Association between Height and Blood Pressure in Middle Age and Older Adults in Southeast Nigeria.

BACKGROUND: This study was carried out in Abia State, Southeast Nigeria, to determine the association between height and blood pressure in middle age and elderly adults. MATERIALS AND METHODS: This was a cross-sectional study carried out in Abia State, Southeast Nigeria, between August 2011 and March 2012. The participants were residents in the state and were recruited from the three senatorial zones of the state. The total number of participants that took part in the study was 2,487 adults. The World Health Organisation STEPwise approach to surveillance of chronic disease risk factors was used. Information collected included blood pressure and anthropometric measurements. The association between height and blood pressure was determined. RESULTS: A total of 1,363 participants that took part in the study were >40 years old. Six hundred and fifty-five participants (48.1%) were males and 708 participants (51.9%) were females. There was no significant inverse relationship between height and blood pressure components ( Systolic Blood Pressure Diastolic Blood Pressure, and Pulse Pressure ) among the males. Among the females there was a high inverse relationship between height and blood pressure components. However, this relationship was not statistically significant. In addition, among the males there was no relationship between height and hypertension. Among the females, there was some degree of inverse relationship between height and hypertension, although multivariate regression analysis showed that this was not significant. CONCLUSION: There was an inverse but non-significant relationship between height and blood pressure components/ hypertension among males and females in Southeast Nigeria in this study.

CONTEXTE: Cette étude a été menée dans l'État d'Abia, au sud-est du Nigeria, pour déterminer, pour déterminer l'association entre la taille et la pression artérielle chez les adultes d'âge moyen et les personnes âgées. MATÉRIEL ET MÉTHODES: Il s'agissait d'une étude transversale réalisée dans l'État d'Abia, au sud-est du Nigeria, entre août 2011 et mars 2012. Les participants étaient des résidents de l'État et ont été recrutés dans les trois zones sénatoriales de l'État. Le nombre total de participants ayant pris part à l'étude était de 2 487 adultes. L'approche STEPwise de l'Organisation mondiale de la santé pour la surveillance des facteurs de risque des maladies chroniques a été utilisée. Les informations recueillies comprenaient la pression artérielle et les mesures anthropométriques. L'association entre la taille et la pression artérielle a été déterminée. RÉSULTATS: Au total, 1 363 participants à l'étude étaient âgés de plus de 40 ans. Six cent cinquante-cinq participants (48,1%) étaient des hommes et 708 participants (51,9 %) étaient des femmes. Il n'y avait pas de relation inverse significative entre la taille et les composantes de la pression artérielle (pression artérielle systolique, pression artérielle diastolique et pression du pouls) chez les hommes. Chez les femmes, on a constaté une forte relation inverse entre la taille et les composantes de la pression artérielle. Cependant, cette relation n'était pas statistiquement significative. En outre, Chez les hommes, il n'y a pas de relation entre la taille et l'hypertension. Chez les femmes, on a constaté un certain degré de relation inverse entre la taille et l'hypertension, bien que l'analyse de régression multivariée a montré qu'elle n'était pas significative. CONCLUSION: Il existe une relation inverse, mais non significative, entre la taille et les composantes de la pression artérielle/ hypertension chez les hommes et les femmes du sud-est du Nigeria. Mots clés: Taille, Hypertension, Pression artérielle, Pression artérielle systolique.

Prevalence and Pattern of Smoking among Health Science Students in Nnamdi Azikiwe University Nigeria.

BACKGROUND AND OBJECTIVE: Cigarette is a Group 1 carcinogen and a major global health concern. The morbidity and mortality attributable to cigarette smoking are preventable. Health workers and health professional students are presumed to be well informed about smoking and are, therefore, absolved from the menace of smoking: The objective of this study was to determine the prevalence and pattern of smoking among preclinical and health professional students, the knowledge they had of the health consequences of smoking and the reasons why they smoked. METHODS: This was a cross-sectional study of 277 students in which self-administered semi-structured questionnaire was used. The variables addressed were age, gender, academic level, departments, smoking or non-smoking status, age at first smoking, tried smoking even puffing, smoking duration, reasons for smoking, thought of smoking as having health benefit, adduced reasons for presuming smoking health benefit, awareness of dangers of smoking (dangers like asthma, COPD, hypertension, diabetes mellitus), reasons for not smoking, and reasons for stopping smoking. Analysis of the variables was doneusing descriptive statistics. RESULTS: The number of subjects studied were 277. The subjects' mean age was 21.47±2.34 years; 161(58.3%) were female subjects, and majority of them were in their 2nd year. Eighty-five percent of the students were in the departments of Medicine, Physiology, Medical Laboratory Science and Physiotherapy. Seven [2.5%, (females 2(0.7%), males 5(1.8%)] of the respondents were current smokers. However, 35[12.6%, females 12(4.3%), males 23(8.3%)] smoked previously but stopped. The mean age of the respondents when they smoked for the first time was 15.78 ± 5.02 years. The main reasons why the respondents smoked were peer pressure (35%), stress (25%) and depression (20%). Furthermore, 15(5.4%) respondents reported that smoking had some health benefits whereas 84% of the students had good knowledge of the health dangers of cigarette smoking and this was the major reason for quitting smoking or not smoking. CONCLUSION: The prevalence of smoking was low among health science students in this study. Stress, depression and peer pressure were the main reasons for smoking, and majority of them had sound knowledge of the health outcomes of smoking. There is a need for further creation of awareness of the dangers of smoking by health institutions to further reduce the prevalence of smoking among health professional students.

CONTEXTE ET OBJECTIF: La cigarette est un cancérogène du groupe 1 et un problème de santé mondial majeur. La morbidité et la mortalité attribuables au tabagisme sont évitables. Les agents de santé et les étudiants en professionnels de la santé sont supposés être bien informés sur le tabagisme et sont donc dispensés de la menace du tabagisme : eu des conséquences sur la santé du tabagisme et des raisons pour lesquelles ils fumaient. MÉTHODES: Il s'agissait d'une étude transversale de 277 étudiants dans laquelle un questionnaire semi-structuré auto-administré a été utilisé. Les variables abordées étaient l'âge, le sexe, le niveau scolaire, les départements, le statut de fumeur ou de non-fumeur, l'âge au début du tabagisme, l'essai de fumer même en bouffant, la durée du tabagisme, les raisons du tabagisme, la perception du tabagisme comme bénéfique pour la santé, les raisons invoquées pour présumer du tabagisme bienfaits pour la santé, sensibilisation aux dangers du tabagisme (dangers comme l'asthme, la MPOC, l'hypertension, le diabète sucré), les raisons de ne pas fumer et les raisons d'arrêter de fumer. L'analyse des variables a été effectuée à l'aide de statistiques descriptives. RÉSULTATS: Le nombre de sujets étudiés était de 277. L'âge moyen des sujets était de 21,47 ± 2,34 ans ; 161 (58,3%) étaient des sujets féminins, et la majorité d'entre eux étaient dans leur 2e année. Quatre-vingt-cinq pour cent des étudiants étaient dans les départements de médecine, physiologie, sciences de laboratoire médical et physiothérapie. Sept [2,5 % (femmes 2 (0,7 %), hommes 5 (1,8 %)] des répondants étaient des fumeurs actuels. Cependant, 35 [12,6 %, femmes 12 (4,3 %), hommes 23 (8,3 %)] ont déjà fumé. mais arrêté. L'âge moyen des répondants lorsqu'ils ont fumé pour la première fois était de 15,78 ± 5,02 ans. Les principales raisons pour lesquelles les répondants ont fumé étaient la pression des pairs (35 %), le stress (25 %) et la dépression (20 %). , 15 (5,4 %) répondants ont déclaré que le tabagisme avait des effets bénéfiques sur la santé alors que 84 % des étudiants avaient une bonne connaissance des dangers pour la santé du tabagisme et c'était la principale raison d'arrêter de fumer ou de ne pas fumer. CONCLUSION: La prévalence du tabagisme était faible chez les étudiants en sciences de la santé de cette étude. Le stress, la dépression et la pression des pairs étaient les principales raisons du tabagisme, et la majorité d'entre eux avaient une bonne connaissance des effets du tabagisme sur la santé. Il est nécessaire de sensibiliser davantage les établissements de santé aux dangers du tabagisme afin de réduire davantage la prévalence du tabagisme chez les étudiants en professionnels de la santé. Mots-clés: Tabagisme, Raisons du tabagisme, étudiants en professionnels de la santé.

Profiles of Tuberculosis Patients: A Single-Center Experience in a Semi-Urban Tuberculosis Center in Southeast Nigeria.

BACKGROUND AND OBJECTIVES: Tuberculosis infection (TB) is a global healthcare problem. In Sub-Saharan African countries TB-HIV co-infection is an evil duo. This study sought to evaluate TB characterization and mortality rate in TB subjects in a semi-urban tuberculosis center in Southeast Nigeria. METHODOLOGY: This was a retrospective study of 241 TB patients between September 2014 and August 2017. Data on clinical profiles, demography, anthropometry, occupation, HIV status, treatment, treatment outcome, and loss to treatment were retrieved and compared within subgroups. RESULTS: The male subjects were 97(40.2%) and female 144(59.8%). TB rate was low at extremes of age. Traders (38.2%) and artisans (17.4%) have high TB rate, with male preponderance, p=0.039. TB cure rate was 11.2%, death rate 17.4%, treatment completion 29.5%, loss to follow-up12.5%. TB-HIV co-morbidity rate was 42.3% and was high among traders, artisans, dependents, drivers, as well as civil servants, p=0.039 and specifically higher in females, p = 0.039. Low TB cure rate (25.0%) and high TB mortality rate (66.7%) occurred with TB-HIV co-infection, p=0.003. CONCLUSION: TB infection declined at extremes of age, and was high among traders and artisans. TB-HIV co-infection rate was high overall, associated with low TB cure rate and high mortality rate in this study.

Performance of Multiple True or False Options with Negative Scoring Schemes Against Single Best of Five Answer Options in a Medical School.

BACKGROUND AND OBJECTIVES: The multiple true or false (MTF) options with different negative scoring schemes and the Single Best of Five Answer (SBOFA) option of multiple choice questions are used in assessing knowledge in medical schools in Nigeria. There are diverse reasons for specific institutions to use a given scheme. These include large candidates' population, time pressure on those conducting the examination and limited resources. This study was set out to compare the performance of two negative scoring schemes of the MTF pattern of objective questions with the SBOFA pattern as the standard objective questions pattern in a medical school Methodology: In this cross-sectional comparative study, selected response items were administered to medical students. A set comprised of SBOFA options (taken here as A-score) and the other two, MTF options with different negative marking schemes; negative marking (-1/2) as B-score, and negative marking (-1) as C-score. The mean scores were compared among the three schemes. Cutoff or pass mark was 50% across-board. Correlation statistics, Bland Altman plots and ROC analyses were used to compare the two negative scoring schemes of the MTF pattern with the SBOFA pattern as the standard objective questions pattern Results: The mean scores of the students for the schemes were A-score 42.9%, B-score 45.6% and C-score 35.0%. The correlation between A-score and B-score was significant (r=0.351, p=0.009). A-score also correlated significantly with C-score, (r=0.381, p=0.004). In B-score versus A-score the bias was -2.6 (47.4%), limits of agreement -29.4 - 24.1 (20.6% -74.1%). In C-score versus A-score the bias was 8.1 (58.1%) and limits of agreement -21.5 - 37.7 (28.5%-087.7%). For B-score and A-score area under receiver operator curve (AUROC) was 0.720 and for C-score and A-score 0.714. B-score at best cutoff mark 45.0% (sensitivity 93%), predicted A-score 50.0%. C-sore at best cutoff mark 33.0% (sensitivity 93%) predicted A-score 50%. CONCLUSION: The MTF objective questions with negative marking scheme of -1/2 as penalty and the SBOFA scheme were more closely related than the MTF with -1 as penalty and SBOFA option. The SBOFA option had better correlation with the MTF with -1 as penalty while the -1/2 penalty had a much higher pass rate.

Risk Factors for Chronic Kidney Disease in Newly Diagnosed Hypertensive Subjects in Southeast Nigeria.

BACKGROUND: The aim of this study was to determine the prevalence and associated risk factors for chronic kidney disease (CKD) in newly diagnosed hypertensive patients. MATERIALS AND METHODS: This was a cross-sectional analytical study involving consenting newly diagnosed hypertensive patients who presented at GOPD of Federal Medical Centre, Umuahia, within 0-3 months of diagnosis; and non-hypertensive controls. A semi-structured interviewer- administered questionnaire was used to record the socio-demographic, anthropometric, clinical and bio-chemical characteristics of the respondents. Data were analyzed and compared between the hypertensive group and the non-hypertensive control group. RESULTS: Two hundred and sixty participants took part in the study. However, only 240 completed the study (120 hypertensive, and 120 control participants). After follow-up for 3 months, 42 (35.0%) hypertensive patients had CKD compared to 11 (9.2%) of the non-hypertensive control group. The prevalence of CKD in the hypertensive participants was significantly higher (2=23.27, p<0.001). Multivariate regression analysis of CKD with variables in the hypertensive study group showed an association between CKD and sex (p=0.020), serum triglycerides (p=0.030) as well as serum uric acid (p=0.030). In the control group there was significant association between CKD and sex (p=0.020), serum total cholesterol (p=0.030) as well as serum uric acid (p=0.030). CONCLUSION: The prevalence of CKD among newly diagnosed hypertensives in southeast Nigeria was high. In this group, CKD had an association with sex, serum uric acid and serum triglyceride.

Examining Socioeconomic Status of Patients with Chronic Kidney Disease Attending Renal Clinic in Southeast Nigeria: A Single Centre Experience.

BACKGROUND: There are few reports on socioeconomic status (SES) of patients with chronic kidney disease (CKD) in Nigeria and indeed Africa, South of the Sahara. Identifying SES as an important factor for disability in people with CKD would provide a means for early identification of those at risk and, possible intervention. OBJECTIVE: To determine the SES of CKD patients attending renal clinic in the University of Nigeria Teaching Hospital. METHODS: Cross-sectional descriptive design was adopted using pretested questionnaire to elicit data on SES (age, place of residence, household asset ownership, source of drinking water; source of cooking energy; and type of toilet facility) from one hundred and forty-five (145) CKD patients attending renal clinic in the University of Nigeria Teaching Hospital. Principal component analysis was used to classify the SES into five quintiles. RESULTS: Majority of the respondents (patients) in stages 4 and 5 CKD, constituting 17.2% and 39.3% respectively were from the lower SES. There was significant correlation between SES and age of the patients; place of residence; hypertension history; ownership of some household assets; source of drinking water; source of cooking energy; and type of toilet facility. CONCLUSION: This study demonstrated that many of our patients were from the lower SES. It is recommended that both governmental and non-governmental agencies should help these patients with some form of health insurance to alleviate their healthcare cost burden.

Urine osmolality in treatment-naïve HIV-positive subjects in Southeast Nigeria.

BACKGROUND AND OBJECTIVES: Urine osmolality varies over a wide range of values in a healthy state. Dilute urine or concentrated urine may be observed in many environmental, physiologic, and disease conditions. Urine osmolality is not commonly evaluated in routine clinical practice and in human immunodeficiency virus (HIV) subjects. The factors that influence urine osmolality have not been completely identified. The aim of this study was to evaluate urine osmolality in treatment-naïve HIV subjects and to identify the factors that may influence dilute and concentrated urine in this group of patients. METHODOLOGY: This was a cross-sectional study of treatment-naive HIV subjects conducted in Federal Medical Centre (FMC), Owerri, Nigeria. Demographic and anthropometric data were obtained. Urine osmolality and other relevant investigations were conducted. Normal urine osmolality was defined as 24-h urine osmolality (24 HUOsm) 300-750 mOsm/kgH2O, dilute urine as 24 HUOsm 2O and concentrated urine as 24 HUOsm> 750 mOsm/kgH2O. The association between the variables and urine osmolality and the strength of variables to predict dilute urine and concentrated urine were determined. RESULTS: The mean 24HUOsm was 564 ± 501 mOsm/kgH2O and the mean spot urine osmolality (SUOsm) 464 ± 271 mOsm/kgH2O. Normal urine osmolality was observed in 29.6%, dilute urine in 64.5%, and concentrated urine in 5.9% of the HIV subjects. There was a significant association between urine osmolality and body mass index (BMI), creatinine clearance, as well as serum cholesterol level. Only high-density lipoprotein cholesterol (HDL) predicted dilute urine, whereas BMI, spot urine protein, 24-h urine protein, spot urine creatinine, serum HDL, and CD4 cell count predicted concentrated urine. CONCLUSION: The prevalence of dilute urine was high among the treatment-naïve HIV subjects. Abnormalities of serum lipids, renal function, and weight were common in treatment-naïve HIV subjects who had dilute urine. There is a need for clinicians to routinely assess urine osmolality and further diagnose for dyslipidemia, renal function impairment, and abnormal weight in HIV subjects at the early stage of the infection.

Prevalence and predictors of chronic kidney disease in newly diagnosed human immunodeficiency virus patients in Owerri, Nigeria.

Human immunodeficiency virus (HIV) infection is a common cause of chronic kidney disease (CKD) in Sub-Saharan Africa. This study aims at identifying the prevalence and predictors of CKD in newly diagnosed HIV patients in Owerri, South East Nigeria. This was a cross-sectional study consisting of 393 newly diagnosed HIV-seropositive subjects and 136 age- and sex-matched seronegative subjects as controls. CKD was defined as 24-hour urine protein (24-HUP) ≥0.3 g and/or glomerular filtration rate (GFR) < 60 ml/min. Subjects were recruited from the HIV clinic and the Medical Outpatient Department of Federal Medical Centre, Owerri. Clinical and anthropometric data were collected. Relevant investigations were performed, including HIV screening and relevant urine and blood investigations. The mean age of the HIV subjects was 38.84 ± 10.65 years. CKD was present in 86 (22.9%) HIV subjects and 11 (8.l %) controls. Low waist circumference (WC), high serum creatinine, high spot urine protein/creatinine ratio (SUPCR), high 24-HUP/creatinine Ratio (24-HUPCR), high 24-HUP/osmolality Ratio (24-HUPOR) predicted CKD in HIV subjects. CKD prevalence is high (22.9%) among newly diagnosed HIV patients in South East Nigeria. The predictors of CKD included WC, serum creatinine, SUPCR, 24-HUPCR, and 24-HUPOR.