Audit of Stroke Admissions in a Tertiary Hospital in South East Nigeria.

INTRODUCTION: Stroke is one of the commonest causes of medical admissions and mortality in Nigeria. Documenting the pattern of stroke and risk factors for stroke is important not only for public health policy makers but also for physicians in implementing both primary and secondary preventive programs. OBJECTIVES: The aim of this study was therefore to document the pattern of stroke and risk factors for stroke in stroke patients admitted in a tertiary hospital in Enugu. METHODS: This was a cross-sectional descriptive study carried out at Enugu State University Teaching Hospital, Enugu. Data were analyzed using the SPSS version 26 (IBM Corporation, New York, USA). RESULTS: Data from 350 patients were included in the present study. The three commonest risk factors for stroke were diabetes (69.1%), hypertension (64.9%), and age 65 years and above (51.1%). A total of 74.9% of the patients had ischemic stroke and 25.1% had hemorrhagic stroke. Hemorrhagic stroke was significantly higher in patients < 50 years (46.5%) and people with hypertension, (31.7%). About 31.4% of the patients had two risk factors and 28.6% had three risk factors. Age 65 years and above positively correlated with having ischemic stroke and hypertension positively correlated with hemorrhagic stroke. When controlled for age, the correlation between hypertension and hemorrhagic stroke was still significant. CONCLUSION: The reported frequency of ischemic stroke was 74.9% and of hemorrhagic stroke was 25.1%. The commonest risk factors for stroke documented among stroke patients in a tertiary hospital in Enugu were diabetes, hypertension, and age 65 years and above. When controlled for age, the correlation between hypertension and hemorrhagic stroke was still significant.

INTRODUCTION: L'accident vasculaire cérébral (AVC) est l'une des causes les plus courantes d'admissions médicales et de mortalité au Nigeria. Il est important de documenter le profil des et les facteurs de risque des accidents vasculaires cérébraux sont importants non seulement pour le santé publique mais aussi pour les médecins dans la mise en œuvre des programmes de prévention primaire et secondaire. OBJECTIFS: L'objectif de cette étude était donc de documenter le modèle d'AVC et les facteurs de risque d'AVC chez les patients admis dans un hôpital tertiaire d'Enugu. MÉTHODES: Il s'agit d'une étude descriptive transversale menée à l'hôpital universitaire d'Enugu, Enugu. Les données ont été analysées à l'aide du SPSS version 26 (IBM Corporation, New York, USA). RÉSULTATS: Les données de 350 patients ont été incluses dans la présente étude. Les trois facteurs de risque d'accident vasculaire cérébral les plus courants étaient le diabète (69,1 %), l'hypertension (64,9 %) et l'âge de 65 ans et plus (51,1 %). Un total de 74,9 % des patients ont eu un AVC ischémique et 25,1 % un AVC hémorragique. L'AVC hémorragique était significativement plus élevé chez les patients < 50ans (46,5 %) et les personnes souffrant d'hypertension (31,7 %). Environ 31,4 % des patients présentaient deux facteurs de risque et 28,6 % trois facteurs de risque. Âge 65 ans et plus était positivement corrélé au fait d'avoir un AVC ischémique et l'hypertension était en corrélation positive avec l'AVC hémorragique. Après contrôle de l'âge, la corrélation entrel'hypertension et l'AVC hémorragique était toujours significative. CONCLUSION: La fréquence rapportée de l'accident vasculaire cérébral ischémique était de 74,9 %. et celle de l'AVC hémorragique était de 25,1 %. Les facteurs de risque les plus courants pour d'AVC documentés chez les patients victimes d'un AVC dans un hôpital tertiaire de Enugu étaient le diabète, l'hypertension et l'âge de 65 ans et plus. Lorsque l'âge, la corrélation entre l'hypertension et l'AVC hémorragique était toujours significative. MOTS CLÉS: AVC ischémique, AVC hémorragique, Facteurs de risque, Nigeria.

Prevalence and distribution of hypertension in overweight and obese subjects in an urban community in Enugu, South East Nigeria. A post hoc analysis.

BACKGROUND: Most recent studies in Nigeria have documented high prevalence of hypertension, diabetes, and obesity. Several mechanisms may link hypertension and obesity hence the high prevalences of both disorders in Nigeria. There are however no studies on the prevalence of hypertension among the obese in urban settings. AIMS: The aim of this study was to describe the prevalence and pattern of hypertension in overweight/obese individuals in a community. METHODS: We conducted a post-hoc analysis on obese subjects 20 years and above from two urban settlements within Enugu metropolis. For database management and statistical analyses, we used the SPSS version 22. RESULTS: Data from a total of 301 individuals with obesity who met the selection criteria were re-analyzed. A total of 198 (65.8%) individuals were found to have hypertension most of whom were newly diagnosed 110 (55.6%). The prevalence of hypertension was 65.8% and increased with age and BMI. CONCLUSION: Individuals with overweight/obesity have very high rates of hypertension. The prevalence of hypertension also increased with and BMI. Thus, there is need for targeted health education in adults to address the burden of obesity and hypertension to reduce the burden of cardiovascular disease in the community.

Availability and functionality of sphygmomanometers at health care institutions in Enugu, Nigeria.

OBJECTIVE: Our aim was to investigate the availability of functional blood pressure monitors at health care institutions in Enugu, Nigeria. METHODS: During repeated surveys of 15 (primary, secondary and tertiary) health care institutions in Enugu between 2007 and 2012, records were made of the availability and functional status of sphygmomanometers in the clinics and wards. We also assessed the degree of agreement between measurements by institutional staff and measurements by trained observers using the same or the standard sphygmomanometer. RESULTS: Apart from three institutions, there was inadequate availability of fully functional sphygmomanometers: 61 staff attending to outpatients were sharing 35 sphygmomanometers, 6 of which were faulty i.e. needing repairs. Wards invariably had only one or two functional sphygmomanometers, regardless of bed occupancy. Institutional staff ignored recommended guidelines for blood pressure measurement. The overall mean difference in blood pressure measurements between institutional staff and a trained observer (1.6 mmHg; 95% confidence interval, CI: -0.3 to 3.4; P=0.1) was greater and more significant than the mean difference between the two observers (0.1 mmHg; CI: -1.5 to 1.7; P=0.9) and the mean difference between institutional and standard sphygmomanometers (-0.2 mmHg; CI: -1.7 to 1.3; P=0.8). CONCLUSION: There has been a notable lack of reporting on the availability of blood pressure measuring devices in third world health care institutions. Our surveys have shown inadequate availability of functional sphygmomanometers in the institutions, but satisfactory agreement between measurements by institutional staff and trained observers. In view of recent guidelines and recommendations, there is need to supplement office readings with mercury devices with oscillometric home or automated office blood pressure recording.