ABSTRACT
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.
ABSTRACT
BACKGROUND: Multiple myeloma (MM) is one of the hematological malignancies that require palliative care. This is because of the life-threatening nature and the suffering associated with the illness. The aim of this study is to bring to the fore the complications experienced by people living with MM in the Niger-Delta region of Nigeria and the outcome of various palliative interventions. METHODS: This was a 10-year multi-center retrospective study of 26 patients diagnosed and managed in three major centers in the Niger-Delta region of Nigeria from January 2003 to December 2012. Information on the clinical, laboratory, radiological data, and palliative treatment was obtained at presentation and subsequently at intervals of 3 months until the patient was lost to follow-up. RESULT: The mean duration from onset of symptoms to diagnosis was 13.12 months (95% CI, 6.65-19.58). A total of 16 (61.5%), eight (30.8%), and two subjects (7.7%) presented in Durie-Salmon (DS) stages III, II, and I, respectively. The complications presented by patients at diagnoses included bone pain (84.6%), anemia (61.5%), nephropathy (23.1%), and hemiplegia (35%). All the patients received analgesics, while 50.0% received blood transfusion, 56.7% had surgery performed, 19% had hemodialysis, and 3.8% received radiotherapy. A total of 10 (38%) patients benefited from bisphosphonates (BPs). A total of 57.6% of patients were on melphalan-prednisone (MP) double regimen, while 19% and 8% patients were on MP-thalidomide and MP-bortezomib triple regimens, respectively. A total of 3.8% of patients at DS stage IIIB disease had autologous stem-cell transplantation (ASCT). Only 7.6% of the myeloma patients survived up to 5 years post diagnosis. The overall mean survival interval was 39.7 months (95% CI, 32.1-47.2). CONCLUSION: Late diagnosis and inadequate palliative care account for major complications encountered by MM patients in the Niger-Delta region of Nigeria. This could be responsible for the poor prognostic outcome and low survival interval of MM individuals in this region. There is, therefore, a need to improve the quality of palliative care received by myeloma patients in this region. This is achievable via provision of relevant and affordable health care facilities for diagnosis and treatment of the disease.
ABSTRACT
The aim of the study is to validate the use of Siriraj Stroke Score (SSS) in the diagnosis of acute hemorrhagic and acute ischemic stroke in southeast Nigeria. This was a prospective study on validity of SSS in the diagnosis of stroke types in southeast Nigeria. Subjects diagnosed with stroke for whom brain computerized tomography (CT) scan was performed on admission were recruited during the study period. SSS was calculated for each subject, and the SSS diagnosis was compared with brain CT scan-based diagnosis. A total of 2,307 patients were admitted in the hospital medical wards during the study period, of whom 360 (15.6%) were stroke patients and of these, 113 (31.4%) adult subjects met the inclusion criteria. The mean age of the subjects was 66.5±2.6 years. The mean interval between ictus and presentation was 2.5±0.4 days. Ischemic stroke was confirmed by CT in 74 subjects; however, SSS predicted 60 (81.1%) of these subjects correctly (P<0.05). Hemorrhagic stroke was confirmed by CT in 39 subjects, and SSS predicted 36 (92.3%) of them correctly (P<0.05). In acute ischemic stroke, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of SSS were 92%, 94%, 97%, 86%, and 93%, respectively, while in patients with hemorrhagic stroke, the corresponding percentages were 94%, 92%, 86%, 97%, and 93%, respectively. SSS is not reliable enough to clinically differentiate stroke types in southeast Nigeria to warrant interventions like thrombolysis in acute ischemic stroke.
