An overview of sickle cell disease from the socio-demographic triangle - a Nigerian single-institution retrospective study.

Introduction: Sickle cell disease (SCD) is a hereditary red blood cell disorder of public health importance globally with Nigeria the epicenter zone in Africa. There is a paucity of knowledge on how hemoglobin variants, personal characteristics, and environment (socio-demographic triangle) interact to influence SCD propagation. A clinical overview of these epidemiologic parameters may proffer strategies for controlling the SCD disease burden. The objective of this study was to examine the prevalence patterns of SCD, including other associated epidemiologic and hematological (i.e., hemoglobin concentration, ABO blood groups) parameters from laboratory data. Methods: this was a retrospective cross-sectional study of 138 newly diagnosed SCD patients in the laboratory unit of the department of haematology using routine alkaline cellulose acetate hemoglobin electrophoresis technique from 2013 to 2014. Demographic and other relevant data were obtained from case notes and laboratory records at the presentation. The agent-host-environment variables were used in the construction of the epidemiological triad chain of transmission. Results: a total of 138 (1.63%) newly diagnosed SCD patients aged 7 months to 41 years made up of 39% (0.63% SCD prevalence) adults and 61% (1% SCD prevalence) pediatric age-groups were seen out of 8457 consecutive patients screened within the study period. About 98.55% and 1.45% were homozygous sickle-hemoglobin (SS) and heterozygous sickle-hemoglobin C (SC) variants, respectively. The pediatric department (CHER+CHOP) recorded the highest proportion of SCD (65%). In contrast, the public health department had the least proportion (1%). There was a statistically significant difference in the gender status and the months of SCD diagnosis (p=0.0147). The month of April had the highest proportion of SCD. A majority (66.7%) of the SCD had moderate grade anemia. Conclusion: the study revealed a gender disparity in the months of SCD diagnosis. However, there was no statistical difference in the pediatric and adult SCD prevalence patterns.

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.

Prevalence and Predictors of Chronic Kidney Disease in a Semiurban Community in Lagos.

BACKGROUND AND OBJECTIVES: The prevalence of noncommunicable diseases like chronic kidney disease is on the rise in third-world countries. In Nigeria and most sub-Saharan African countries, there is dearth of community-based studies on prevalence and predictors of chronic kidney disease, prompting us to undertake this study. MATERIALS AND METHODS: This was a cross-sectional study, aimed at ascertaining the prevalence and predictors of chronic kidney disease (CKD) in a semiurban community in Lagos, Southwest Nigeria. The study's subjects were recruited from Agbowa community in Ikosi-Ejirin Local Council Development Area of Lagos state. The community was randomly selected. Questionnaires were used to obtain relevant information from the subjects. Body mass index, anthropometric measurements, and other relevant data were also collected. RESULTS: CKD was observed in 30 subjects given prevalence of 7.5% in the community. Nine out of the 30 subjects (30%) with CKD were males, while 21 (70%) subjects were females. The prevalence of CKD was significantly higher in the female population. 28 of the subjects with CKD were in stage 3, while 2 of the subjects with CKD were in stage 4. Age, hypertension, and hyperuricemia were significantly associated with CKD. Using multiple logistic regression analysis, 4 variables predicted CKD in the study population. These were age (P =0.01, OR = 0. 274, CI = 0.102 - 0.739), hypertension (p = 0.011, OR = 0. 320, CI = 0.132 - 0.773), hyperuricemia (p=0.001, OR = 0.195, CI =0.083 - 0.461), and female sex (p = 0.009, OR = 3.775, CI = 1.401 - 10.17). CONCLUSION: The prevalence of CKD in the population is low compared with other studies from other parts of the country, and the predictors included age, hypertension, hyperuricemia, and female gender. This is the first community-based study in Nigeria to identify hyperuricemia as a risk factor for chronic kidney disease in the country.

Prevalence of chronic kidney disease in Nigeria: systematic review of population-based studies.

BACKGROUND: The aim of this study was to identify and discuss published population-based studies carried out in Nigeria that have information on the prevalence of chronic kidney disease (CKD) and have also used the Kidney Disease Outcomes Quality Initiative (KDOQI) practice guidelines in defining CKD, with emphasis on the performance of three estimating equations for glomerular filtration rate (GFR) - Modification of Diet in Renal Disease (MDRD), Cock-croft-Gault, and CKD epidemiology collaboration (CKD-EPI) creatinine equation. MATERIALS AND METHODS: A systematic literature search was carried out in Google, MEDLINE, PubMed, and AJOL database, with the aim of identifying relevant population-based studies with information on the prevalence of CKD in a location in Nigeria. RESULTS: Seven cross-sectional population-based studies were identified. Two of the studies used the Cockcroft-Gault and observed a prevalence of 24.4% and 26%. Four of the studies used the MDRD and the prevalences observed were 12.3%, 14.2%, 2.5%, and 13.4%. One of the studies used the CKD-EPI equation and the prevalence was 11.4%. The male to female ratios of CKD prevalence in six studies were 1:1.9, 0.8:1, 1:1.6, 1:2, 1:1.8, 1:1.4, and the observed risk factors in the studies were old age, obesity, diabetes mellitus, hypertension, family history of hypertension, family history of renal disease, low-income occupation, use of traditional medication, low hemoglobin, and abdominal obesity. CONCLUSION: The prevalence of CKD was high but variable in Nigeria, influenced by the equation used to estimate the GFR. MDRD and CKD-EPI results are agreeable. There is a need for more population-based studies, with emphasis on repeating the GFR estimation after 3 months in subjects with GFR <60 mL/min/1.7 m2.

Clinicians-related determinants of anticoagulation therapy and prophylaxis in Nigeria.

BACKGROUND: Thromboembolic and hypercoagulable diseases are common life-threatening but treatable problems in hospital practice. Fortunately, anticoagulation is an efficacious management practice indicated for arterial, venous, and intracardiac thromboembolism. Clinicians in developing countries may have gaps in their knowledge of anticoagulation therapy/prophylaxis which could affect their clinical decision. OBJECTIVES: The study examined the knowledge and attitude of clinicians to anticoagulation therapy/prophylaxis in some tertiary hospitals in Nigeria. METHODOLOGY: The study was a multicenter survey. A pretested questionnaire was administered to clinicians in six tertiary hospitals in Southeast Nigeria. RESULTS: A total of 528 questionnaires were returned by 419 (79.4%) residents and 109 (20.6%) consultants. We observed significant abysmal knowledge and lack of awareness of direct oral anticoagulants (DOACs) among most respondents irrespective of their job grades (P = 0.02, odds ratio [OR] 0.59, 95% confidence interval [CI] 0.38-0.90). Their knowledge of anti-Xa assay as laboratory monitoring tool was also significantly inadequate (P = 0.001, OR 0.23, 95% CI 0.10-0.51). On statement analysis on their attitude to anticoagulation therapy/prophylaxis, "Do you think anticoagulation therapy/prophylaxis is clinically relevant" had the highest mean of 4.60, P = 0.01, and a high degree of agreement; while "Should hospital inpatient with > 3 days admission routinely receive anticoagulation/prophylaxis?" had the lowest mean of 2.27, P = 0.02, and a low degree of agreement. CONCLUSION: There is the need to upscale knowledge of anticoagulation agents and an attitude change to anticoagulation therapy/prophylaxis, especially on the DOACs through continuing medical education activities in emerging countries such as Nigeria.