West African journal of medicine最新文献

Background: The informal labour sector is laden with peculiar dietary and lifestyle behaviours which affect their nutritional status, and commercial drivers are not an exception. Therefore, this study was designed to assess the nutritional knowledge, dietary habits, and anthropometric status of commercial drivers.

Methods: The study used a descriptive cross-sectional design and a multi-stage sampling to recruit 220 respondents. A validated structured self-administered questionnaire was used to collect data. Anthropometric and physical activity levels were measured and categorized using the appropriate procedures and reference standards. Analyses were done using IBM SPSS version 23.

Results: Results revealed that selected commercial drivers were mainly young adults, Christians, married, earn between 50,000 to 100,000 with secondary education. The prevalence of good knowledge was considerably low while the bulk of them had poor knowledge of nutrition. Waist circumference and waist-hip-ratio measurement revealed that most respondents were at low risk of obesity and other metabolic diseases. A significant relationship exists between the nutrition knowledge of the respondents and dietary habits. Physical activity level had an inverse association with the BMI values of the respondents.

Conclusion: The respondents had low nutrition knowledge, poor dietary habits, low physical activity and high body mass index which are significantly interlinked. Thus, efforts to promote healthy dietary habits and physical activity engagement of the respondents through enhanced nutrition education efforts and improved quality of street food environment and creative sports events for these groups should be encouraged.

Introduction/background: Chronic heart failure (CHF) has important gender-specific aspects, which are worthy of note, as they influence the haemodynamic state of patients the choice of therapy, aetiology, and clinical outcomes. Women are less frequently represented in CHF studies and clinical trials than males. While some published data are conflictive, more studies tailored to this critical discourse are necessary to inform patient care and improve outcomes in patients with CHF.

Objectives: The study aims to describe the rationale, design and clinical presentations, profile, and 1-year outcomes of the first 1290 CHF in the Ibadan CHF project.

Materials/methods: We analyzed the differences between the genders regarding the aetiology of heart disease, comorbidities, triggers, left ventricle functional state, treatment, and all cause-mortality at 1 year.

Results: A total of 1290 patients (55.8% men) were included. The men were older than the women (p<.001) and had a higher prevalence of alcohol and cigarette use, comorbidities, and worse cardiac structural abnormalities (p<.001). The are also gender differences in the pattern of aetiology of HF. HHF, DCM, and pericardial diseases are more common in men. Women have higher rates of rheumatic heart disease. Mortality rates at 6- and 12 months were higher in men.

Conclusions: There is a gender difference in clinical profile and outcomes of CHF in this cohort. Males appear to have a worse clinical profile, structural cardiac abnormalities as well as worse one-year outcomes.

Background: Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia from deficiencies in insulin secretion, action, or both. It reduces the quality of life and life expectancy of patients26. Research shows that adequate nutritional knowledge and good nutritional status have a huge role in reducing its risk. The nutritional status of an individual is influenced by food intake and physical health8.

Objectives: 1. To assess the nutritional knowledge among diabetics in secondary health facilities (SHF), Kaduna metropolis. 2. To assess the nutritional status among diabetic patients in SHF, Kaduna metropolis.

Methodology: A cross-sectional descriptive study was carried out with a multistage sampling technique among 184 respondents. Nutritional knowledge and Body mass index (BMI) were assessed. IBM SPSS (Version 26) was used for data analysis. Results were presented using frequency tables and charts; Chi-square/ Fisher's exact test were used to assess the relationship between dependent and independent variables (level of significance set at p<0.05).

Result: The mean age was 57.3 ± 12.67 years. Only 25.5% had good nutritional knowledge while 73.9% had fair knowledge. Normal BMI was found in 36.1%, and overweight and obesity were found in 39.1% and 19.5% respectively. There was no statistically significant relationship between the BMI and the nutritional knowledge. (p = 0.876).

Conclusion: Only about a quarter of the respondents had good nutritional knowledge; more than half of the respondents were found to be either overweight or obese. Thus, there should be concerted efforts to address the gap in the nutritional knowledge of diabetic patients.

Background: Post-partum depression (PPD) significantly contributes to maternal morbidity and mortality, particularly in developing countries, impacting the well-being of women, their families, and society.

Objective(s): This study assessed the prevalence of PPD and its associated factors among parous women in Ibadan SouthWest LGA.

Methods: The cross-sectional study utilized a multi-staged sampling technique to select 454 postpartum women from six selected primary health care centres in Ibadan. Data on socio-demographics, obstetric history, patterns of intimate partner violence (IPV), family connectedness, and PPD experiences were elicited using interviewer-administered questionnaires. Data analysis included descriptive statistics, chi-square test and logistic regression with significance level for all test sets at 5%.

Results: The mean age of the women was 29.4±5.3, with the majority being married (96.3%) and in monogamous unions (88.8%). About two-fifths (41.4%) had husbands with postsecondary education and the pregnancy of respondents (76.7%) was planned and wanted. Over half (56.2%) of the women experienced emotional violence during pregnancy, and 45.2% were from dysfunctional families. Prevalence of post-partum depression was 44.6%. Husband's education level (p=0.041), family type (p=0.002), pregnancy desire (p=0.037), and family connectedness (p=0.029) were associated with PPD. Independent predictors of postpartum depression included being married (OR=0.242; 95%CI=0.06-0.92) and experiencing emotional or physical abuse (OR=3.960; 95%CI=1.787-8.796 and OR=1.764; 95%CI=1.162-2.680).

Conclusions: PPD was prevalent among women; who experienced IPV, whose spouses had lower education, with unplanned or unwanted pregnancies, and dysfunctional families. Health education and social support for women are advocated to prevent the experience of postpartum depression.

Key message: Postpartum depression is common among urban women in Southwest Nigeria and is significantly influenced by experience of IPV and marital status. Single women had higher odds, with additional factors includingeducational level, family dynamics, and pregnancy intention affecting PPD. Education, family and societal support are vital to help prevent PPD

Background: There has been an increase in gambling or betting in the population, increasing the risk of gambling-related disorders. There is insufficient knowledge about the extent and determinants of this problem across Nigeria.

Objective: To assess the prevalence, pattern, and sociodemographic correlates of gambling behaviour across different geopolitical zones in Nigeria.

Methods: Nigerian citizens of diverse age groups were conveniently sampled from the North-Central, South-East, South-South and South-West geopolitical zones of the country. A self-paced, pre-tested gambling questionnaire designed for the study was used to collect relevant data.

Results: 310 Nigerians were included in this study and were mostly between the ages of 18 to 27 (44.2%) years. The study revealed a high prevalence (40.3%) of gambling behaviours among the participants. Among those engaged in gambling, "Bet9ja" emerged as the predominant platform. The desire to 'make money' was the most prevalent driver of gambling among participants (62.4%). A significant association was seen between respondents' knowledge and perceptions of gambling and their propensity to gamble (p < 0.001). Various sociodemographic factors (sex, marital status, socioeconomic status, and geopolitical zone) were also significantly associated with gambling.

Conclusions: The study shows the notable prevalence of gambling in Nigeria and highlights its associations with sociodemographic factors, perceptions, and patterns of gambling which should be considered in strategies to mitigate gambling-related problems. This research bridges gaps by incorporating data from diverse geopolitical zones, providing a more representative population study.

Introduction: Human immunodeficiency virus HIV causes a well-known global disease, acquired immunodeficiency syndrome (AIDS), which has a high disease burden in Africa. HIV infection is known to be associated with oxidative stress, which may contribute to disease severity. However, the effect of HAART is equivocal, and requires more studies. 8-hydroxy-2-deoxyguanosine (8-OHdG), a useful biomarker to assess oxidative DNA damage in biological fluids, was therefore measured in this study.

Objectives: The study measured 8-OHdG in HIV seronegative and seropositive participants and correlated it with the duration of HAART.

Research question: Does HIV infection have an effect on oxidative DNA damage? Does HAART have an effect on oxidative DNA damage? Does HAART duration have an effect on oxidative DNA damage?

Methods: This was a cross-sectional study consisting of 99 participants in 4 strata: 20 HIV seronegative, 25 HAART naïve, 26 on HAART <5 years, and 28 on HAART >5 years. Those on HAART were all on Tenofovir, Lamivudine, and Dolutegravir (TLD) combination. The questionnaires were administered, and blood samples were collected from all the participants. The serum 8-OHdG was measured with enzyme-linked immunosorbent assay in all the participants. The universal biosafety standards were strictly adhered to. The data were collected and analyzed with SPSS 2016 version.

Results/discussion: The serum levels of 8-OHdG of the participants were shown below. Our findings showed higher 8-OHdG in HIV patients than the Controls and is much higher in HAART naïve when compared with those on HAART (p = 0.005). The serum 8-OHdG and HAART duration were compared and showed a statistically significant negative correlation (r = - 0.331, p= 0.014).

Conclusion: This study found that HIV infection causes oxidative DNA damage which is more in patients who have not started HAART than those on HAART. This showed that the TLD-HAART regimen reduces HIV-associated oxidative stress over time, though not completely. This finding further supports a critical role of oxidative stress in HIV infection, a protective effect of HAART, and a potential role of antioxidants that requires further research.

Introduction: Severe acute symptomatic hypocalcemia, requiring emergency medical intervention, is a significant but poorly understood condition with high morbidity. In our setting, patients present to emergency rooms with painful carpo-pedal spasms that last for several hours, sometimes mimicking seizure disorders. Metabolomics and genetic profiling are innovative approaches that pinpoint molecular and genetic determinants of hypocalcemia risk which can be adopted to guide treatment in our population.

Objective: To determine the prevalence of hypocalcemia in urban Kano as a preliminary step towards identifying key risk factors.

Methods: We obtained retrospective data from patients who presented to a tertiary hospital between January and December 2023. Serum calcium levels were measured on Abbott Architect c4000 autoanalyzer. We analyzed data using R statistical software (version 4.3.2). Chi-square tests were used to assess significant differences (p < 0.05).

Results: A total of 1,270 samples were analyzed, consisting of 59.3% (n = 753) males, their mean age was 36.2 ± 4 years. Mean serum calcium levels were 2.05 ± 0.34 mmol/L to 2.11 ± 1.00 mmol/L. Overall prevalence of hypocalcemia (serum calcium < 2.2 mmol/L) was 52.2%. Females exhibited a significantly higher prevalence (58.8%) compared to males (p = 0.03). The highest prevalence was observed in the 40-59-year age group (p < 0.01).

Conclusion: Hypocalcemia is highly prevalent in our population emphasizing the need for innovative approaches to better understand the genetic predictors, enable early intervention and prevent the long-term complications. These findings also provide a foundation for future multicenter studies and could inform public health policies targeting at risk groups. Keywords: Hypocalcaemia, Risk prediction,Metabolomics, Genetic markers.

Introduction: Cardiac rehabilitation is crucial in managing coronary disease, particularly in type 2 diabetes, yet it remains almost non-existent in West Africa.

Objectives: This study aimed to compare the profiles of diabetic and non-diabetic coronary patients undergoing cardiac rehabilitation at the Principal Hospital of Dakar, Senegal.

Methodology: A comparative, descriptive, and analytical study was conducted from January 2019 to December 2022 involving two groups of coronary patients (diabetic and nondiabetic) at the rehabilitation centre. Patients who completed at least 10 sessions were included. We analysed sociodemographic, clinical, and paraclinical data before and after rehabilitation, as well as therapeutic adherence. Data analysis was performed using SPSS version 18, with a significance level set at 0.05.

Results: A total of 199 coronary patients participated, including 75 diabetics and 124 non-diabetics. The average age was 61.6 ± 8.3 years for diabetics and 59.8 ± 12.4 years for non-diabetics, with a male predominance (sex ratio: 2 for diabetics and 3.9 for non-diabetics). In diabetics, the main cardiovascular risk factors were age (80%), hypertension (62.7%), physical inactivity (57.3%), dyslipidaemia (40%), and smoking (33.3%). Cardiac rehabilitation significantly improved clinical symptoms and parameters such as systolic blood pressure, heart rate, and abdominal obesity in diabetic patients. Glycated haemoglobin levels were balanced in 70.4%, an improvement of 40.8%. Rehabilitation had a greater impact on METS improvement and adherence in diabetic patients, along with reduced depression.

Conclusion: Cardiac rehabilitation improves control of cardiovascular risk factors, but its availability and accessibility need improvement.

Background: Stroke is a neurological emergency with high prevalence, especially in developing countries where it assumes an epidemic proportion. It is globally the second most common cause of death after ischemic heart disease, and it is projected to remain so by 2030. It had a global prevalence of 1,300.6 per 100,000 people in 2017.

Objectives: This study compared the socio-demographic, clinical and laboratory characteristics of acute Haemorrhagic and Ischaemic stroke patients managed over nine years in a private tertiary hospital in Abakaliki, Nigeria.

Methods: This is a Retrospective and comparative Hospital-based study conducted at a tertiary hospital in Abakaliki Nigeria from January 2014 to December 2022. Relevant data were retrieved from the case notes and the sociodemographic, clinical, and laboratory parameters of Haemorrhagic stroke victims were compared with that of Ischaemic stroke patients.

Results: Out of the 172 (males- 56.98%, females- 43.02%) patients that fulfilled the inclusion criteria, 53 (30.81%) had a Haemorrhagic stroke while 119 (69.19%) had an ischemic stroke. The overall admission mortality rate was 15%, and it was more preponderant among Haemorrhagic stroke victims. Haemorrhagic stroke was statistically associated with admitting hyperglycaemia , anaemia, hypercholesterolemia, neutrophilic leucocytosis, hypernatremia, alteration in consciousness, low educational attainment, and higher mortality.

Conclusions: Haemorrhagic stroke is more prevalent among female folks, and it is associated with higher morbidity and mortality. There is a need for a grassroots stroke awareness campaign amongst the populace to ensure prompt stroke symptom recognition and early presentation.

Introduction: Globally, hypertension is considered a public health problem affecting over 1.3 billion individuals of which 60% need reminders to take medication to achieve adherence, optimal blood pressure and avert complications. Literature shows electronic short message reminders (eSMS) improved medication adherence.

Objective: To determine the effect of e-SMS reminders on medication adherence among hypertensive patients in Katsina State.

Methods: A quasi-experimental study was employed to determine the effect of e-SMS reminders on medication adherence among 252 control and 252 intervention groups selected using a multistage sampling technique. e-SMS reminders were sent to the intervention group only. Data was collected using a pretested interviewer-administered questionnaire, and analysed using IBM-SPSS-25, while medication adherence was assessed using the 8-item Modified Morisky Adherence Scale.

Results: The commonest respondents' age group was 40-49 years (23.8%) and Male-Female ratio was 0.8:1 Majority were Hausas (97.6%) by tribe and Muslims (98%). Adherence in the study group was 59.5% and 75.9% (P<0.001) that of the control group was 63.1% and 66% at pre and post-intervention stages respectively. Factors associated with adherence in the intervention group were sex, occupation, insurance coverage, and being in the 4th wealth quintile. e-SMS reminder increased adherence in the intervention groups by >16% (P<0.001) In the control group, males were 3.4 times more likely to adhere to medication than females (aOR 3.4; 95% CI 1.4-8.3) while in the intervention group, business tycoons were 3 times more likely to adhere to medication than other occupations (aOR 3.7; 95% CI 1.006-13.75;).

Conclusion: e-SMS reminders significantly increased adherence to the intervention. Determinants of adherence were occupation, male sex, insurance coverage, and being in the 4th wealth quintile. It is recommended that the State Hospital Management Board integrate e-SMS reminders as part of hypertension treatment protocols due to their potential to improve medication adherence.