Metabolic syndrome in urban city of North-Western Nigeria: prevalence and determinants.

INTRODUCTION: The aim of this study was to investigate the prevalence of metabolic syndrome in Sokoto metropolis of North-Western Nigeria. METHODS: A cross-sectional community based study was carried out. Four hundred and ten subjects (201 males and 209 females) were recruited for the study using a multi-stage sampling technique. Demographic and the life style data was obtained from the participants. Evaluation of anthropometric variables, fasting blood sugar, lipid profiles, insulin resistance and blood pressure was performed. The classification of metabolic syndrome was based on the NCEP ATP III guidelines. RESULTS: The mean (SD) age of the sample population was 39.6 (14.4) years. The mean (SD) age of the male subjects was 38.4(14.9) years and that of the females was 40.8(13.9) years (p> 0.05). The overall prevalence of metabolic syndrome was 35.1% with the females having 42.83% and the males 27.36%. The frequencies of metabolic syndrome parameters in the study subjects were low HDL (56.1%), hypertension (46.1%), dysglycemia (32.7%), central obesity (28%), and elevated triglycerides (22.4%). Most of the women had low HDL (62.2%) and central obesity elevated (49.8%). CONCLUSION: Metabolic syndrome is common in residents of North-Western Nigeria, commoner in the females than males. Risk factors for metabolic syndrome should be detected in normal individuals for implementing effective preventive measures.

Obesity among health service providers in Nigeria: danger to long term health worker retention?

INTRODUCTION: Obesity is a global epidemic. There are rising rates of obesity and its associated disorders, especially in developing countries, including among Health Service Providers (HSPs). Obesity is associated with early retirement, increased morbidity and mortality. Thus, obesity has the potential of reducing long-term retention of HSPs in inadequately staffed health systems of developing countries. This study aimed to determine the magnitude of and factors associated with obesity among HSPs of a tertiary health care facility in Lagos, Nigeria. METHODS: A cross sectional study was carried out with a questionnaire, which included the International Physical Activity Questionnaire short form (IPAQ-SF). Obesity was defined as BMI ≥30kg/m2. Statistical significance was set at p < 0.05. RESULTS: 300 HSPs were recruited, of which 47.7% were medical doctors and dentists, 43.3% were nurses and other categories of HSPs. The mean age and BMI of the HSPs were 39.3(9.0) years and 27.7(4.6) kg/m2 respectively. Eight two (27.3%) HSPs were obese and 134 (44.7%) were overweight, 149(49.7%) had central obesity. After adjusting for confounding variables using multivariate logistic regression, age > 40 years (OR 3.51, p=0.003), female gender (OR 2.84, p=0.007) and earning a monthly salary of ≤ 200,000 naira relative to 201,000-400,000 naira (OR 2.58, p=0.006) were significantly associated with obesity. CONCLUSION: Obesity was prevalent among these Nigerian HSPs. This calls for concern, especially with the implication of loosing health workers to obesity related disorders and early retirement.

The relationship between self-monitoring of blood glucose and glycaemic control among patients attending an urban diabetes clinic in Nigeria.

BACKGROUND/OBJECTIVE: Self-monitoring of blood glucose (SMBG) is a component of modern diabetes mellitus (DM) self-management. Its value is discussed controversially, and its impact in resource poor settings has been infrequently studied. The aim of this report is to determine the pattern of SMBG and its relationship with glycemic control amongst type 2 DM (T2DM) patients attending an urban DM clinic in Lagos, Nigeria. METHODS: Data were collected from patients with T2DM in a cross-sectional study, using systematic random sampling, with an interviewer-administered questionnaire investigating demographic data, DM history and SMBG practice. Weight, height, fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) were measured. RESULTS: One hundred patients were studied consisted of 62 (62%) females and 38 (38%) males. The mean age, body mass index and HbA1c of the study population were 59.9 (9.5) years, 26.2 (5.6) kg/m2 and 7.9 (2.2%). The median (interquartile range [IQR]) FPG and duration of DM were 107.0 (82.0-142.0) and 8.5 (5.0-15.0) years respectively. SMBG was practiced by 40 (40.0%) patients with a median (IQR) of 6 (4-15) times/month. SMBG was performed more frequently by persons with tertiary level of education (P = 0.04) and DM duration ≥ 8.5 years (P = 0.04). The mean HbA1c in the group who practiced SMBG was lower though not statistically significant compared to the group that did not (7.8% vs. 8.0%, P = 0.61) practiced. The Spearman's rank correlation coefficient between the frequency of SMBG and HbA1c was -0.025, and P = 0.81 among the entire T2DM patients. CONCLUSION: There was no statistically significant relationship between SMBG and glycemic control. There is a need for larger studies to be carried out in order to justify the value of SMBG in resource poor settings.

An audit of request forms submitted in a multidisciplinary diagnostic center in Lagos.

INTRODUCTION: Request forms are important means of communication between physicians and diagnostic service providers. Pre-analytical errors account for over two thirds of errors encountered in diagnostic service provision. The importance of adequate completion of request forms is usually underestimated by physicians which may result in medical errors or delay in instituting appropriate treatment. The aim of this study was to audit the level of completion of request forms presented at a multidisciplinary diagnostic center. METHODS: A review of all requests forms for investigations which included radiologic, laboratory and cardiac investigations received between July and December 2011 was performed to assess their level of completeness. The data was entered into a spreadsheet and analyzed. RESULTS: Only 1.3% of the 7,841 request forms reviewed were fully completed. Patient's names, the referring physician's name and gender were the most completed information on the forms evaluated with 99.0%, 99.0% and 90.3% completion respectively. Patient's age was provided in 68.0%, request date in 88.2%, and clinical notes/ diagnosis in 65.9% of the requests. Patient's full address was provided in only 5.6% of requests evaluated. CONCLUSION: This study shows that investigation request forms are inadequately filled by physicians in our environment. Continuous medical education of physicians on the need for adequate completion of request forms is needed.

Prevalence of and Risk Factors for Lipoatrophy in Patients with HIV Infection in Nigeria.

Background. Although the association between lipoatrophy and highly active antiretroviral therapy (HAART) is well known, other nondrug factors may be associated with lipoatrophy in people living with HIV/AIDS (PLWHA). There are no reports of lipoatrophy from Nigeria, a country with the second largest number of PLWHA. We aimed to determine the prevalence, characteristics, and factors associated with lipoatrophy in a cohort of patients attending the HIV clinic in Lagos University Teaching Hospital, Nigeria. Methods. Two hundred and eighty-eight patients with HIV infection were recruited for the study. The study protocol involved administration of a questionnaire, targeted physical examination (including anthropometric indices and skin fold thickness), and bioelectrical impedance analysis measurements. Lipoatrophy was defined clinically. Results. Lipoatrophy was present in 75 (26.0%) persons. It was associated with lower body circumferences, skin fold thicknesses, and lower % body fat with preservation of skeletal muscle mass (all P < 0.05). Male gender and HAART use were the factors associated with lipoatrophy on multivariate analysis (P < 0.05). Conclusion. Lipoatrophy is frequently encountered in patients with HIV infection in Nigeria, with HAART use conferring an added factor in its development. There is need for more physician and patient awareness of this condition.