Association between Alanine Aminotransferase, Hypertension and Obesity in Nigerians.

BACKGROUND: Cardiovascular diseases (CVDs) are the leading causes of morbidity and mortality worldwide. Alanine aminotransferase (ALT) is associated with hypertension and obesity. OBJECTIVES: To determine the association between ALT within the reference range with hypertension and obesity. METHODS: This study utilized the data of a cross-sectional health survey involving 558 adult participants. Anthropometry, blood pressure, and plasma glucose were determined with standard protocols. Quartiles of log-transformed ALT were generated and the association with obesity/hypertension was determined with ANOVA and regression analysis. RESULTS: There were 205 (36.7%) men. The mean fasting plasma glucose (FPG) of all participants was 4.7 (1.6) mmol/L. In men, there was a positive correlation between ALT and body mass index (BMI) (r=0.148; p=0.038), waist circumference (WC) (r=0.166; p=0.020), and waist-to-height-ratio (WHtR) (r=0.163; p=0.021). No correlation was observed between ALT and anthropometric indices in women, or with blood pressure indices in both genders. In men, only WHtR (p for trend, 0.045) was significantly associated with ALT quartiles, whereas in women, only WC (p for trend, 0.028) was significantly associated with ALT quartiles. In men, compared to 1st quartile, the OR for general obesity of the 4th quartile of Log ALT was 2.662 (95% CI 1.219 - 5.816; p=0.014). In women, the OR for hypertension of the 3rd quartile of Log ALT versus the 1st quartile was 1.955 (95% CI 0.694 - 2.416; p=0.041). Log ALT did not predict hypertension and obesity in men and women, respectively. CONCLUSIONS: The risks of obesity and hypertension increase as the ALT level increases within the normal ALT range. People with normal levels of ALT in the upper limits need to be evaluated for metabolic disorders.

CONTEXTE: Les maladies cardiovasculaires (MCV) sont des causes principales de morbidité et de mortalité dans le monde. L'alanine aminotransférase (ALT) est associée à l'hypertension et à l'obésité. OBJECTIFS: Déterminer l'association entre l'ALT dans la plage de référence avec l'hypertension et l'obésité. MÉTHODES: Cette étude utilise les données d'une enquête transversale sur la santé impliquant 558 participants adultes. L'anthropométrie, la pression artérielle et la glycémie plasmatique ont été déterminées selon des protocoles standard. Les quartiles de l'ALT transformée en logarithme ont été générés et son association avec l'obésité/l'hypertension a été déterminée avec une analyse de variance (ANOVA) et une analyse de régression. RÉSULTATS: Il y avait 205 hommes (36,7%). La glycémie plasmatique à jeun moyenne (FPG) de tous les participants était de 4,7 (1,6) mmol/L. Chez les hommes, il y avait une corrélation positive entre l'ALT et l'indice de masse corporelle (IMC) (r=0,148, p<0,038), la circonférence de taille (CT) (r=0,166, p<0,020) et le rapport tour de taille/taille (WHtR) (r=0,163, p<0,021). Aucune corrélation n'a été observée entre l'ALT et les indices anthropométriques chez les femmes, ni entre les indices de pression artérielle dans les deux sexes. Chez les hommes, seul le WHtR (p pour la tendance, 0,045) était significativement associé aux quartiles de l'ALT, tandis que chez les femmes, seule la CT (p pour la tendance, 0,028) était significativement associée aux quartiles de l'ALT. Chez les hommes, par rapport au 1er quartile, le rapport de cotes (RC) pour l'obésité générale du 4ème quartile de Log ALT était (2,662, IC à 95%, 1,219-5,816; p=0,014). Chez les femmes, le RC pour l'hypertension du 3ème quartile de Log ALT versus le 1er quartile était (1,955, IC à 95%, 0,694-2,416; p=0,041). Le Log ALT n'a pas prédit l'hypertension et l'obésité chez les hommes et les femmes respectivement. CONCLUSIONS: Le risque d'obésité et d'hypertension augmente à mesure que le niveau d'ALT augmente dans la plage normale d'ALT. Les personnes présentant un niveau normal d'ALT aux limites supérieures doivent être évaluées pour des troubles métaboliques. MOTS-CLÉS: Maladies cardiovasculaires, Obésité, Hypertension, Alanine aminotransferase.

Perceived Stress and Coping Strategies among Adults with Asthma in Ile-Ife, Nigeria.

BACKGROUND AND OBJECTIVES: Asthma is one of the common chronic diseases globally. There is paucity of data on perceived stress among patients with asthma in Nigeria. This study aimed to determine the extent of perceived stress and its association with coping strategies among adults with asthma. METHODS: This is a cross-sectional descriptive study in which 100 adults with asthma were consecutively recruited from the Respiratory Clinic of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. They completed a questionnaire containing demographic details, Perceived Stress Scale(PSS), Brief Coping Orientation to Problems Experienced (Brief-COPE) Scale and Asthma Specific Coping Scale(ASCS). RESULTS: Most of the respondents were female (56%, n = 56) with mean age of 38.8 (±16.5), and FEV1% predicted was 78.9%±24.5. Sixty-three (63%) participants had high levels of perceived stress. Patients with asthma who had high perceived stress were significantly younger than those with low perceived stress (χ2 = 2.66; p=0.01). The mean scores of coping strategies for asthma patients with high stress level was generally higher compared with those with low stress level, and was significantly higher in the adaptive coping strategy (t=-3.36; p=0.01) and its subscales. For asthma specific coping scale, there was significant difference between those with high perceived stress and low perceived stress in the positive appraisal (t=-2.95, p=0.004) and ignoring asthma (t=-2.09, p=0.040) subscales. CONCLUSION: The level of perceived stress is high among Nigerian patients with asthma. This study showed that the more stressed they are, the more they are likely to use coping strategies.

CONTEXTE ET OBJECTIFS: L'asthme est l'un des maladies chroniques courantes dans le monde. Il y a peu de données sur stress perçu chez les patients asthmatiques au Nigeria. Ceci étude visant à déterminer l'étendue du stress perçu et son association avec des stratégies d'adaptation chez les adultes asthmatiques. MÉTHODES: Il s'agit d'une étude descriptive transversale dans laquelle100 adultes asthmatiques ont été recrutés consécutivement parmi les clinique respiratoire de l'Université Obafemi Awolowo Enseignement Complexe hospitalier, Ile-Ife, Nigéria. Ils ont complété un questionnaire contenant des détails démographiques, Stress perçu Échelle (PSS), Brève orientation d'adaptation aux problèmes rencontrés(Brief-COPE) Échelle et échelle d'adaptation spécifique à l'asthme (ASCS). RÉSULTATS: La plupart des répondants étaient des femmes (56 %, n = 56)avec un âge moyen de 38,8 ans (±16,5 ans) et un VEMS 1 % prédit était78,9 %±24,5. Soixante-trois (63 %) participants avaient des niveaux élevés destress perçu. Patients asthmatiques qui avaient une perception élevée le stress était significativement plus jeune que celui des personnes ayant une faible perceptioncontrainte (χ2 = 2,66; p = 0,01). Les scores moyens des stratégies d'adaptation pour les patients asthmatiques avec un niveau de stress élevé était généralement plus élevé par rapport à ceux ayant un faible niveau de stress, et était significativement plus élevé dans la stratégie d'adaptation adaptative (t =-3,36; p = 0,01) et sessous-échelles. Pour l'échelle d'adaptation spécifique à l'asthme, il y avait une différence entre ceux qui ont un stress perçu élevé et un stress faiblele stress perçu dans l'évaluation positive (t=-2,95, p=0,004) et ignorer les sous-échelles de l'asthme (t = -2,09, p = 0,040). CONCLUSION: Le niveau de stress perçu est élevé chez patients nigérians souffrant d'asthme. Cette étude a montré que leplus ils sont stressés, plus ils sont susceptibles d'utiliser l'adaptation stratégies. Mots-clés: Stress perçu, Stratégie d'adaptation, Asthme, Adaptatif adaptation.

Seropositive status disclosure to partners and safer sexual behaviours among people living with HIV: An issue in prevention and treatment.

AIMS AND OBJECTIVES: The objective of this study was to determine the rate of disclosure to sexual partners and consequent safer sexual practices among people living with HIV (PLHIV). MATERIALS AND METHODS: This was a cross-sectional study. A semi-structured interviewer administered questionnaire was used to collect demographic data of age, gender, marital status as well as HIV status disclosureand consistent condom use. This information was collected from consenting consecutive antiretroviral-therapynaive PLHIV accessing care at the Lagos State University Teaching Hospital (LASUTH), southwest Nigeria. Collected data were analysed using statistical package for social sciences (version 10.0, spss) and group comparisons were done with chi square tests. RESULTS: A total of 443 respondents were interviewed. The age of the respondents ranged from 18 to 75 years with a mean of 46.5±9. Majority 268 (60.5%) of respondents were females while 175 (39.5%) were males. The disclosure rate to sexual partners was 43 (9.7%) among studied PLHIV. Consistent condom use was highest (12.7%) among PLHIV who had disclosed to sexual partners while inconsistent use was highest (93.3%) among the undisclosed.p=0.26 CONCLUSION: This study reveals that there is a low sexual partner disclosure rate among studied PLHIV. Seropositive status disclosure to sexual partners was associated with consistent condom use.

Risk factors for un-investigated dyspepsia among primary care patients in northern Nigeria.

BACKGROUND: Many risk factors have been speculated to be associated with uninvestigated dyspepsia amongst different population groups. Some of which have been subjected to epidemiological survey while others remain unevaluated. OBJECTIVE: We evaluated some of the documented risk factors amongst patient presenting with uninvestigated dyspepsia and compared with a matched group without dyspepsia in a primary care setting. METHODS: The study was a matched case controlled study. 103 consecutive patient aged between 18 and 50 years that presented with dyspepsia (cases) were enrolled. These were matched by age and sex with the same number of subjects without dyspepsia (controls). Data were collated using a structured questionnaire Odds ratios and p-values were used to determine the significance of documented categorical risk factors associated with dyspepsia using two by two tables. For risk factors that were continuous variables the means, standard deviations and p-values were used. Risk factors with their p-values <0.2 were entered into logistic regression to identify those independently associated with dyspepsia. RESULT: H.pylori seropositivity was 22.3% and 13.6% among cases and controls respectively (p = 0.10). Pepper intake (p <0.0001) and tea intake (p = 0.0002) and greater years of education (p = 0.0065) were significantly associated with dyspepsia. H. pylori seropositivity was not related to the risk of developing dyspepsia. CONCLUSION: Helicobacter pylori seropositivity was not found to be a significant contributor to risk of developing dyspepsia among the studied population contrary to general belief. Pepper intake, tea intake and greater years of education were found to significant contributors to dyspepsia.

Condom use among antiretroviral therapy naive people living with HIV at a tertiary health care hospital in Lagos, Nigeria: implication for prevention of new infections.

BACKGROUND: The consistent use of male latex condom significantly reduces the risk of HIV infection among men and women. OBJECTIVE: This study was designed to assess the prevalence and pattern of male and female condom use among antiretroviral therapy naïve people living with HIV (PLHIV) in Lagos, Nigeria. METHODS: This was a cross-sectional descriptive study. Interviewer administered questionnaires were used to collect demographic data of age, gender, marital status, rate, pattern of and reasons for not using condoms among PLHIV. RESULTS: Four hundred and forty three respondents were interviewed with age rangefrom 14 to 75 years and a mean of 35 ± 9 years. There were 175 (39.5%) males and 268 (60.5%) females in the study. Overall, 71 (16.0%) of respondents used condom consistently. Only 55 (12.4%) of the respondents were aware of female condom while 9 (2%) used it. CONCLUSION: This study reveals that there is a low consistent use of male condoms and a very low awareness and use of female condoms among studied PLHIV.

The non-association of Panton-Valentine leukocidin and mecA genes in the genome of Staphylococcus aureus from hospitals in South Western Nigeria.

PURPOSE: Virulence genes play important roles in pathogenesis of infections caused by S. aureus. The aim of this study was to determine the prevalence of PVL, eta and mecA genes in S. aureus isolated from patients in South-Western Nigeria. MATERIALS AND METHODS: In this study, a total of 116 S. aureus isolates from the clinical specimens submitted to laboratories in tertiary hospitals in the South Western Nigeria were used. Antibiotic susceptibility test was carried out to determine the susceptibility pattern of the isolates using multiple antibiotics disc. Minimum inhibitory concentration (MIC) was also carried out to determine the degree of resistant of the isolates to methicillin. PCR was used to screen for the presence of PVL, eta, and mecAgenes. RESULTS: mecA gene was detected in 48 (41.4%) of 116 strains of S. aureus. The MIC 50 and MIC 90 for mecA negative strains were 1 and 8 µg/ml, respectively while the MIC 50 and MIC 90 for mecA positive were >256 µg/ml. Twenty eight (24.1%) of 116 isolates were PVL gene positive with none of them mecA+. The prevalence of community acquired MRSA (CA-MRSA) was estimated to be 6.9% using molecular techniques. No localization of mecA gene and PVL gene on the genome of the entire S. aureus strains studied. Site of isolation of organism /specimen type was found to be associated with the prevalence of PVL+ and mecA+ S. aureus (P< 0.01). CONCLUSION: This study concludes that the PVL+ MRSA is rare and the prevalence of CA-MRSA is low in South-Western, Nigeria.

Drug prescription pattern for asthma among nigerian doctors in general practice: A cross-sectional survey.

BACKGROUND: A wide range of medications are now available for the treatment of asthma and selection of the optimal treatment combination of agents is essential. OBJECTIVES: This study was designed to evaluate a self-reported drug prescribing pattern for asthma among Nigerian doctors in general practice. METHODS: It was a cross-sectional survey conducted among general practitioners in six states of Nigeria. RESULTS: For acute severe asthma, 75.9% of the doctors prescribed intravenous methylxanthines, which was combined with oral or inhaled short-acting ß(2) agonists (SABA) by 56.3% of them. Systemic steroids were prescribed mainly via the intravenous route by 58.8% of them. Aberrant drugs such as antibiotics, antihistamines, and mucolytics were prescribed by 25.6% of them. For long-term, follow-up treatment of asthma, oral steroids, and oral SABA were commonly prescribed, while inhaled corticosteroids (ICS) and ICS/LABA (long acting beta agonists) were infrequently prescribed. Aberrant drugs such as analgesics, antimalaria, and antihistamines were prescribed by 22.8% of them. About 48% of the doctors had never attended any form of update training on asthma management, whereas, only 16.3% attended update training on asthma within the last year preceding this study. Awareness of international guidelines on asthma treatment was poor among them with only 16.4% being able to mention any correct guideline on asthma management. CONCLUSION: The poor anti-asthma prescribing behavior among these doctors is associated with a low level of participation at update training on asthma management and poor awareness of asthma guidelines. The Nigerian Medical Association and the Nigerian Thoracic Society should urgently address these problems.

Plasmid-mediated fluoroquinolone-resistance QnrA and QnrB genes among Escherichia coli from cattle in Ado-Ekiti, Nigeria.

OBJECTIVE: This is to investigate the implication of fluoroquinolone usage in veterinary practice and the food chain system. SUBJECTS AND METHODS: Five hundred isolates of commensal E coli were recovered from the faeces of apparently healthy cattle in Ado-Ekiti, Nigeria. The susceptibility of the bacteria was tested using standard laboratory procedures. Polymerase chain reaction (PCR) was carried out to detect the presence of qnrA and qnrB genes, which were selected on the basis of their fluoroquinolone-resistant patterns. RESULTS: The agar disc diffusion technique revealed that the representative isolates showed multiple fluoroquinolone-resistance and this formed the basis for their selection for PCR amplification. The PCR revealed that ten of the 17 quinolone-resistant representative isolates showed distinct bands which are specific for the qnrB gene; in addition, only one strain of the 20 representative isolates of commensal E coli carried plasmids on which the qnrA gene was detected. CONCLUSION: This study has confirmed that plasmid-mediated quinolone resistance is a possible mechanism among the fluoroquinolone-resistant commensal E coli isolated from faeces of apparently healthy cattle in the study location.

Crohn's disease presenting as a recurrent perianal fistula: a case report.

Crohn's disease (CD) is a multifactorial polygenic disease characterized by chronic inflammation of the gastrointestinal tract (GIT), often complicated by the development of intestinal strictures and/or formation of fistulas. Several diagnostic criteria have been proposed, usually relying on clinical, endoscopic, radiological or histological features. report a case of Crohn's disease of the entire colon with rectal sparing presenting with recurrent perianal fistula that had earlier on been misdiagnosed and treated for other things. The patient was treated successfully with corticosteroids and aminosalicylates and had since remained stable.

Portal biliopathy in a 13-year-old Asian girl: a case report and review of literature.

Portal biliopathy (PB) is a term used to describe biliary ductal and gallbladder wall abnormalities seen in patients with portal hypertension. The pathogenesis of PB is not well known. It has been postulated that external pressure of portal cavernoma and/ or ischemia may play a role. We report a case of a patient with PB presenting with obstructive jaundice that involved endoscopic sphincterotomy and stenting.

CD4+ T-lymphocytes cell counts in adults with human immunodeficiency virus infection at the medical department of a tertiary health institution in Nigeria.

OBJECTIVES: To evaluate the CD4+ cell counts in adults with human immunodeficiency virus (HIV) infections presenting at the medical department of the Federal Medical Centre, Ido-Ekiti, Nigeria. METHODS: This study was carried out at the medical department of the Federal Medical Centre (FMC), Ido-Ekiti, Nigeria, in the period July-December 2006. FMC, Ido, was recently upgraded to serve as the only center for HIV/AIDS referral, diagnosis and treatment in Ekiti State. The center offers free antiretroviral therapy. All patients with a diagnosis of HIV/AIDS, either diagnosed at the center or referred from other hospitals, admitted to the medical department within the study period had their blood sample taken for CD4 cell counts estimation at the first visit to the center, as part of the routine workup to assess their disease status and need for antiretroviral therapy. RESULTS: A total of 87 patients comprising of 54 (62.1%) females and 33 (37.9%) males had their CD4+ T-Lymphocytes cell counts evaluated within their first week of presentation. The total mean age of the population studied was 33.17 +/- 7.01 years. The mean age of the females was 31 +/- 5.6 years, while that of the males was 36.5 +/- 8.2 years. The difference between the mean ages of females and males was statistically significant (P = 0.0004). The female: male ratio was 1.6:1. Out of the 87 patients, 30 were referrals from other hospitals within the state. The total mean CD4+ cell count was 230.7 +/- 311.9 cells/microL. The mean CD4 cell count of females was 212.17 +/- 264.96 cells/microL, while that of males was 261.0 +/- 389.19 cells/microL. This difference was not significant (P = 0.4876). Majority of the patients (75, [86.2%]), had CD4 cell count < 350 cells/microL, comprising of 48 females and 27 males. Of the 75 patients, 57 (76%) had a CD4 cell count < 200 cells/microL (33 females vs. 24 males). CONCLUSION: At the time of HIV diagnosis, majority of our patients had a CD4+ cell count < 200 cells/microL. This was consistent with a relatively advanced disease. More women than men in the population were found positive for HIV. More sustained and vigorous awareness campaigns need be embarked upon in the HIV propaganda in the Ekiti State on one hand and Nigeria on the other hand to bring down this Hydra-headed monster called HIV/AIDS.

Pattern and outcome of diabetic admissions at a federal medical center: a 5-year review.

BACKGROUND: Prevalence of diabetes mellitus (DM) is increasing worldwide, with the major increases expected to occur in developing countries. It has been observed that the pattern of hospital admissions can be used to determine the effectiveness of outpatient care of DM. OBJECTIVE: This study was aimed to examine diabetes-related admissions to medical wards of a federal medical center in Ekiti, Nigeria. Such data would be useful to determine the burden on health care system and in the planning of appropriate management strategies. METHODS: A 5-year retrospective analysis of diabetes-related admissions to the medical wards of Federal Medical Centre, Ido Ekiti, Ekiti State, between 2003 and 2007 was carried out using medical records of the patients. SPSS 13 software was used to analyze data. RESULTS: Of the total 2,696 medical admissions, 118 (4.4%) were diabetes related. The mean age of these patients was 57 +/- 16.2 years. Majority (37.29%) of the patients were admitted for diabetic foot ulcer. Other major reasons for admission were severe hypertension (13.56%), uncontrolled hyperglycemia (13.56%), hyperglycemic emergencies (11.86%) and stroke (10.17%). Duration of hospital stay ranged from 1 to 107 days, with a mean duration of 17.5 +/- 9.2 days. Mean duration of hospital stay was the longest (25.3 +/- 23.9 days) for those admitted for diabetic foot ulcer. Most (74.6%) of the patients were discharged and only 4 (3.4%) died. Majority of those who left against medical advice were admitted for diabetic foot ulcer. CONCLUSION: There is a need to emphasize foot care as one of the cardinal features of optimal diabetes care. Establishing clinics specializing in treating diabetes and having facilities for treatment of all aspects of diabetes, including diabetic complications, will help in providing better patient care and in minimizing hospital admissions.

Treatment to Targets in Type 2 Diabetics: Analysis of Out-Patients Practice at a Remote Western Nigerian Hospital

Diabetes mellitus (DM) is a leading cause of morbidity and mortality all over the world. Tight control of diabetes in the outpatients will reduce complications and hospitalizations. This study of Nigerian patients with diabetes examined the adequacy of glycemic and BP control in line with current guidelines. A 4 month retrospective analysis of type 2 diabetics attending Medical Outpatients Department (MOPD) of Federal Medical Centre, Ido Ekiti, Ekiti State, Nigeria between June and September 2008 was carried out using medical records of the patients. SPSS 13 software was used to analyze data. Data are expressed as mean ± Standard Deviation (SD) and frequency expressed as a percentage where necessary. A total of 308 type 2 diabetes mellitus patients, aged between 35 and 85 years were analyzed. Their mean age was 60.90 ± 11.60years. There were 125 males (40.6%) and 183 females (59.4%) giving an M: F ratio of 1:1.46. Mean duration of clinic attendance was 26.18 ± 24.46 months. Glycemic control was achieved in only about a third of the patients (29.3% and 32.5% using IDF-Europe and ADA criteria respectively). Blood pressure control was achieved in 24.5% and 48.7% had BMI ≥ 25kg/m2. No correlation between mean fasting plasma glucose (FPG) and body mass index (BMI). Frequencies of insulin and low dose aspirin use were low (5.3% and 37% respectively). The results from this study showed poor control of blood glucose, BP and weight in the patients. We are of the opinion that current practices are not aggressive enough to manage a substantial proportion of type 2 diabetes patients

Biodegradation of Nigerian wood wastes by Pleurotus tuber-regium (Fries) Singer.

Studies were carried out for 90days on the degradation of wood wastes of four economically important Nigerian trees; Terminalia superba, Mansonia altissima, Holoptelia grandis and Milicia excelsa by white rot fungus, Pleurotus tuber-regium a Nigerian edible mushroom. The pH of the wastes dropped to 4.0/4.2, 90days after incubation. On the contrary, amino nitrogen content of the wastes increased consistently during this period of solid-state fermentation. Lignin degradation also increased with the increase in incubation days. The greatest lignin reduction was observed in H. grandis followed by T. superba, M. altissima and M. excelsa. Digestibility of spent substrates by ruminants increased during fermentation as follows: M. excelsa>M. altissima>T. superba>H. grandis. These results are discussed in relation to the use of fermented wood wastes as feeds for ruminants.

Case report: acute fatty liver of pregnancy in a 30-year-old Nigerian primigravida.

Acute fatty liver of pregnancy is an uncommon, potentially fatal disorder that usually occurs in the third trimester of pregnancy or in the early post partum. We present here a 30-year-old Nigerian primigravida with acute fatty liver of pregnancy. She was successfully managed and discharged.

Antibacterial potency of methanol extracts of lower plants.

Antibacterial potency of methanol extracts of three green lower plants, Pneumatopteris afra, Platycerium bifurcatum and Nephrolepsis bisserata was determined using agar dilution method on clinical strains of Escherichia coli, Staphylococcus aureus, Klebsiella spp. and Salmomelia typhi. Antibacterial activities were observed at concentrations of 12.5, 25.0, 50.0 and 100.0 microg/ml. Their minimum inhibitory concentrations ranged from 12.5approximately 100 microg/ml. Extracts of P. afra and P. bifurcatum were most active. Antibacterial activities observed with N. bisserata were less pronounced with no detectable activity at extract concentrations of 12.5 and 25.0 microg/ml. E. coli, together with S. aureus appeared to be the most susceptible of the test bacteria while Klebsiella spp. was least sensitive. The significance of our findings is discussed.

Knowledge and perception of stroke among at risk medical out-patients in a tertiary health institution in Nigeria.

BACKGROUND: Patients who recognize their increased risk of stroke are more likely to engage in stroke prevention practices than those who do not. METHOD: All patients attending medical out-patient clinic of the Federal Medical Center, Ido, Ekiti-State, Nigeria between January 2004-December 2004 were recruited into the screening process following their verbal consent. A set of questionnaire was administered to collect data. RESULTS: A total of 155 patients were studied having satisfied the inclusion criteria. The mean age of the patients was 58.4 +/- 18.7 years. Majority of the patients indicated paralysis of one side of the body as the most common symptom of stroke. Patients with higher education p = 0.002 and men p = 0.004 were more aware of their increased risk factor for stroke than those with low education and women. CONCLUSION: Perception about stroke among the at risk medical out patients as found out in this study indicates that more health education both at the community and the hospital is very vital to reducing the prevalence, recurrence, disability and mortality of stroke. Health providers are enjoined to communicate information about stroke risk to their patients.

Seroprevalence of hepatitis B surface antigenemia among health care workers in a Nigerian tertiary health institution.

OBJECTIVE: The aim of this study was to determine the seroprevalence of Hepatitis B surface antigenaemia among the health care workers at the Federal Medical Centre, Ido-Ekiti, Nigeria. DESIGN AND METHOD: The study was carried out on all the staff members in the employment of the Federal Medical Center, Ido Ekiti, Nigeria as at 30th April 2003. Data were collected by administering a set of questionnaire to every member of staff. Blood samples (3mls) were taken from the left cubital fossa of all the respondents and Hepatitis B surface antigen status determined using the agglutination kits manufactured by Biotech Laboratories USA. RESULTS: A total of 420 staff members were screened. 168 (40%) were males while 252 (60%) were females. Only 18 were found to be positive for Hepatitis B surface antigen giving a prevalence of 4.3%. 9 (50%) of those that were positive for Hepatitis B surface antigen were ward maids/attendants, 6 (33%) were nurses, 2 (11%) were administrative staff and 1 (6%) was a health record staff. CONCLUSION: Health care workers are at increased risk of having hepatitis B infection. Health education should be carried out routinely in our hospitals to raise the awareness level among the hospital staff and standard safety measures such as sharps policy should be adopted in the handling of blood products and sharps.

Clinical and laboratory indices of cholelithiasis in adult Nigerians with sickle-cell anaemia.

The clinical and laboratory indices of cholelithiasis in adult Nigerians with homozygous sickle-cell disease (SCD) were studied in 100 consecutive patients attending the adult SS clinic of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. The study examined the role of clinical (sickle cell (SS) crises, body mass indices [BMIs]), haematological (reticulocyte count, haemoglobin) and biochemical (serum bilirubin, serum alkaline phosphatase and serum amino transaminases) indices in predicting the likelihood of finding cholelithiasis in patients with SS anaemia. A positive correlation was found between the BMI, SS crises, reticulocyte count, serum bilirubin, serum alanine and asparate transferases on one hand and the development of cholelithiasis (at P values of 0.04, 0.03, 0.05, 0.01 and 0.04, respectively) on the other. No such association was found between the other indices studied and cholelithiasis.

A serosurvey of Haemophilus ducreyi, syphilis, and herpes simplex virus type 2 and their association with human immunodeficiency virus among female sex workers in Lagos, Nigeria.

BACKGROUND AND OBJECTIVES: To determine the prevalence rates of serological reactivity of Haemophilus (H.) ducreyi, Treponema pallidum, and herpes simplex virus type 2 (HSV-2) antibodies among female sex workers (FSWs) and their association with human immunodeficiency virus (HIV) antibody status. STUDY DESIGN: Cross-sectional, standard serological assays were used for syphilis, HSV-2 and HIV; a modified enzyme-linked immunosorbent assay (ELISA) was used to detect specific anti-H. ducreyi immunoglobulin (Ig) G and IgA antibodies. RESULTS: Seroprevalence rates were 86% for anti-H. ducreyi IgG and 69% for anti-H. ducreyi IgA; 4% for rapid plasma reagin (RPR) and Treponema palladium hemagglutination assay (TPHA) confirmed syphilis; 59% for HSV-2; 12% for HIV-1 and 2% for HIV-2. Lower-class FSWs were significantly more likely than upper-class FSWs to be H. ducreyi seropositive (IgG: OR = 42.7; IgA: OR = 7.6) and have current or past syphilis infection (RPR: OR = 3.5; RPR and TPHA: OR = 4.5). The presence of syphilis increased significantly with older age (P-trend < 0.001). Non-Nigerian FSWs had significantly higher reactivity to chancroid (IgG: OR = 3.5; IgA: OR = 1.8) and borderline reactivity to syphilis (RPR: OR = 1.6; TPHA: OR = 2.0). A history of sex with non-Nigerian Africans was significantly associated with chancroid reactivity and borderline significant with syphilis serostatus. H. ducreyi seropositivity was significantly more likely in FSWs with HSV-2 (OR = 2.4) and syphilis (OR = 5.6). Chancroid and HSV-2 antibodies were also more common in HIV-infected FSWs. CONCLUSION: The prevalence of H. ducreyi antibodies is the highest rate that has been reported. Our findings underscore the importance of an effective program to control GUDs as part of the strategy to prevent the potentially explosive spread of HIV in Nigeria.

PIP: Cross-sectional standard serologic assays were used to determine the prevalence of Haemophilus ducreyi, Treponema pallidum, and herpes simplex virus type 2 (HSV-2) antibodies among 796 female commercial sex workers from Lagos, Nigeria, and their association with HIV antibody status. The seroprevalence rates were 86% for anti-H. ducreyi IgG and 69% for anti-H. ducreyi IgA, 4% for rapid plasma reagin and Treponema palladium hemagglutination assay confirmed syphilis, 59% for HSV-2, 12% for HIV-1, and 2% for HIV-2. Lower-class sex workers were significantly more likely than upper-class sex workers to be H. ducreyi-positive and to have current or past syphilis infection. The presence of syphilis increased significantly with older age. Non-Nigerian sex workers had significantly higher reactivity to chancroid and borderline reactivity to syphilis. A history of sex with non-Nigerian Africans was significantly associated with chancroid reactivity and borderline significant with syphilis serostatus. H. ducreyi seropositivity was significantly more likely in female sex workers with HSV-2 and syphilis. Chancroid and HSV-2 antibodies were also more common in HIV-infected sex workers. The high prevalence of H. ducreyi antibodies detected in this study underscores the importance of an effective program to control genital ulcerative disease as part of the strategy to prevent the spread of HIV in Nigeria.