Prevalence of hypertension in a rural community in southeastern Nigeria; an opportunity for early intervention.

Hypertension is a leading cause of non-communicable morbidity in Sub Saharan Africa. Recent studies suggest and increase in the prevalence of hypertension in rural Sub-Saharan Africa. Using a three-phase approach, a structured questionnaire was used to determine the prevalence of hypertension in a rural settlement is Enugu State, Southeast Nigeria. Blood pressure measurement was done according to the guidelines of the European Society of Hypertension. Out of 1576 participants aged 18 years and above, 1082 (68.7%) completed the full survey, their blood pressure was measured, and data analyzed. The prevalence of hypertension in this study was 27.6%, (95%CI 25-30.4), similar in males 29.2, (95%CI 24.7-30.4) and females 26.8%, (95%CI 23.5-30.2). p = 0.39. The prevalence of hypertension increased with age reaching a peak of 32.8% (95%CI 26.2-40) in the 40-49 age group, however this was not statistically significant P = 0.22. This age-related increase in the prevalence of hypertension tended towards significance in males (p = 0.05) but not in females (p = 0.44). Awareness of hypertension was 7.2%. Systolic blood pressure positively correlated with older age, higher blood glucose levels and waist-hip ratio. Diastolic blood pressure correlated with the type of work the patients is involved in and blood glucose levels. In conclusion, the prevalence of hypertension in a rural southeastern Nigeria community was 27.6%, however awareness was very low (7.9%). Most participants had mild hypertension thus offering a window of opportunity for public health educators in preventing the complications of hypertension. There is therefore the need for awareness campaigns to be intensified in rural communities.

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.

Screening for chronic kidney disease in an urban population in Nigeria.

Background: Chronic kidney disease has been reported to be on the increase globally and worse in the developing countries. Early detection has been associated with a better outcome. The objective of the study is to screen for kidney disease and its risk factors in the urban population in Nigeria. Materials and Methods: This is a cross-sectional nonrandomized study of residents of Enugu metropolis of Nigeria. Ethical approval was obtained from the ethical committee of the hospital. The study population was consecutive subjects aged 18 years and above who gave consent to the study. The details of the study were explained to the participants and informed consent obtained. The biodata, relevant clinical parameters, and blood and urine samples were obtained from each participant. The serum creatinine and urine protein of each participant were assessed. The estimated glomerular filtration rate (eGFR) was calculated using the modification of diet in renal disease epidemiology formula. Kidney disease is defined as eGFR <60 ml/min/1.73 m2 and/or proteinuria. The data obtained were analyzed using SPSS software version 20. The results were presented in tables and charts as frequencies, mean and standard deviation. P < 0.05 was considered statistically significant. Results: Four hundred and sixty-six participants participated in the study, 77.3% were females with a male: female ratio of 1:3.4. The age range was 18-90 years with a mean of 35.7 ± 12.7 years; 11.8%, 1.3%, and 0.6% had hypertension, diabetes mellitus, and kidney disease, respectively. Systolic blood pressures (BPs) of 140 mmHg and above and diastolic BP of 90 mmHg and above were found in 20% and 18.5% of the participants, respectively. Furthermore, 16.9% of the participants had a random blood glucose >11 mmol/l. The range of serum creatinine was 27.3-1029.1 µmol/l with a median of 69.1umol/l. eGFR <60 ml/min/1.73 m2 was found in 6.6% and proteinuria in 18.2%; however, 23.1% of the participants had kidney disease detected by eGFR <60 ml/min/1.73 m2 and/or proteinuria. Age, male sex, BP, and body mass index were found to have a statistically significant inverse relationship with kidney function. Conclusion: Prevalence of kidney disease in an urban population in Nigeria is high. The risk factors were hypertension, increasing age, male sex, and obesity.

RésuméLe fond: La maladie rénale chronique est en augmentation dans le monde et en aggravation dans les pays en développement. La détection précoce a été associée à de meilleurs résultats. L'objectif de l'étude est de dépister la maladie rénale et ses facteurs de risque dans la population urbaine du Nigéria. Méthode: Il s'agit d'une étude transversale non randomisée des résidents de la métropole d'Enugu dans l'état d'Enugu au Nigeria. L'approbation éthique a été obtenue du comité d'éthique de l'hôpital. La population de l'étude était constituée de sujets consécutifs âgés de 18 ans et plus qui ont donné leur consentement à l'étude. Les détails de l'étude ont été expliqués aux participants et un consentement éclairé a été obtenu. Les données biologiques, les paramètres cliniques pertinents, les échantillons de sang et d'urine ont été obtenus auprès de chaque participant. La créatinine sérique et les protéines urinaires de chaque participant ont été évaluées à l'aide des échantillons de sang et d'urine respectivement. Le taux de filtration glomérulaire estimé (DFGe) a été calculé à l'aide de la formule épi MDRD. La maladie rénale est définie comme un DFGe inférieur à 60 ml / min / 1,73 m2 et / ou une protéinurie. Les données obtenues ont été analysées en utilisant SPSS Vs 16. Les résultats ont été présentés dans des tableaux et des graphiques sous forme de fréquences, de moyenne et d'écart type. Une valeur p inférieure à 0,05 était considérée comme significative. Résultat: Quatre cent soixante six (466) sujets ont participé à l'étude, 77,3% étaient des femmes avec un rapport H: F de 1: 3,4. La tranche d'âge était de 18 à 90 ans avec une moyenne de 35,7 ± 12,7 ans; 11,8%, 1,3% et 0,6% souffraient respectivement d'hypertension, de diabète sucré et d'insuffisance rénale. Une pression artérielle systolique de 140 mmHg et plus et une pression artérielle diastolique de 90 mmHg et plus ont été retrouvées respectivement chez 20 et 18,5% des participants. De plus, 16,9% des participants avaient une glycémie aléatoire supérieure à 11 mmol / l. La gamme de créatinine sérique était de 27,3 à 1029,1 umol / l avec une médiane de 69,1 umol / l. Un DFGe inférieur à 60 ml / min / 1,73 m2 a été trouvé dans 6,6% et une protéinurie dans 18,2%, cependant 23,1% des participants avaient une maladie rénale détectée par un DFGe inférieur à 60 ml / min / 1,73 m2 et / ou une protéinurie. L'âge, le sexe masculin, la tension artérielle et l'indice de masse corporelle ont une relation négative statistiquement significative avec la fonction rénale. Conclusion: La prévalence de la maladie rénale dans une population urbaine au Nigéria est cohérente avec d'autres études dans des populations urbaines similaires. Les facteurs de risque étaient l'hypertension, l'augmentation de l'âge, le sexe masculin et l'obésité.

Kidney transplant in Nigeria: a single centre experience.

INTRODUCTION: Kidney transplant is the preferred renal replacement therapy for patients with end stage kidney disease. However management of patients with kidney transplant in resource poor countries is evolving and groaning under several mental, financial and infrastructural challenges. The objective of the study is to evaluate the management of patients with kidney transplant in a kidney care Centre in Nigeria. METHODS: This was a non-randomized prospective study. The study population were post-transplant patients presenting between 1st August 2010 and 31st December 2014.The biodata, pre and post-transplant details of these patients were documented. The data was analysed using SPSS Vs 17. RESULTS: A total of 47 patients were studied with M: F ratio of 4:1, the mean age was 45.4 ± 13.6 years. Chronic glomerulonephritis, hypertension, diabetes mellitus and HIV related kidney disease were the commonest cause of CKD. Financial constraint delayed transplant in 66% and non-availability of donor in 17.2%. About 90% of the transplants were in India and 81% either financed the transplant either directly or through a relation. There was no cadaveric transplant and about 70% of the donors were not related. Tacrolimus, mycophenolate and prednisolone were most frequently used immunosuppressive combination. The one and three years graft survival were 95.3% and 67.6% respectively while corresponding patients survival were 97.7% and 82.4% respectively. Septicaemia, acute rejection and urinary tract infection were most common complications. CONCLUSION: Management of patients with kidney transplant has good prospect despite the challenges.

Screening for risk factors of chronic kidney disease in a community in Niger Delta Nigeria.

BACKGROUND: Chronic kidney disease (CKD) is associated with many traditional and nontraditional risk factors. Screening for these risk factors has been associated with appropriate interventions and preventive measures in the management of CKD. The aims and objective of this study are to screen for risk factors of CKD in a Niger Delta community in Nigeria. SUBJECTS AND METHODS: This was a cross-sectional study. The study location was Ido, a Niger Delta community in Rivers State. All subjects aged 18 years and above who gave consent were recruited for the study. Their bio data, relevant medical history, clinical and laboratory parameters were documented. The obtained data were analyzed with SPSS versions 17.0. RESULTS: A total of 105 persons participated in the study. The age range was 18-86 years, 50.5% were above 50 years. Females were 75.0%, 66.7% had either primary or no education, 14.6% were retiree and 40.4% were traders. 14.1% were known hypertensive, and 39.4% had elevated blood pressure. 6.1% were known diabetic and 6.1% had random blood sugar of 200 mg/dl and above. 27.2% of subjects were obese. About 10.5% and 27.8% had a history of significant intake of tobacco and alcohol respectively. Total serum cholesterol was higher than 200 mg/dl in 51.5%. None of the participants had past or family history of kidney disease. CONCLUSION: The prevalence of risk factors for CKD in the Niger Delta community is high.