Pattern of presentation of tuberculosis and the hospital prevalence of tuberculosis and HIVco-infection in University College Hospital, Ibadan: a review of five years (1998 - 2002).

A 5-year review (1998-2002) was done at the pulmonary unit of the University College Hospital (UCH), Ibadan, Nigeria to determine the pattern of presentation of tuberculosis (TB) and the prevalence of TB and human Immunodefiency virus (HIV) co-infection. A total of one thousand patients were managed for TB but 777 confirmed as having TB had their case files analysed. There were 418 males and 359 females giving a male to female ratio of 1.16:1.00. Pulmonary tuberculosis (PTB) accounted for 78.6% of the patients seen over the period, followed by tuberculosis meningitis 7.8% then TB spine 6.8% and that of the lymph node 4.1%. The other types of TB (Abdomen, pericardial and miliary) accounted for less than 3%. The highest number of cases of tuberculosis (27.8%) was in the 20-29 age group for both male and female followed by those less than 40 years (26.0%). Less than 20% (18.3%) were 40 years old and above. The number of TB cases decreased sharply from a total of 188 in the year 2000 to 89 in 2002. The decrease in number was most likely due to the fact that directly observed therapy short course (DOTS) are now available at other centres within the city and its environs. Only 180 out of the 640 cases of TB were confirmed as HIV positive giving a seroprevalence rate of 28.12%. The annual distribution of TB/HIV co-infection showed a rising trend from 26 cases in 1998 to 42 cases in 2002.

Abnormalities in thrombogenic and rheologic factors in Nigerian hypertensive patients.

Platelet aggregation, plasma viscosity and plasma fibrinogen concentration were measured in 20 hypertensive Nigerian patients (10 males and 10 females) aged 32-72 years. Another 20 patients gender-matched normotensive subjects, served as controls. Platelet aggregate ratio was significantly lower (P < 0.05) in hypertensive (0.38 +/- 0.24) than in normotensive subjects (0.80 +/- 0.19). The relative plasma viscosity of the hypertensive patients (2.04 +/- 0.14) was higher (P < 0.05) than the value in control subjects (1.64 +/- 0.25). Plasma fibrinogen concentration, determined by the direct clot weight technique, was also significantly higher (p < 0.05) in hypertensive patients (3.90 +/- 0.62mg/dL) than in normotensive patients (2.70 +/- 0.60mg/dL). There was no evidence of gender differences in all the above variables except in the plasma fibrinogen concentration, which was significantly higher (P < 0.01) in male hypertensive patients. It is thus evident that haemorheological and thrombogenic abnormalities may be present in hypertensive Nigerian patients at the time of diagnosis and therapeutic interventions that reduce the risk of thrombogenesis and rheologic abnormalities should be considered in the management of Nigerian patients with hypertension.