.62 cells/µL and 315.44±271.11copies/mL, respectively. The distribution of RVSF according to CD4 cell count showed, fifteen (14.01%) patients with CD4 cell count less than 250 had reduced right ventricular systolic function (RVSF), 30 (28.03%) patients with CD4 cell count 250 - 500 had reduced RVSF, 1 (0.93%) patient with CD4 cell count 250 - 500 had normal RVSF, 47 (43.92%) patients with CD4 cell count 501 -1,000 had normal RVSF and 14(13.08%) patients with CD4 cell count greater than 1,000 had normal RVSF. Fourteen (13.08%) patients with undetectable viral load had normal RVSF, 47(43.92%) patients with viral load 50 - 1,500 had normal RVSF, 1(0.93%) patient with viral load 1,501 - 10,000 had normal RVSF, 30(28.03%) patients with viral load 1,501 - 10,000 had reduced RVSF and 15(14.01%) patients with viral load 10,000 - 50,000 had reduced RVSF. There was a positive and significant correlation between tricuspid annular plain systolic excursion with CD4 cell count and a negative but significant correlation HIV viral load. CONCLUSION: We therefore concluded that asymptomatic right ventricular systolic dysfunction exists among patients with HIV infection and there was positive and significant correlation between tricuspid annular plain systolic excursion with CD4 cells count and a negative but significant correlation HIV viral load.

CONTEXTE: L'introduction du traitement antirétroviral hautement actif (HAART) a réduit la morbidité et la mortalité associées à l'infection par le VIH; cependant, cet avantage de survie n'est pas exempt de complications. Les patients VIH ont plus de risques de développer des maladies cardiovasculaires par rapport à la population générale, et une dysfonction systolique ventriculaire droite est dite être associée à des résultats plus graves. Nous avons donc cherché à évaluer la fonction systolique ventriculaire droite à l'aide de l'excursion systolique du plan annulaire tricuspidien (TAPSE) chez les patients VIH sous HAART et sa relation avec la charge virale et le taux de lymphocytes CD4. MÉTHODES: L'étude était une étude transversale menée auprès de patients VIH recevant le HAART au Federal Medical Centre, Nguru, État de Yobe, dans le nord-est du Nigéria. La fonction systolique ventriculaire droite a été évaluée à l'aide de l'excursion systolique du plan annulaire tricuspidien. RÉSULTATS: Cent sept (107) sujets ont été recrutés dans l'étude, dont trente-sept (34,6%) hommes et soixante-dix (65,4%) femmes. Le taux moyen de lymphocytes CD4 et la charge virale des patients étudiés étaient respectivement de 612,65 ± 347,62 cellules/µL et 315,44 ± 271,11 copies/mL. La répartition de la fonction systolique ventriculaire droite selon le taux de lymphocytes CD4 a montré que quinze (14,01%) patients ayant un taux de lymphocytes CD4 inférieur à 250 présentaient une fonction systolique ventriculaire droite réduite, 30 (28,03%) patients ayant un taux de lymphocytes CD4 de 250 à 500 avaient une fonction systolique ventriculaire droite réduite, 1 (0,93%) patient ayant un taux de lymphocytes CD4 de 250 à 500 avait une fonction systolique ventriculaire droite normale, 47 (43,92%) patients ayant un taux de lymphocytes CD4 de 501 à 1 000 avaient une fonction systolique ventriculaire droite normale et 14 (13,08%) patients ayant un taux de lymphocytes CD4 supérieur à 1 000 avaient une fonction systolique ventriculaire droite normale. Quatorze (13,08%) patients avec une charge virale indétectable avaient une fonction systolique ventriculaire droite normale, 47 (43,92%) patients avec une charge virale de 50 à 1 500 avaient une fonction systolique ventriculaire droite normale, 1 (0,93%) patient avec une charge virale de 1 501 à 10 000 avait une fonction systolique ventriculaire droite normale, 30 (28,03%) patients avec une charge virale de 1 501 à 10 000 avaient une fonction systolique ventriculaire droite réduite et 15 (14,01%) patients avec une charge virale de 10 000 à 50 000 avaient une fonction systolique ventriculaire droite réduite. Il y avait une corrélation positive et significative entre l'excursion systolique du plan annulaire tricuspidien et le taux de lymphocytes CD4 et une corrélation négative mais significative avec la charge virale du VIH. CONCLUSION: Nous concluons donc qu'une dysfonction systolique ventriculaire droite asymptomatique existe chez les patients atteints d'une infection par le VIH et qu'il existe une corrélation positive et significative entre l'excursion systolique du plan annulaire tricuspidien et le taux de lymphocytes CD4, ainsi qu'une corrélation négative mais significative avec la charge virale du VIH. MOTS CLÉS: Fonction Systolique Ventriculaire Droite, Excursion Systolique du Plan Annulaire Tricuspidien (TAPSE), CD4, Charge Virale, VIH.

Impact of Climate Change on Management of Systemic Hypertension in North-Eastern Nigeria.

The impact of climate change on health, including changes in epidemiology and heat-related complications, has been variously reported in many parts of the world. Maiduguri, the capital of Borno state in north-eastern Nigeria, has been bearing the brunt of increasing temperatures over the past years, especially during the early months of the year building up to the commencement of the rainy season; with an average daily temperature forecasted to be around 40C. Patients with systemic hypertension and other forms of cardiovascular diseases are vulnerable to heat-related complications including dehydration, hypotension, and orthostatic hypotension (OH). This is particularly true in patients receiving various forms of antihypertensive medication, including diuretics. We present three cases of symptomatic OH occurring during the peak of heat season in Maiduguri among patients receiving various combinations of antihypertensive medication.L'impact du changement climatique sur la santé, y compris les changements dans l'épidémiologie et les complications liées à la chaleur, a été diversement rapporté dans de nombreuses régions du monde. Maiduguri, la capitale de l'État de Borno, dans le nord-est du Nigeria, a subi de plein fouet l'augmentation des températures au cours des dernières années, en particulier au cours des premiers mois de l'année, jusqu'au début de la saison des pluies. Les patients souffrant d'hypertension systémique et d'autres formes de maladies cardiovasculaires sont vulnérables aux complications liées à la chaleur, notamment la déshydratation, l'hypotension et l'hypotension orthostatique (OH). Cela est particulièrement vrai chez les patients recevant diverses formes de médicaments antihypertenseurs, notamment des diurétiques. Nous présentons trois cas d'OH symptomatique survenus pendant le pic de la saison chaude à Maiduguri chez des patients recevant diverses combinaisons de médicaments antihypertenseurs. Mots clés: Changement climatique, Hypertension, Agents antihypertenseurs, Hypotension orthostatique, Zone semiaride, Maiduguri, Nigeria.

Relationship between CD4 Cell Count, Viral Load and Left Ventricular Function among HIV-1 Infected Patients Asymptomatic for Cardiac Disease on HAART.

INTRODUCTION: Human immunodeficiency virus (HIV) infected patients are at increased risk for myocardial infarction and cardiomyopathy. Low CD4 cell count and high viral load were identified as independent risk factors for cardiac disease. Asymptomatic cardiac dysfunction has also been reported in HIV-infected individuals. METHODS: This was a cross-sectional study conducted among consecutive HIV patients who are asymptomatic for cardiac disease receiving highly active antiretroviral therapy (HAART) at the ART clinic of Federal Medical Centre Nguru, Yobe State Northeastern Nigeria. DATA ANALYSIS: Statistical analysis was done using SPSS version 21.0 (SPSS IBM) Chicago Illinois. Data were presented as mean ± standard deviation (SD) for continuous variables, while categorical variables were expressed as frequencies and proportions. Correlation and regression analyses were done to determine the relationship between CD4 cell count, viral load and left ventricular function. A p-value of d"0.05 was considered significant. RESULTS: Patients with high CD4 cells count (>500 cells/µL) were found to have preserved left ventricular systolic function while those with low CD4 cells count (500 cells/µL while those with low CD4 cell count (1500 copies/mL) were associated with reduced left ventricular systolic function and severe diastolic dysfunction. We therefore suggest that there is need for early evaluation of left ventricular function in HIV patients before developing symptoms of cardiac decompensation.

RÉSUMÉ: Les patients infectés par le virus de l'immunodéficience humaine (VIH) présentent un risque accru d'infarctus du myocarde et de cardiomyopathie. Un faible nombre de cellules CD4 et une charge virale élevée ont été identifiés comme des facteurs de risque indépendants de maladie cardiaque. Un dysfonctionnement cardiaque asymptomatique a également été rapporté chez des personnes infectées par le VIH. MÉTHODES: Il s'agissait d'une étude transversale menée auprès de patients VIH consécutifs asymptomatiques de maladie cardiaque recevant un traitement antirétroviral hautement actif (HAART) à la clinique ART du Federal Medical Center Nguru, dans l'État de Yobe, au nord-est du Nigéria. ANALYSE DES DONNÉES: L'analyse statistique a été effectuée à l'aide de SPSS version 21.0 (SPSS IBM) Chicago Illinois. Les données ont été présentées sous forme de moyenne ± écart-type (SD) pour les variables continues, tandis que les variables catégorielles ont été exprimées sous forme de fréquences et de proportions. Des analyses de corrélation et de régression ont été effectuées pour déterminer la relation entre le nombre de cellules CD4, la charge virale et la fonction ventriculaire gauche. Une valeur p de d"0,05 a été considérée comme significative. RÉSULTATS: Les patients avec un nombre élevé de cellules CD4 (> 500 cellules/µL) ont conservé la fonction systolique ventriculaire gauche tandis que ceux ayant un faible nombre de cellules CD4 (500 cellules/µL tandis que ceux ayant un faible nombre de cellules CD4 (1500 copies/mL) étaient associée à une fonction systolique ventriculaire gauche réduite et à un dysfonctionnement diastolique sévère. Nous suggérons donc qu'il est nécessaire d'évaluer précocement la fonction ventriculaire gauche chez les patients VIH avant de développer des symptômes de décompensation cardiaque. MOTS CLÉS: VIH, fonction ventriculaire gauche, numération des CD4 et charge virale.

Bacterial isolates associated with pelvic inflammatory disease among female patients attending some hospitals in abuja, Nigeria.

BACKGROUND: Pelvic inflammatory disease refers to any infection in the female lower reproductive tract that spreads to the upper reproductive tract. The disease comprises a spectrum of inflammatory disorders of the upper female genital tract, including any combination of endometritis, salpingitis, tubo-ovarian abscess and pelvic peritonitis. PID is not a notifiable disease in most countries, so accurate statistics are not available. This situation is not in any way different here in Nigeria and more so in the Federal Capital Territory, Abuja where this research was conducted, there had never been any published report so far on PID. It therefore became pertinent that such studies be carried out to evaluate the bacterial organisms which may be associated with the disease in this part of Nigeria so that health care providers could take a better look at this affliction in women. MATERIALS AND METHODS: Endocervical swabs totalling 100 were aseptically collected from patients with confirmed Pelvic Inflammatory Disease (PID), attending some hospitals in Abuja, Nigeria for detection of bacterial pathogens based on cultural and biochemical characterisation tests. Antibiogram was also conducted on the identified bacterial isolates. RESULTS: Out of the 100 samples analysed, 43% yielded pure cultures of bacterial isolates, 2% yielded mixed cultures while no bacterial growths were recorded from the remaining 55% samples. Organisms encountered were Staphylococcus aureus (16%), Escherichia coli (10%), Streptococcus faecalis (8%), Pseudomonas aeruginosa (4%), Streptococcus pyogenes (3%), Klebsiella pneumoniae (3%), Proteus rettgeri (2%) and Proteus mirabilis (1%). The highest percentage occurrence of pathogenic isolates was observed in polygamous married patients (90%). The age group most affected falls within the mean age 30.5 years (68%) while the least affected group falls within the mean age 40.5 years (5%). There was a significant difference in the acquisition of PID in relation to marital status (P < 0.05). However there was no significant difference in the acquisition of the disease with respect to age (P > 0.05). Antibiogram patterns of pathogenic isolates revealed varied resistance to most of the antibiotics employed. Cefotaxime (a new generation cephalosporin antibiotic) was established in this study as the best antimicrobial agent for treatment of PID due to Gram-positive and Gram-negative bacteria isolated from the women examined. CONCLUSION: In conclusion, Pelvic inflammatory disease is a major health problem in developed or developing countries of the world. PID is not a notifiable disease, as accurate statistics on disease prevalence are rarely available. There is therefore no doubt thousands of young women have salpingitis every year and their sheer number makes it an important health problem. PID hence can be said to be a very serious complication of sexually transmitted disease which should be critically and promptly handled by healthcare providers. The right type sample should be aseptically collected and be appropriately handled for laboratory investigation. Treatment of PID should be initiated as soon as the presumptive diagnosis has been made. Immediate administration of antibiotics has been effective in the long-term sequelae associated with PID, especially new generation antibiotics, such as cefotaxime as recorded in this study.

Bacterial isolates associated with pelvic inflammatory disease among female patients attending some hospitals in Abuja, Nigeria

Background: Pelvic inflammatory disease refers to any infection in the female lower reproductive tract that spreads to the upper reproductive tract. The disease comprises a spectrum of inflammatory disorders of the upper female genital tract; including any combination of endometritis; salpingitis; tubo-ovarian abscess and pelvic peritonitis. PID is not a notifiable disease in most countries; so accurate statistics are not available. This situation is not in any way different here in Nigeria and more so in the Federal Capital Territory; Abuja where this research was conducted; there had never been any published report so far on PID. It therefore became pertinent that such studies be carried out to evaluate the bacterial organisms which may be associated with the disease in this part of Nigeria so that health care providers could take a better look at this affliction in women. Materials and Methods: Endocervical swabs totalling 100 were aseptically collected from patients with confirmed Pelvic Inflammatory Disease (PID); attending some hospitals in Abuja; Nigeria for detection of bacterial pathogens based on cultural and biochemical characterisation tests. Antibiogram was also conducted on the identified bacterial isolates. Results: Out of the 100 samples analysed; 43 yielded pure cultures of bacterial isolates; 2 yielded mixed cultures while no bacterial growths were recorded from the remaining 55 samples. Organisms encountered were Staphylococcus aureus (16); Escherichia coli (10); Streptococcus faecalis (8); Pseudomonas aeruginosa (4); Streptococcus pyogenes (3); Klebsiella pneumoniae (3); Proteus rettgeri (2) and Proteus mirabilis (1). The highest percentage occurrence of pathogenic isolates was observed in polygamous married patients (90). The age group most affected falls within the mean age 30.5 years (68) while the least affected group falls within the mean age 40.5 years (5). There was a significant difference in the acquisition of PID in relation to marital status (P 0.05). However there was no significant difference in the acquisition of the disease with respect to age (P 0.05). Antibiogram patterns of pathogenic isolates revealed varied resistance to most of the antibiotics employed. Cefotaxime (a new generation cephalosporin antibiotic) was established in this study as the best antimicrobial agent for treatment of PID due to Gram-positive and Gram-negative bacteria isolated from the women examined. Conclusion: In conclusion; Pelvic inflammatory disease is a major health problem in developed or developing countries of the world. PID is not a notifiable disease; as accurate statistics on disease prevalence are rarely available. There is therefore no doubt thousands of young women have salpingitis every year and their sheer number makes it an important health problem. PID hence can be said to be a very serious complication of sexually transmitted disease which should be critically and promptly handled by healthcare providers. The right type sample should be aseptically collected and be appropriately handled for laboratory investigation. Treatment of PID should be initiated as soon as the presumptive diagnosis has been made. Immediate administration of antibiotics has been effective in the long-term sequelae associated with PID; especially new generation antibiotics; such as cefotaxime as recorded in this study

A survey for neutralizing antibodies to the three types of poliovirus among children in Maiduguri, Nigeria.

The milestone in polio eradication program is to protect effectively children aged 0-5 years against the three serotypes of poliovirus. It became necessary to measure the level of neutralizing antibodies to the three poliovirus types in an endemic State in Nigeria. Neutralizing antibodies to the poliovirus types among children aged 0-5 years was estimated using micro neutralization assay. Of 129 children, 99 (76.8%), 95 (73.6%), and 95 (73.6%) had neutralizing antibodies with the geometric mean titer of 42.7, 31.3, and 33.2 for the poliovirus type 1, 2, and 3, respectively. Fifty-three percent of the children were protected against the three types of poliovirus. Combination of poliovirus types 1 and 2, 1 and 3, and 2 and 3 were neutralized by 62.8, 58.9, and 61.2% of the children studied, respectively. Only poliovirus type 1 induced antibody titres ≥1:1,024. The number of children with neutralizing antibodies after receiving three doses was significantly higher than those who received one or two doses of oral polio vaccine (P ≤ 0.05). However, those who received more than three doses of oral polio vaccine showed no significant difference in their antibody response. The existence of immunity gap poses a risk of re-emergence of the paralytic poliovirus. The existence of unimmunized and unprotected children along with high birth rate could impede the success of polio vaccination in Nigeria. Elimination of non-compliance to polio vaccine, promotion of health education and documented evidence of vaccination of each child with the parents may facilitate the success of polio eradication program in Nigeria.

Sabin and wild polioviruses from apparently healthy primary school children in northeastern Nigeria.

Despite significant success of the Global Polio Eradication Initiative (GPEI) in Nigeria, Afghanistan, India, Pakistan, wild poliovirus still occurs due to persistently high proportions of under and unimmunized children. The study aimed at determining the type of poliovirus often excreted into the environment. Four hundred nine fecal samples collected from apparently healthy school children aged 5-16 years in Borno and Adamawa States, northeastern Nigeria, were tested for poliovirus by tissue culture technique. The isolates were characterized further by intratypic differentiation testing and genetic sequencing. Three wild poliovirus type, 11 Sabin type, combination of Sabin-types 1 + 2 and 2 + 3 poliovirus, and 22 non-polio enteroviruses were obtained. The continued excretion of wild-type poliovirus among children above 5 years old vaccinated with oral polio vaccine contributes to the persistent circulation of these viruses in the environment and may limit the population immunity. However, the excreted Sabin poliovirus is capable of immunizing the unvaccinated children and promotes herd immunity. Similarly, the excretion of combination of two polio serotypes indicates the child susceptibility to the missing serotype (s) and therefore indicates an immunity gap. The common unhygienic practices in the environment could aid the spread of these viruses through oral-fecal route. Asymptomatic transmission of wild poliovirus among older oral polio vaccine-vaccinated children poses a serious threat to polio eradication program in Nigeria and therefore, environmental and serological surveillance with larger sample size are important for monitoring poliovirus circulation in Nigeria.

Left ventricular geometry in Nigerians with type II diabetes mellitus.

BACKGROUND: Left ventricular hypertrophy is independently associated with increased incidence of cardiovascular disease, cardiovascular and all cause mortality. In a relatively healthy hypertensive adult population, type II diabetes is associated with higher left ventricular mass, concentric left ventricular geometry and lower myocardial function independent of age, sex, body size, and arterial blood pressure. OBJECTIVE: The study is to investigate left ventricular geometry in Nigerians with Type II Diabetes mellitus. METHODS: The study design was cross-sectional and it comprised 75 consecutive patients with type II diabetes mellitus with or without hypertension. Using a structured pre-evaluated questionnaire, the demographic and clinical data were obtained. All subjects had two dimensional (2D) and 2D derived M-mode echocardiography using Sonoline G60s Ultrasound imaging system with 4.2 MHZ transducer equipped with simultaneous ECG tracing. RESULTS: A total of 75 consecutive type II diabetic patients with or without hypertension were recruited into the study. There were 18 (24.0%) hypertensive-diabetic and 12 (16.0%) normotensive-diabetic males and Thirty-four (45.3%) hypertensive-diabetic and 11 (14.0%) normotensive-diabetic were females. Hypertensive-diabetic males had significantly higher left ventricular mass compared to normotensive-diabetic counterpart 207.05 +/- 41.5g and 156.00 +/- 27.1g P = 0.001. Similarly, left ventricular mass index was found to be higher in hypertensive-diabetic males than their normotensive-diabetic counterpart 114.50 +/- 29.2g/m2 and 92.28 +/- 20.5g/m2 P = 0.014. Hypertensive-diabetic female significantly had higher LVM compared to the normotensive-diabetics 196.06 +/- 41.5g and 161.54 +/- 31.6g P = 0.016. Left ventricular mass index was also found to be higher in hypertensive-diabetic female than their normotensive counterpart 118.52 +/- 27.8g/m2 and 95.75 +/- 23.0g/m2 P = 0.019. Hypertensive-diabetics had predominantly concentric left ventricular hypertrophy compared to the normotensive-diabetics 36 (69.2. %) and 5 (21.7%) P = 0.001. CONCLUSION: The study reported that hypertensive-diabetics have predominantly concentric left ventricular hypertrophy, higher left ventricular mass and left ventricular mass index compared to normotensive-diabetic. Female hypertensive-diabetic had predominantly concentric left ventricular hypertrophy, while male hypertensive-diabetic and normotensive-diabetic had predominantly concentric left ventricular remodelling.

C-reactive protein in healthy adult Nigerians.

BACKGROUND: C-reactive protein (CRP) is an acute phase reactant produced in the liver in response to tissue injury or systemic inflammation, its release is stimulated by cytokines (interleukin-6 and tumour necrosis factor-alpha). Elevated CRP levels have been linked to an increased risk of later development of diabetes mellitus and systemic hypertension. Baseline level of C-reactive protein in apparently healthy men and women predict long-term risk of a first myocardial infarction. METHOD: The study design was cross-sectional conducted among apparently healthy adult relative of patients and hospital staff of the Obafemi Awolowo University Teaching Hospitals complex (OAUTHC) Ile Ife, Osun State south western Nigeria. Serum lipids and fasting blood glucose were measured, while C-reactive protein measurement was based on the principle of solid phase enzyme-linked immunosorbent assay (ELISA). RESULTS: Atotal of 50 apparently healthy consecutive adult subjects were recruited into the study comprising 19 male and 31 female. There was no significant difference in mean Fasting blood glucose and serum lipids between the male and female study subjects. However, C-reactive protein was found to be higher in female compared to male, but the difference was not statistically significant. CONCLUSION: This study showed that apparently healthy adult female Nigerians have higher level of C-reactive protein compared to male, but with no significant difference.

Serum C-reactive protein in Nigerians with type II diabetes mellitus.

BACKGROUND: C-reactive protein is an acute-phase proteins, produce in the liver, its release is stimulated by cytokines (interleukin 6 and tumour necrosis factor alpha). Elevated level of it is a risk factor for coronary heart disease. Baseline levels of C-reactive protein in apparently healthy men and women predict long-term risk of a first myocardial infarction. Diabetics are at increased risk for coronary heart disease, data from the Framingham Study showed a two-to three-fold elevation in the risk of clinically evident atherosclerotic disease in patients with type II diabetes compared to those without diabetes. However, but data regarding CRP in Nigerian diabetic is lacking. OBJECTIVES: The study was to determine serum C-reactive protein in Nigerian with Type II diabetes mellitus. METHODS: The study design was cross-sectional conducted among patients attending out patient clinic of the Obafemi Awolowo University Teaching Hospitals complex (OAUTHC) Ile Ife, Osun State south western Nigeria. Measurement of C-reactive protein was based on the principle of solid phase enzyme-linked immunosorbent assay (ELISA). RESULTS: A total of 125 consecutive subjects were recruited comprising 75 patients with type II diabetes mellitus with or without hypertension and 50 apparently healthy age-and-sex comparable controls. There was a significant difference between the mean systolic and diastolic blood pressures of the patients and controls. The fasting blood glucose and C-reactive protein were significantly higher in diabetics compared to controls. There was a positive and significant correlation between FBG and CRP in both patients and controls. CONCLUSION: This study showed that diabetics have significantly higher serum C-reactive protein compared to the apparently controls. Also there was a positive and significant correlation between C-reactive protein and fasting blood glucose among both patients and controls.

Serum C-reactive protein in Nigerians with type 2 diabetes mellitus.

BACKGROUND: C-reactive protein is an acute-phase proteins, produce in the liver, its release is stimulated by cytokines (interleukin 6 and tumour necrosis factor alpha). Elevated level of it is a risk factor for coronary heart disease. Baseline levels of C-reactive protein in apparently healthy men and women predict long-term risk of a first myocardial infarction. Diabetics are at increased risk for coronary heart disease, data from the Framingham Study showed a two- to three-fold elevation in the risk of clinically evident atherosclerotic disease in patients with type II diabetes compared to those without diabetes. However, but data regarding CRP in Nigerian diabetic is lacking. METHOD: A cross-sectional study conducted among patients attending out patient clinic of the Obafemi Awolowo University Teaching Hospitals complex OAUTHC) Ile Ife, Osun State south western Nigeria. Measurement of C-reactive protein was based on the principle of solid phase enzyme-linked immunosorbent assay (ELISA). RESULTS: A total of 125 consecutive subjects were recruited comprising 75 patients with type II diabetes mellitus with or without hypertension and 50 apparently healthy age-and-sex comparable controls. There was a significant difference between the mean systolic and diastolic blood pressures of the patients and controls. The fasting blood glucose and C-reactive protein were significantly higher in diabetics compared to controls. there was a positive and significant correlation between FBG and CRP in both patients and controls. CONCLUSION: This study showed that diabetics have significantly higher serum C-reactive protein compared to the apparently controls. Also there was a positive and significant correlation between C-reactive protein and fasting blood glucose among both patients and controls.

Serological evidence of brucellosis among predisposed patients with pyrexia of unknown origin in the north eastern Nigeria.

Brucellosis is the zoonosis of world wide distribution and common cause of economic loss and ill health among animals and human populations. Patients with pyrexia of unknown origin (PUO) who were predisposed to brucellosis through rearing of animals and consumption of different animal products were tested for presence of Brucella abortus antibodies using Rose Bengal and serum agglutination antigens. Twenty six (5.2%) of the 500 patients had B. abortus antibody. The high titres of 320, 640 and 1280 obtained in the sera of patients in this study are suggestive of the endemicity of the disease in this environment. No significant difference in age and sex distribution of brucella antibody prevalence was observed. Similarly, spatial distribution of brucella antibody in different locations was not statistically significant. Although higher serological prevalence was noted in children and students than in other populations examined, the difference in prevalence between the various occupational groups was not significant. Animal handling activities including rearing are not important factors in the prevalence of brucellosis. However, among the rearers, the highest prevalence (20%) was observed among cattle handlers followed in decreasing order of prevalence by goat rearers (10%), mixed sheep and cattle rearers (9%), mixed sheep and goat rearers (8%), and 4% among each of sheep rearers and non rearers of animals. In addition, consumers of yoghurt and fresh goat milk had higher prevalence (20%) than consumers of other milk products. However, brucella antibody prevalence between consumers and non-consumers of animal products was not significantly different. The high economic loss and public health implications of brucellosis necessitates the need for effective surveillance as well as appropriate preventive and control measure among human and animal populations.

Prevalence of hepatitis B surface antigen among patients suspected of liver diseases in a Nigerian hospital.

Hepatitis B virus (HBV) infection has been reported to be the aetiological factor for hepatocellular carcinoma (HCC), hepatitis and liver cirrhosis. This study was therefore carried out to determine the seroprevalence of hepatitis B surface antigen (HBsAg), a specific marker of HBV infection in patients with suspected liver diseases. The investigation was carried out among patients attending the University of Maiduguri Teaching Hospital (UMTH), Nigeria with clinical symptoms suggestive of liver diseases and others with non-specific clinical features during the period from 1990-1995. A total of 197 (38%) of 517 patients tested positive for HBsAg, 81 (49%) out of 144 with symptoms suggestive of hepatitis, 75 (50%) of 149 HCC and 10 (56%) of 18 liver cirrhosis were HBsAg positive. Comparison of the yearly total prevalence values of HBsAg for the six years under study showed no significant difference. Similarly, yearly prevalence values amongst patients with suspected liver diseases showed no significant differences. Nevertheless, significant difference, (P < 0.05) between the prevalence of HBsAg among suspected cases of liver diseases and others with non-specific signs and symptoms was observed. Similarly, HBsAg was statistically significantly higher among males than females. The high prevalence rate of HBsAg in our environment may be associated with the suspected cases of liver diseases, which are equally prevalent in our locality. Health education to prohibit traditional practices that could predispose individuals to HBV infections is emphasised. The incorporation of HBV vaccination in the national programme on immunization currently in use in Nigeria is highly recommended. This would be an effective method of preventing HBV infection from childhood.