CASE FINDING OF HYPERTENSION AT A SECONDARY HEALTH CARE FACILITY IN SOUTH-WEST NIGERIA.

BACKGROUND: The prevalence of hypertension is higher in Semi-urban areas than in rural areas. There is a rising prevalence of hypertension in developing countries. Significant independent association has been found between age, family history and prevalence of hypertension according to the literature. This study sought to determine the prevalence of hypertension at the State Hospital Oyo and provide evidence for routine checks of blood pressure (BP) for adult patients. METHODS: A Cross-sectional study was conducted at the General Outpatient Clinic of the State Hospital Oyo. 350 adults between the ages of 18 and 70 years were recruited for the study. A total sampling technique was used to recruit consecutive patients until a sample size of 350 was achieved. RESULTS: The prevalence of hypertension was 102/350 = 29%. Thirty (29.70%) of respondents who were 55 years and above had systolic hypertension while 24 (23.80%) had normal BP (χ2 = 87.62, p-value = 0.0001). Majority (57.6%) of respondents who had tertiary education had normal blood pressure while 24 (20.3%) had systolic hypertension (χ2 = 39.88, p-value = 0.0001). Twenty one (36.8%s) of respondents who were obese had systolic hypertension while 16 (28.1%) had normal blood pressure (χ2 = 20.61 , p-value = 0.02). Thirteen (12.80%) of respondents who were 55 years and above had diastolic hypertension while a majority (58.40%) had normal BP (χ2 = 33.40, p-value = 0.0001). CONCLUSION: Age, obesity and education were found to be risk factors for developing hypertension. However after adjusting for other variables, the predictor of risk of developing hypertension was age of respondents.

Ownership of mobile phones and willingness to receive childhood immunisation reminder messages among caregivers of infants in Ondo State, south-western Nigeria

Background. The timely completion of the childhood immunisation schedule for children under the age of 1 year by caregivers is key to reducing the high morbidity and mortality of vaccine-preventable diseases among infantsglobally.Objective. To determine the ownership of mobile phones among caregivers of children under the age of 1 year, their knowledge about immunisation service delivery and willingness to receive childhood immunisation schedule reminder messages in Ondo State, south-western Nigeria.Method. A descriptive cross-sectional study using semi-structured interviewer-administered questionnaires was conducted with 615 caregivers of infants, who brought their children to clinics conducting immunisation in 24 health facilities in rural, semi-urban and urban settlements in Ondo State in December 2014.Results. The mean (standard deviation, SD) age of respondents was 28.49 (6.01) years, 76.7% were Yoruba, 91.4% were married and living with their spouses and 4.2% were single. Mobile phone ownership was 74.5% among rural-based respondents, and 95.8% among urbanbased.Forty-six percent of the respondents had good knowledge of immunisation, vaccine-preventable diseases and vaccination schedules,while 27.5% had poor knowledge. The majority of the respondents (99.7%) were willing to receive childhood immunisation reminder messages on their mobile phones. About 50% of the respondents preferred to receive reminder messages at any time, rather than specific times. The most preferred language for reminders was English (54.5%). Residing in an urban area and having post-secondary education were predictors of mobile phone ownership.Conclusion. The high mobile phone ownership level, and the willingness of caregivers of infants in this study area to receive immunisation schedule reminder messages, is encouraging, and should be optimised to improve routine immunisation uptake. However, caregivers of infants in rural areas need to be provided with mobile phone support, and trained in their usage in order to benefit from such an intervention in childhood immunisation

High efficacy of two artemisinin-based combinations (artemether-lumefantrine and artesunate plus amodiaquine) for acute uncomplicated malaria in Ibadan, Nigeria.

OBJECTIVE: To test the hypothesis that artesunate plus amodiaquine (ASAQ) is as effective as artemether-lumefantrine (AL) in the treatment of acute uncomplicated malaria in Nigerian children. METHODS: In an open label, randomized controlled clinical trial, children aged 6 months to 10 years were randomized to receive artesunate (4 mg/kg daily) plus amodiaquine (10 mg/kg daily) or AL (5-14 kg, one tablet; 15-24 kg, two tablets and 25-34 kg, three tablets twice daily). Both drug regimens were given for 3 days and follow-up was for 28 days. RESULTS: A total of 132 children (66 in each group) were randomized to receive either ASAQ or AL. Day 28 cure rates in the per protocol (PP) population were 93% for ASAQ and 95% for AL (OR = 0.71, 95% CI = 0.12-3.99, rho = 0.66). Using Kaplan-Meier product-limit estimates of failure, the median survival time for ASAQ was 21 days and for AL 28 days (P = 0.294). PCR corrected day 28 cure rate for PP populations were 98.4% for ASAQ and 100% for AL. Both drugs were well-tolerated. CONCLUSION: ASAQ is as effective as AL and both combinations were efficacious and safe.

Polymorphisms in Plasmodium falciparum dhfr and dhps genes and age related in vivo sulfadoxine-pyrimethamine resistance in malaria-infected patients from Nigeria.

Mutations in Plasmodium falciparum dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) genes have been used as means to predict treatment failure to sulfadoxine-pyrimethamine (SP) and for monitoring/surveillance of resistance to the drug in many areas where malaria is endemic. However, patients responses to treatment are significantly dependent on factors like host immunity profile of treated patients. In order to investigate the relationship between molecular markers of SP resistance, host immunity and clinical outcome, the association between pre-treatment dhfr and dhps genotypes, age and treatment outcomes was evaluated in 109 children treated with SP for acute uncomplicated malaria in Ibadan, Nigeria. Seventy-three percent of the children were cured with the drug, while 27% failed treatment after 28 days of follow-up. All children infected with parasites harboring less than two dhfr/dhps mutations were cured with SP. The dhfr triple (Asn-108/Ile-51/Arg-59) mutants or the dhps double mutants (Gly-437/Glu-540) were independently associated with SP treatment failure in children aged less than 5 years, but not in older children. The dhfr and dhps quintuple mutant (dhfr triple mutant+dhps double mutant) was the genotype most strongly associated with SP treatment failure (OR=24.72, 95%CI=8.24-74.15) in both younger and older children.