Are lifestyle cardiovascular disease risk factors associated with pre-hypertension in 15-18 years rural Nigerian youth? A cross sectional study.

BACKGROUND: Cardiovascular disease (CVD) is a public health concern worldwide. Hypertensive heart disease is predominant in Nigeria. To effectively reduce CVD in Nigeria, the prevalence of, and factors associated with, pre-hypertension in Nigerian youth first need to be established. METHODS: A locally-validated CVD risk factor survey was completed by 15-18 year olds in a rural setting in south-west Nigeria. Body Mass Index (BMI), waist-hip ratio and systolic and diastolic blood pressure was measured. Putative risk factors were tested in gender-specific hypothesized causal pathways for overweight/obesity, and for pre-hypertension. RESULTS: Of 1079 participants, prevalence of systolic pre-hypertension was 33.2 %, diastolic pre-hypertension prevalence approximated 5 %, and hypertension occurred in less than 10 % sample. There were no gender differences in prevalence of pre- hypertension, and significant predictors of systolic pre-hypertension (high BMI and older age) were identified. Considering high BMI, older age was a risk for both genders, whilst fried food preference was female-only risk, and low breakfast cereal intake was a male-only risk. CONCLUSION: Rural Nigerian adolescents are at-risk of future CVD because of lifestyle factors, and high prevalence of systolic pre-hypertension. Relevant interventions can now be proposed to reduce BMI and thus ameliorate future rural adult Nigerian CVD.

High prevalence and clustering of modifiable CVD risk factors among rural adolescents in southwest Nigeria: implication for grass root prevention.

BACKGROUND: Cardiovascular disease (CVD) is an immense global problem with serious economic and social consequences. Modifiable risk factors for CVD have been identified internationally in adolescents where early intervention programs have the potential to reduce CVD risk on individual and population levels. In developing countries such as Nigeria, little is known about the prevalence of modifiable CVD risk factors among adolescents especially in the rural areas. METHODS: This paper reports on a cross-sectional survey of modifiable CVD risk factors among rural adolescents in South-West Nigeria. All 15-18 years old adolescents in all the schools at Ibarapa central local government were approached and all those who assented and consented to participate in the study were involved. A total of 1500 adolescents participated in the study. Measurements of CVD risks factors taken were; smoking, physical activity, alcohol, dietary pattern using a questionnaire developed by authors. Other CVD risk factors such as waist hip ratio and BMI were taken using standardized instruments. Data were analyzed using STATA version 12. RESULTS: Data from 1079 adolescents (56.5% males and 53.5% females) were analyzed. Mean age of males was 16.4 ± 1.14 years and mean age for females was 16.29 ± 1.13 years. Adolescents showed clustering of CVD risk factors with about 72% having between two and four risk factors. A total of 102 clustering patterns were reported. The most common clustering pattern (19.6%) included high animal lipid and salt diet. CONCLUSION: There is high level and clustering of CVD risk factors among rural adolescents in Southwest Nigeria. The most common clustering pattern was biased towards dietary factors. The high prevalence of CVD risk factors among rural adolescents in Southwest Nigeria suggests that urgent primary prevention programs are required to prevent the next generation of Nigerians from suffering of CVD.

Sexual dysfunction in Nigerian stroke survivors.

BACKGROUND: Over three-quarters of stroke survivors experience disruption of sexual functioning. Studies reporting poststroke sexual function of Nigerian patients are few. OBJECTIVES: This survey reports sexual dysfunction in Nigerian stroke survivors, and determines the influence of sociodemographic, clinical and psychological factors on the dysfunction. METHODS: Participants were 77 stroke survivors (60 males; 17 females) recruited consecutively from a teaching hospital. Participants completed the Beck Depression Inventory, Stroke Specific Quality of Life Scale and post-stroke sexual function questionnaire. Participants' motor ability was rated on the Modified Motor Assessment Scale. Data were analysed using Chi square test and Mann-Whitney U test (alpha level set at 0.05). RESULTS: Participants were aged 55.2 ± 10.8 (28-79) years. Most (94.8%) participants reported a dysfunction in sexual function. Decline in libido and coital frequency were reported by >70% and in erection, ejaculation and orgasm by >60% of participants. Participants' with erectile dysfunction were significantly older than those without (U=267.0; p=0.02). Depression, quality of life, willingness to have sex, general attitude to sex and ability to express sexual feelings had significant influence on sexual dysfunction reported by participants (p<0.05). CONCLUSION: Our findings suggest that sexual dysfunction is common among Nigerian stroke survivors and it is mostly associated with psychological factors.

Ibadan knee/hip osteoarthritis outcome measure: process of development.

The development of instruments for the assessment of therapeutic intervention has been an age long practice. However, many of the published instruments do not have detailed information on how the instruments were developed. It is necessary for authors to provide detailed (step by step) information on how measuring scales/instruments are developed. The Ibadan Knee/Hip Osteoarthritis Outcome Measure (IKHOAM) was developed as a Nigerian-environment and culture-friendly instrument for the assessment of the effectiveness of therapeutic interventions in individuals with osteoarthritis of the knee and/or hip. This article outlines the steps involved in developing an outcome measure using IKHOAM as a template.

Health behaviour and quality of life of patients with Type 2 diabetes attending selected hospitals in South Western Nigeria / Comportamiento hacia la salud y calidad de vida de los pacientes con diabetes tipo 2 que asisten a hospitales seleccionados en Nigeria Sudoccidental

BACKGROUND: Type 2 diabetes is a chronic disease that affects patients 'general health and well-being in various ways. Modification of lifestyle is essential in preventing Type 2 diabetes including its secondary complications. OBJECTIVE: This study assessed the profile, health behaviour and quality of life of patients presenting with Type 2 diabetes and attending the diabetic clinics of Lagos State University Teaching Hospital, Lagos State and the Ring Road State Hospital, Ibadan. SUBJECTS AND METHOD: A total of 100 diabetic patients aged between 40 and 85 years participated in this study. Their physical activity levels were determined by using the International Physical Activity Questionnaire (IPAQ); quality of life (QOL) was assessed using the Diabetes Quality of Life (DQOL) Inventory questionnaire and alcohol and smoking status as well as nutrition patterns were assessed using the Alcohol, Smoking and Nutrition Questionnaire (ASNQ). Age, gender, body mass index, waist circumference, waist-hip-ratio and blood pressure were also reported. Data were presented using descriptive statistics ofmean, standard deviation, percentages and are presented in figures and tables. RESULTS: Results showed that most of the participants were overweight and/or obese with 62% having a body mass index greater than 25 kg/m². About 78% of females showed a waist circumference of > 88 cm while 48% of the male participants had a > 92 cm waist circumference. Ninety-seven per cent of the female participants had a waist-hip ratio above 0.85 while 32% of the males had above 1.0 waist-hip ratio. Using the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC 7) classification for hypertension, 49% of the participants were found to be at stages 1 and 2 hypertension by systolic blood pressure while 43% of the participants were at stages 1 and 2 hypertension by diastolic blood pressure. Sixty-two per cent ofthe participants revealed a low physical activity level, 34% had a moderate physical activity level while 4% had a high physical activity level. All the participants indicated that they neither consumed alcohol nor smoked at the time of the study. Thirty-four per cent of the participants had adequate quantities of fruit, 31% of them also consumed an adequate quantity of legumes and 73% of them ate an adequate quantity offish per week. Fifty-eight per cent of the participants took less quantities of salt with their food as compared to their peers while 95% of the participants did not add sugar to their food; 79% of them preferred their food boiled. The mean score of the participants' QOL was 31.85 ± 7.98 out of a total score of 75. The QOL as reported by the participants thus indicated a fairly good quality of life. CONCLUSION: Patients with Type 2 diabetes were generally found to be overweight, obese, sedentary and were frequently found to be hypertensive. It is, therefore, suggested that patients need to pay attention to their weight by participating in weight reduction programmes and also improve their physical activity levels in order to reduce their risk ofdeveloping the complications associated with Type 2 diabetes.

ANTECEDENTES: La diabetes tipo 2 es una enfermedad crónica que afecta la salud general y el bienestar de los pacientes de diversas maneras. La modificación del estilo de vida es fundamental para prevenir la diabetes de tipo 2, incluyendo sus complicaciones secundarias. OBJETIVO: Este estudio evaluó el perfil, el comportamiento en torno a la salud, así como la calidad de vida de pacientes que padecen la diabetes tipo 2, y que asisten a las clínicas para diabéticos en el Hospital Docente de la Universidad de Lagos, Lagos State, y el Hospital Estatal de Ring Road, en Ibadan. SUJETOS Y MÉTODO: Un total de 100 pacientes diabéticos con edades entre 40 y 85 años participaron en este estudio. Sus niveles de actividad física fueron determinados usando el Cuestionario Internacional de Actividad Física (IPAQ). La calidad de vida (QOL) se evaluó usando el Inventario de la calidad de vida en la diabetes (DQOL), en tanto que el consumo de alcohol y el hábito de fumar así como los patrones de nutrición se evaluaron usando el Cuestionario sobre nutrición, alcohol y hábito defumar (ASNQ). También se reportó la edad, el sexo, el índice de masa corporal, la circunferencia de la cintura, el índice cintura-cadera, y la presión sanguínea. Los datos se presentaron usando estadísticas descriptivas sobre la media, la desviación estándar, y los porcentajes, acompañados con cifras y tablas. RESULTADOS: Los resultados mostraron que la mayoría de los participantes o bien tenían sobrepeso, o bien eran obesos, teniendo el 62% un índice de masa corporal mayor de 25 kg/m². Aproximadamente 78% de las hembras mostraron una circunferencia de la cintura de > 88 centímetros, mientras que el 48% de los participantes masculinos tenían una circunferencia de cintura de > 92 centímetros. El noventa y siete por ciento de los participantes hembras tenían un índice cintura-cadera por encima de 0.85, mientras que el 32% de los varones tenían un índice cintura-cadera por encima de 1.0 Partiendo de la clasificación de la hipertensión establecida por el Comité Nacional Conjunto para la Prevención, Detección, Evaluación y Tratamiento de la Hipertensión Arterial (JNC 7), se halló que 49% de los participantes se encontraban en las fases 1 y 2 de hipertensión por tensión arterial sistólica, mientras que 43% de los participantes estaban en las fases 1 y 2 de hipertensión por tensión arterial diastólica. Sesenta y dos por ciento de los participantes reveló un nivel bajo de actividad física, 34% tenían un nivel de actividad física moderado mientras 4% tenían un nivel de actividad física alto. Todos los participantes indicaron que ni consumían alcohol ni fumaban en el momento del estudio. Treinta y cuatro por ciento de los participantes comían cantidades adecuadas de fruta, 31% de ellos también consumieron una cantidad adecuada de legumbres y 73% de ellos comían cantidades adecuada de pescado a la semana. Cincuenta y ocho por ciento de los participantes consumían menos cantidades de sal en sus comidas, en comparación con sus iguales, en tanto que 95% de los participantes no agregaban azúcar a su comida; 79% de ellos preferían sus alimentos hervidos. La puntuación promedio de la calidad de vida de los participantes fue 31.85 ± 7.98 de una puntuación total de 75. Por consiguiente, de acuerdo con lo reportado por los participantes, la calidad de vida era satisfactoriamente buena. CONCLUSIÓN: Se halló que los pacientes con diabetes tipo 2, se caracterizaban generalmente por sobrepeso, obesidad, y sedentarismo, y eran frecuentemente hipertensos. Por tanto, se sugiere que los pacientes presten atención a su peso participando en programas de reducción de peso, y mejorando sus niveles de actividad a fin de reducir el riesgo de desarrollar complicaciones asociadas con la diabetes de tipo 2.

Health behaviour and quality of life of patients with type 2 diabetes attending selected hospitals in south western Nigeria.

BACKGROUND: Type 2 diabetes is a chronic disease that affects patients' general health and well-being in various ways. Modification of lifestyle is essential in preventing Type 2 diabetes including its secondary complications. OBJECTIVE: This study assessed the profile, health behaviour and quality of life of patients presenting with Type 2 diabetes and attending the diabetic clinics of Lagos State University Teaching Hospital, Lagos State and the Ring Road State Hospital, Ibadan. SUBJECTS AND METHOD: A total of 100 diabetic patients aged between 40 and 85 years participated in this study. Their physical activity levels were determined by using the International Physical Activity Questionnaire (IPAQ); quality of life (QOL) was assessed using the Diabetes Quality of Life (DQOL) Inventory questionnaire and alcohol and smoking status as well as nutrition patterns were assessed using the Alcohol, Smoking and Nutrition Questionnaire (ASNQ). Age, gender, body mass index, waist circumference, waist-hip-ratio and blood pressure were also reported. Data were presented using descriptive statistics of mean, standard deviation, percentages and are presented in figures and tables. RESULTS: Results showed that most of the participants were overweight and/or obese with 62% having a body mass index greater than 25 kg/m2. About 78% of females showed a waist circumference of > 88 cm while 48% of the male participants had a > 92 cm waist circumference. Ninety-seven per cent of the female participants had a waist-hip ratio above 0.85 while 32% of the males had above 1.0 waist-hip ratio. Using the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC 7) classification for hypertension, 49% of the participants were found to be at stages 1 and 2 hypertension by systolic blood pressure while 43% of the participants were at stages 1 and 2 hypertension by diastolic blood pressure. Sixty-two per cent of the participants revealed a low physical activity level, 34% had a moderate physical activity level while 4% had a high physical activity level. All the participants indicated that they neither consumed alcohol nor smoked at the time of the study. Thirty-four per cent of the participants had adequate quantities of fruit, 31% of them also consumed an adequate quantity of legumes and 73% of them ate an adequate quantity of fish per week. Fifty-eight per cent of the participants took less quantities of salt with their food as compared to their peers while 95% of the participants did not add sugar to their food; 79% of them preferred their food boiled. The mean score of the participants' QOL was 31.85 +/- 7.98 out of a total score of 75. The QOL as reported by the participants thus indicated a fairly good quality of life. CONCLUSION: Patients with Type 2 diabetes were generally found to be overweight, obese, sedentary and were frequently found to be hypertensive. It is, therefore, suggested that patients need to pay attention to their weight by participating in weight reduction programmes and also improve their physical activity levels in order to reduce their risk of developing the complications associated with Type 2 diabetes.

Physical activity levels of senior secondary school students in Ibadan, western Nigeria.

BACKGROUND: Inactivity and low levels of physical activity are predisposing factors to many chronic diseases such as heart disease which are showing an increase in prevalence in Sub-Saharan Africa generally and Nigeria in particular. Physical activity levels have been found to be decreasing among young people in many countries around the world resulting in a state where young people are not found to be sufficiently active in order to safeguard their present and future health and well-being. OBJECTIVE: This study was designed to assess the physical activity levels of students in government-owned senior secondary schools located in the South-east Municipality, Ibadan, Western Nigeria, and its association with their physical characteristics and level of study. SUBJECTS AND METHOD: Multi-stage sampling was used to select participants from senior secondary schools. A modified version of the self-reported physical activity questionnaire for adolescents (PAQ-A) validated for Nigerian adolescents was used for data collection. One thousand and two questionnaires were distributed to the respondents. The questionnaire was designed to collect the respondents' demographic data and assess their physical activity levels. One thousand (1000) questionnaires were completed. Two of the 1002 questionnaires were not properly completed and were therefore discarded. The data were analysed using descriptive statistics of mean, standard deviation and cumulative percentage. A table was used to present the results. The chi-square test was used to determine the association between physical activity levels and the physical characteristics of the participants. Independent t-test was used to determine the difference in the physical activity levels of the participants. RESULTS: The results indicated that 38% of the participants engaged in low activity levels, 58.8% in moderate activity levels and 3.2% in high activity levels. Furthermore, physical activity levels (PAL) had significant positive associations with the physical characteristics of the participants and males appeared to be significantly more active than females. CONCLUSION: Adolescents are not involved in adequate physical activities that could safeguard their present and future health and well-being. Therefore, it is recommended that there should be educational programmes in place which emphasize the benefits of exercise, primordial prevention of future chronic and cardiovascular diseases and also the incorporation of physical education in the secondary school curriculum.

Treatment of sports injuries referred for physiotherapy at a national sports medicine centre in Nigeria: a retrospective study.

BACKGROUND: Physiotherapists are important members of the sports medicine team and are involved in the prevention and management of injured athletes right from the acute stage of injury to the stage of rehabilitation. However, the type of treatments rendered to injured athletes and level of physiotherapy utilisation in terms of injury referrals for physiotherapy in sports medicine in Nigeria is not fully known. OBJECTIVE: To find out the extent of referral of sports injuries for physiotherapy and types of treatments rendered to injured athletes referred for physiotherapy at the National Sports Medicine Centre (NSMC), Lagos, South-West, Nigeria. METHODS: All case files at the general records unit from January 1995 to December 2002 were investigated. Information on athlete's sport, body part treated and physiotherapy modalities used between January 1997 and December 2002 were also extracted from the treatment register at the physiotherapy department of the sports medicine centre. RESULTS: A total of 171 sports related injuries were reported at the general records unit of the NSMC, with a male to female ratio of 2:1. Of this number, 121 (70.8%) were referred for physiotherapy with strain (n = 57, 33.3%) constituting the majority of physiotherapy referrals. At the physiotherapy department, the knee (n = 43, 30.1%) and the thigh (n = 33, 25.4%) were the most treated body parts. Track and field events (n = 48, 36.9%) recorded the highest number of injuries treated. Exercise therapy (n = 81, 25.5%) was the most frequently used modality, followed closely by transcutenous electrical nerve stimulation therapy (n = 73, 20.3%). CONCLUSION: The frequency of referral of sports injuries for physiotherapy at the NSMC was high. Exercise therapy was the most frequently used treatment modality and injuries affecting the lower limbs were mostly treated. Emphasis should therefore be laid on prevention of lower limb injuries.

Treatment of Sports Injuries Referred for Physiotherapy at a National Sports Medicine Centre in Nigeria: a Retrospective Study

Background: Physiotherapists are important members of the sports medicine team and are involved in the prevention and management of injured athletes right from the acute stage of injury to the stage of rehabilitation. However; the type of treatments rendered to injured athletes and level of physiotherapy utilisation in terms of injury referrals for physiotherapy in sports medicine in Nigeria is not fully known. Objective: To find out the extent of referral of sports injuries for physiotherapy and types of treatments rendered to injured athletes referred for physiotherapy at the National Sports Medicine Centre (NSMC); Lagos; South-West; Nigeria. Methods: All case files at the general records unit from January 1995 to December 2002 were investigated. Information on athlete's sport; body part treated and physiotherapy modalities used between January 1997 and December 2002 were also extracted from the treatment register at the physiotherapy department of the sports medicine centre. Results: A total of 171 sports related injuries were reported at the general records unit of the NSMC; with a male to female ratio of 2:1. Of this number; 121 (70.8) were referred for physiotherapy with strain (n= 57; 33.3) constituting the majority of physiotherapy referrals. At the physiotherapy department; the knee (n=43; 30.1) and the thigh (n=33; 25.4) were the most treated body parts. Track and field events (n=48; 36.9) recorded the highest number of injuries treated. Exercise therapy (n=81; 25.5) was the most frequently used modality; followed closely by transcutenous electrical nerve stimulation therapy (n=73; 20.3). Conclusion: The frequency of referral of sports injuries for physiotherapy at the NSMC was high. Exercise therapy was the most frequently used treatment modality and injuries affecting the lower limbs were mostly treated. Emphasis should therefore be laid on prevention of lower limb injuries

Prevalence of low back pain among peasant farmers in a rural community in South West Nigeria.

This study is a survey conducted in Iju-Odo rural community of Ondo State in South West Nigeria to determine the prevalence and risk factors for low back pain amongst peasant farmers. Five hundred peasant farmers were selected using a multi-stage sampling technique. A questionnaire was administered which sought information on demographic characteristics, presence of low back pain in the last 12 months prior to the time of the study and the duration, severity of low back pain and its effect on farming activity. The five hundred peasant farmers that participated in this study were 276 men (55.2%) and 224 women (44.8%). Three hundred and sixty two peasant farmers (72.4% of the population) had low back pain in the last 12 months prior to the time of this study, of which two hundred and three (73.5%) were males and one hundred and fifty nine (71.0%) were females peasant farmers having low back pain. The nature of onset of low back pain was that of gradual onset in 57.5%. One hundred and eighty-eight (51.9%) respondents indicated that low back pain reduced their farming workload, while one hundred and twenty four (34.3%) respondents were prevented from going to farm because they could not walk, resulting in 675 work days being lost by one hundred and twenty one (24.2%) peasant farmers in the last one-year with a mean of 5.6 days lost. This study concluded that low back pain prevalence is high among peasant farmers, with higher prevalence in males compared with females (P<0.05). The prevalence also increased with age (P<0.05). Years of farming was found to have a significant influence on the prevalence of low back pain (P<0.05) with prevalence of low back pain increasing as years of farming increases. Low back pain was found to be a cause of work absenteeism in this working population.