An overview of sickle cell disease from the socio-demographic triangle - a Nigerian single-institution retrospective study.

Introduction: Sickle cell disease (SCD) is a hereditary red blood cell disorder of public health importance globally with Nigeria the epicenter zone in Africa. There is a paucity of knowledge on how hemoglobin variants, personal characteristics, and environment (socio-demographic triangle) interact to influence SCD propagation. A clinical overview of these epidemiologic parameters may proffer strategies for controlling the SCD disease burden. The objective of this study was to examine the prevalence patterns of SCD, including other associated epidemiologic and hematological (i.e., hemoglobin concentration, ABO blood groups) parameters from laboratory data. Methods: this was a retrospective cross-sectional study of 138 newly diagnosed SCD patients in the laboratory unit of the department of haematology using routine alkaline cellulose acetate hemoglobin electrophoresis technique from 2013 to 2014. Demographic and other relevant data were obtained from case notes and laboratory records at the presentation. The agent-host-environment variables were used in the construction of the epidemiological triad chain of transmission. Results: a total of 138 (1.63%) newly diagnosed SCD patients aged 7 months to 41 years made up of 39% (0.63% SCD prevalence) adults and 61% (1% SCD prevalence) pediatric age-groups were seen out of 8457 consecutive patients screened within the study period. About 98.55% and 1.45% were homozygous sickle-hemoglobin (SS) and heterozygous sickle-hemoglobin C (SC) variants, respectively. The pediatric department (CHER+CHOP) recorded the highest proportion of SCD (65%). In contrast, the public health department had the least proportion (1%). There was a statistically significant difference in the gender status and the months of SCD diagnosis (p=0.0147). The month of April had the highest proportion of SCD. A majority (66.7%) of the SCD had moderate grade anemia. Conclusion: the study revealed a gender disparity in the months of SCD diagnosis. However, there was no statistical difference in the pediatric and adult SCD prevalence patterns.

Prevalence of overweight and obesity in Nigeria: Systematic review and meta-analysis of population-based studies.

In Nigeria, several studies have assessed the prevalence of overweight/obesity with different reports. The purpose of this study was to use a systematic review and meta-analysis to analyze these overweight and obesity reports from different locations in Nigeria over the last ten years. In addition, there was a dearth of systematic reviews and meta-analyses on the prevalence, trends, and demographic characteristics of overweight and obesity in the country. This was a systematic review and meta-analysis of cross-sectional population-based studies among adult Nigerians on the prevalence of overweight/ obesity (defined by body mass index) published from January 2010 to December 2020. Relevant abstracts were scrutinized and articles that included adults of all age groups and were not restricted to a particular group of people (e.g. university community) were selected. Each article was scrutinized by more than 2 authors before selection. The prevalence of overweight/obesity among all participants, among men and among women in Nigeria and its 6 geopolitical zones was determined. All analyses were performed using STATA version 14 (Stata Corp. College Station, Texas, USA). Thirty-three studies were selected and the number of participants was 37,205. The estimated prevalence of overweight and obesity was 27.6%, and 14.5% respectively. The prevalence of overweight among men and among women was 26.3% and 28.3% respectively and, the prevalence of obesity among men and women was 10.9% and 23.0% respectively. The prevalence of overweight in the 6 geopolitical zones was Southeast 29.3%, Southwest 29.3%, South-south 27.9%, Northwest 27.2%, North-central 25.3%, Northeast 20.0% and obesity South-south 24.7%, Southeast 15.7%, Southwest 13.9%, Northwest 10.4%, North-central 10.2%, Northeast 6.4%. Egger's tests showed no statistically significant publication bias among the studies that reported the overweight and obesity prevalence respectively (p = 0.225, P 0.350). The prevalence of overweight/obesity in Nigeria is high. The southern geopolitical zones had a higher prevalence of overweight/obesity.

Short-term rehospitalisation or death and determinants after admission for acute heart failure in a cohort of African patients in Port Harcourt, southern Nigeria.

BACKGROUND: Heart failure (HF) is a major health burden globally and contributes significantly to morbidity and mortality related to cardiovascular disease. The aim of this study was to determine the outcome, and factors determining these outcomes in patients admitted for acute HF and followed up for six months. METHOD: This was a hospital-based, prospective study. Subjects included consecutive patients with a confirmed diagnosis of acute HF admitted to the medical wards of the University of Port Harcourt Teaching Hospital (UPTH) in Nigeria over one year. All had a full physical examination and relevant investigations, including echocardiography. Subjects were followed up for six months and reassessed for outcome/endpoint, which was rehospitalisation or death. Factors that predicted these outcomes were also determined. RESULTS: There were 160 subjects, 84 females and 76 males, age range 20 to 87 years, mean age 52.49 ± 13.89 years. Sixteen subjects (10.0%) were lost to follow up, 66 (41.3%) showed clinical improvement, 57 (35.6%) were rehospitalised, while 21 (13.1%) died. Determinants of rehospitalisation were New York Heart Association (NYHA) class, heart failure type, haemoglobin level at presentation and estimated glomerular filtration rate (eGFR). Determinants of mortality were NYHA class and haemoglobin level at presentation. CONCLUSION: Heart failure rehospitalisation and mortality rates of 35.6 and 13.1%, respectively, were high compared to developed countries.