Population-based prevalence of high blood pressure among adults in an urban slum in Enugu, South East Nigeria.

In sub-Saharan Africa (SSA), rapid urbanization and changing lifestyle have modified the profile and pattern of various medical disorders. Apart from high prevalence rates, recent trends with regard to hypertension in Africa include: low levels of awareness, treatment and control. Although a large number of studies provide data about hypertension in SSA, few studies focused on special populations such as urban slum dwellers. The WHO STEP-wise approach to surveillance of noncommunicable diseases was used to access the prevalence of hypertension among adults in one of the urban slums in Enugu. Out of the 811 individuals aged 20 years and above surveyed, 774 (95.4%) cases were analyzed. About 4.7% and 2.7% reported a past history of diabetes and stroke, respectively, whereas 15% had a positive family history of hypertension. The mean (95% confidence interval (CI)) body mass index (BMI) was 23.7 (23.2-24.2) kg m(-2) among males and 26.6 (25.7-26.7) kg m(-2) among females (P<0.0001). The prevalence of hypertension was 52.5% (95% CI: 48.9-56.0) and 55.4% (95% CI: 49.5-61.3) in males and 50.8% (95% CI: 46.4-55.1) in females (P=0.23). It increased with age peaking at 45-54 years in females and ⩾55 years in males. About 40.1% were aware of their hypertension and 28.8% of those aware had normal blood pressure. In regression analysis, systolic (R(2)=0.192) and diastolic (R(2)=0.129) blood pressures increased with age and BMI. The prevalence of high blood pressure among adults in Enugu slums is very high and a cause for concern, and calls for urgent attention.

Estimated probability of stroke among medical outpatients in enugu South East Nigeria.

BACKGROUND: Stroke is a growing noncommunicable disease in Africa and accounts for a substantial number of medical and neurological admissions in Nigerian hospitals. The prevalence of some risk factors for stroke such as hypertension and diabetes are high and growing among Africans. AIM: The aim was to investigate the distribution of stroke risk factors and estimate the 10-year probability of stroke among patients attending the out-patient clinics in the two biggest hospitals in Enugu South East Nigeria. SUBJECTS AND METHODS: Consecutive consenting patients attending out-patient clinics at University of Nigeria Teaching Hospital and Enugu state University of Science and Technology Teaching Hospital all in Enugu were enrolled. Risk factors for stroke were evaluated using a series of laboratory tests, medical history and physical examinations. The 10-year probability of stroke was determined by applying the Framingham stroke risk equation. Statistical analysis was performed with the use of the SPSS 17.0 software package (SPSS Inc., Chicago, IL, USA). RESULTS: A total of 165 patients were evaluated. Of these 94 were male and 71 were female. The most common risk factors were left ventricular hypertrophy 70.3% (116/165) and raised systolic blood pressure 52.7% (87/165). The mean age of patients was 66.1 (8.1) years. The mean 10-year probability of stroke was 18.1 (14.6) (19.7 [14.9] in men and 14.5 [14.6] women) and was higher in older age groups. CONCLUSION: The 10-year probability of stroke in Nigerians attending medical outpatient Clinic in SE Nigeria may be high. Aggressive interventions are needed to reduce risk factors and the probability of stroke risks especially in men in SE Nigeria.

Pattern of medical admissions at enugu state university of science and technology teaching hospital: a 5 year review.

BACKGROUND: Rapid urbanization and changing lifestyle have modified the profile and pattern of various medical disorders in many Nigerian communities. Surveys of medical admissions into various Nigerian health institutions show an increasing burden of non-communicable diseases in our communities. AIM: To determine the profile and pattern of medical cases admitted and their outcome in a new tertiary medical institution in South East Nigeria. MATERIALS AND METHODS: A review of medical admissions into the Enugu State University of Science and Technology Teaching Hospital (ESUTTH), Enugu, Nigeria over 5 years between January 1, 2006 and December 30, 2010 was undertaken. Morbidity and mortality data were obtained from ward registers and subsequently medical record registers. Classifications of medical disorders were grouped using ICD 10 coding system. RESULTS: A total of 3,865 case records were analyzed. Males were 2,312/3,865 (59.6%) and females 1,660/3,865 (40.2%). The age range was 14-105 years with a mean age of 54.3 (18.1) years. The 4 commonest causes of medical ward admissions were neurological disorders-850/3,865 (22%), endocrine disorders-735/3,865 (19.1%), cardiovascular disorders-718/3,865 (18.5%) and infectious diseases-604/3,865 (15.6%). The diseases encountered most were diabetes mellitus-735/3,865 (19.1%), hypertension/congestive cardiac failure-703/3,865 (18.2%), strokes-614/3,865 (15.9%) and human immunodeficiency virus (HIV)/AIDS-503 (13.1%). The overall mortality was 766/3,865 (19.8%) men-467/2,312 (20.2%); women-299/2,312 (19.3%). Strokes accounted for most of the deaths-171/766 (22.3%) followed by HIV/AIDS 127/766 (16.6%). Hypertension/cardiac failure and diabetes each accounted for 116/766 (15.1%) of all deaths. Case fatality rates for strokes and HIV/AIDS were the highest (171/614 (27.9%) and 127/503 (25.2%) respectively). Mortality rate was highest in the above 70 years age group. CONCLUSION: Non-communicable disorders are the commonest causes of medical ward admission in this tertiary institution. Efforts aimed at primary prevention will help to reduce the burden of these disorders in the community.

Gastric acid secretion studies in Enugu, using pentagastrin stimulation.

Mean acid output was studied in forty-three Nigerian subjects (twenty controls and twenty-three duodenal ulcer patients). 6 micrograms/kg body weight of pentagastrin was given to each after 1 hour basal acid output (B.A.O.) collection. Maximal and peak acid outputs (M.A.O. and P.A.O.) were measured in mmol/hr using the indicator-titration method. Gastric juice volume was measured in mls. For the control the B.A.O., M.A.O. and P.A.O. in mmol/hr were (Mean 1 S.D.) 1.7 +/- 1.6; 13.5 +/- 4.61 and 15.1 +/- 5.3 respectively. The corresponding figures for the duodenal ulcer patients was 3.2 +/- 2.7; 25.1 +/- 8.5; 28.4 +/- 11.1. P less than 0.05, P less than 0.001 and P less than 0.001 respectively). The mean stimulated gastric juice volume of 131.3 +/- 29.6 ml in the controls differed significantly from the volume 198.2 +/- 54.9 in the duodenal ulcer patients (P less than 0.001). 182 mls of gastric juice was found to be the volume above which is duodenal ulcer may be suspected. Acid values are compared with published data and reasons for any differences discussed.

Dose response studies of gastric acid secretion in Nigerians using pentagastrin stimulation.

To determine the does of pentagastrin required for maximal gastric acid secretion, 6, 8, and 10 micrograms/kg body weight of intramuscular pentagastrin were given to twenty Nigerian subjects (ten controls and ten duodenal ulcer patients). The different doses of pentagastrin were administered to each subject on different days. 8 micrograms/kg body weight of pentagastrin caused the highest gastric acid output in all the subjects followed by 6 and lastly 10 micrograms/kg body weight. Significant differences in the mean stimulated acid output by 6 and 8 micrograms/kg body weight to pentagastrin were found only in the duodenal ulcer patients (Maximal Acid Output (M.A.O.).