Epilepsy treatment gap in Sub-Saharan Africa: Meta-analysis of community-based studies.

OBJECTIVE: To evaluate the prevalence, highlight the variation and determine the trend over time, of epilepsy treatment gap (ETG) in Sub-Saharan Africa (SSA). METHODS: We systematically searched PubMed, MEDLINE, Embase, ISI databases, and African Journal Online (AJOL). We determined the pooled prevalence estimate of ETG and the degree of heterogeneity in the region. Further subgroup analysis by sub-region, settlement setting, and cutoff adopted for active epilepsy in the studies was carried out. Meta-regression technique was also used to determine the trend of the ETG magnitude over time. RESULTS: Twenty-three studies from SSA met the inclusion criteria. We found a high level of discordance among the studies that were included. Collectively, the estimated ETG was 68.5% (95% CI: 59.5%-77.5%). On subgroup analysis, the prevalence of the ETG was 67% (95% CI: 52%, 83%) in the Western, 68% (95% CI: 56%, 80%) in the Eastern, and 63% (95% CI: 53%, 73%) in the Southern Africa sub-regions. On stratified analysis based on 1-year, 5-year, and 2-year cutoffs for definition of active epilepsy, the prevalence figures for the ETG were 71% (95% CI: 56%, 85%), 55% (95% CI: 33%, 77%), and 57% (95% CI: 43%, 71%), respectively. Meta-regression result suggested that the prevalence of the ETG decreases by approximately by 0.006 per year. CONCLUSION: The study showed a high prevalence of ETG, higher than the average for resource poor countries, and twice in rural compared with urban settlements in SSA.

Reasons and experiences of home and hospital deliveries among women in Kano, North Western Nigeria

Background: In developing countries most women deliver at home for some reasons and such deliveries are not attended by a skilled birth attendant. In Nigeria 63% of births occurred at home. Objective: To determine the reasons and experiences of home and hospital deliveries among women in Kano, Nigeria. Methods: The study was a comparative cross-sectional study. The study employed a mixed method study. A total of 614 women were selected by multistage sampling technique and enrolled for the study. Focus group discussions with a group of women and husbands as well as key informant interviews with health care workers were conducted in the communities. Quantitative data was analysed using Minitab V17 software. Thematic content analysis was performed for the qualitative data. Data was gathered and analysed using triangulation methods. Results: The questionnaires response rate was of 96.7%. The mean age of respondents was 32.6 ± 6.5 years for home delivery group, and 28.1 ± 5.6 years for the hospital delivery group. Reasons for home deliveries were custom (24.5%), unfriendly attitude of health workers (17.5%), financial barriers (15.5%), and safety was the main reason for hospital delivery (56.7%). Determinants of choice of place of delivery were lower age at first pregnancy AOR=4.06 95%CI (1.633-10.076) and higher education AOR=2.70 95%CI (1.927-3.792) respectively. Conclusion: Mothers have different reasons and experiences with regard to choice of delivery location. Hospital deliveries should be encouraged

A survey of weight perception and social desirability of obesity among adults in Kano Metropolis, Northern Nigeria.

BACKGROUND: Obesity and its complications are emergent health challenges in developing countries including Nigeria. We determined the concordance of perceived with measured weight and assessed the social desirability of obesity among adults in Kano metropolis in northern Nigeria. METHODS: A cross sectional descriptive study was conducted among 400 adults using structured interview questionnaires. RESULTS: Among 386 respondents, 58 (84.1%) of underweight adults, 106 (46.2%) of healthy weight adults, 46 (66.7%) of overweight adults and 16 (84.2%) of obese adults incorrectly perceived their weight category. Sixty (15.5%) participants considered obesity as socially desirable and a sign of good living and affluence. Older respondents (> or = 40 years) (P = 0.0001), Igbo or Yoruba ethnicity (P = 0.0035) and non-formal or primary education (P < 0.0001) were significantly associated with positive view of obesity. However, only ethnicity; Yoruba-Adjusted Odds Ratio (aOR) = 1.60, 95% Confidence Interval (95% CI) (1.20-2.86), P = 0.018, Igbo (aOR = 3.22, 95% CI (1.64-6.3), P =0.005 and educational status; non-formal (aOR = 4.61, 95% CI 1.62-16.9), P = 0.01; primary (aOR = 4.95, 95% CI (1.4-17.8), P = 0.015 remained significant predictors after adjusting for confounding. CONCLUSION: The discordance between perceived and measured weight is worrisome but the low social desirability of obesity should be encouraged. Weight control using periodic weight measurements, nutritional education and physical exercise are paramount.

Prevalence of diabetes in a semi-urban community in Northern Nigeria.

BACKGROUND: Diabetes mellitus is a growing public health problem both in developing and developed nations. The prevalence of diabetes globally is projected to rise from 2.8% in 2000 to 4.4% in 2030. This study was conducted to assess the prevalence of diabetes in Dakace village, near Zaria METHOD: This study was part of a larger study to assess the prevalence of cardiovascular disease risk factors among adults in Dakace village, near Zaria. Out of a total of 492 eligible respondents for the study, a subsample of 199 persons was recruited using a systematic sampling technique had their fasting blood glucose levels determined. Body mass indices of the participants were also determined. RESULTS: A total of 199 subjects (94 males and 105 females) participated in this segment of the study Three subjects had fasting blood glucose (FBG) of more than 7.0 mmol/L; one participant a previously known diabetic on medication had a good glycaemic control. The overall prevalence of diabetes was 2.0%.Five participants (2.5%) had impaired fasting glucose (IFG). Among the diabetics, one was overweight (BMI = 27.43 Kg/m2) and one was obese (BMI = 31.55 Kg/m2), while among those with impaired fasting glucose two were overweight. Forty-three subjects (21.6%) were overweight and 15 (7.5%) were obese. CONCLUSION: The prevalence of diabetes mellitus in this semi-urban community is keeping with what had been reported earlier from across the country.

Prevalence of Diabetes in a Semi-Urban Community in Northern Nigeria

Background: Diabetes mellitus is a growing public health problem both in developing and developed nations. The prevalence of diabetes globally is projected to rise from 2.8in 2000 to 4.4in 2030.This study was conducted to assess the prevalence of diabetes in Dakace village; near Zaria Method: This study was part of a larger study to assess the prevalence of cardiovascular disease risk factors among adults in Dakace village; near Zaria. Out of a total of 492 eligible respondents for the study; a subsample of 199 persons was recruited using a systematic sampling technique had their fasting blood glucose levels determined. Body mass indices of the participants were also determined. Results: A total of 199 subjects (94 males and 105 females) participated in this segment of the study. Three subjects had fasting blood glucose (FBG) of more than 7.0mmol/L; one participant a previously known diabetic on medication had a good glycaemic control. The overall prevalence of diabetes was 2.0.Five participants (2.5) had impaired fasting glucose (IFG). Among the diabetics; one was overweight (BMI= 27.43Kg/m2) and one was obese (BMI=31.55Kg/m2); while among those with impaired fasting glucose two were overweight. Fortythree subjects (21.6) were overweight and 15 (7.5) were obese. Conclusion: The prevalence of diabetes mellitus in this semi-urban community is keeping with what had been reported earlier from across the country