West African journal of medicine最新文献

Background: Although, it is well-recognized that conventional BP alone may not be enough to determine target organ changes associated with hypertension and in cardiovascular events risk assessment, there is scarcity of data on this topic.

Objectives: To determine how central BP compares with conventional BP in their association with left ventricular mass index (LVMI), among hypertensive patients.

Methods: Ninety-five participants were evaluated. Conventional office BP were measured following standard procedures. And central BP was assessed using a well-validated, noninvasive pulsepen tonometric device employing generalized transfer function (GTF) interfaced with a computer. The BP parameters of both procedures were evaluated and the beta-coefficient and the corresponding coefficient of determination (R2) against the LVMI which was determined by echocardiography method and the results compared.

Results: The respective β-coefficient and R2 were as follows; for the systolic BPs, central vs office BP (0.2278, .0299 vs 0.0541, .0018). Diastolic BPs, central vs office BP (0.2030, .0651 vs 0.2050, .0075). For pulse pressure (PP), central vs office PP (0.2673,.0133 vs 0.182, .0100). For Mean arterial pressure (MAP) central vs office BPs (0.2253, .0161 vs 0.2048, .0107). Also evaluated were the central forward pressure (Pf) (β-coefficient =0.2073, and R2 = .0086), backward/reflected pressure wave (Pb) (β-coefficient =0.7034, and R2 = .0133,), the reflection magnitude (RM =Pb/Pf) (β-coefficient =0.8073, and R2 = .0986) and the pulse wave velocity (PWV) (β-coefficient =0.7408, and R2 = .0047).

Conclusions: Central BP indices may have association with LVM-indexed to the height2.7, beyond that shown by conventional BP parameters taken at the arm.

Background: Intimate partner violence (IPV) in pregnancy is a very serious and ubiquitous problem, with severe consequences for both the mother and the unborn child. Understanding the dynamics of disclosure and coping strategies employed by pregnant women facing IPV is crucial for developing effective interventions and facilitating positive maternal and foetal outcomes.

Aim: The study investigated the disclosure pattern and coping strategies of Antenatal attendees who experienced intimate partner violence.

Methods: The study was descriptive cross-sectional with indepth interviews (IDIs) conducted among 400 respondents at the Ante-Natal clinics of Nnamdi Azikiwe University Teaching Hospital.

Results: The overall prevalence of IPV in pregnancy was 27.3%. Among the respondents who experienced IPV, 53.4% (86) did not report it to anybody. Among those that reported, 29.3% reported to health workers, 20.0% reported to their parents/siblings 19.0% committed their spouse to God by praying; 74.3% said they are coping fine; 13.3% said they are managing to cope and 5.7% find it stressful coping with IPV. In the IDIs, 5 of the participants reported to their parents, siblings, and pastors. Three of the participants reported to in-laws. Twelve of the participants did not tell anybody but prayed to God.

Conclusion: Awareness creation, screening of pregnant women, the political will, and appropriate interventions will help in reducing the menace of IPV in pregnancy. This cannot be achieved if reporting and disclosure of IPV by victims to the appropriate venue is not instituted.

Background: Cigarette smoking remains a public health concern and can be influenced within households by relatives or friends who smoke. The mental and physical repercussions of smoking can contribute to intimate partner abuse (IPA).

Objectives: This study assessed smoking in households and its relationship with IPA.

Methods: This descriptive cross-sectional study was conducted in Plateau State, Nigeria. Multi-staged cluster sampling was used to select 661 household heads or adult members residing in two districts for at least six months prior to the study. Internally displaced persons (IDPs) were excluded from the study. IPA was assessed with the 30-item Abusive Behaviour Inventory. Data were analyzed with SPSS version 25, which included Chi-square tests and binary logistic regression, with a significance level set at 5%.

Results: Most household heads were aged 40-49 years (mean; 44.5 ± 12.7) with 62.5% having post-secondary education. Household heads who currently smoke and households with members who smoke were 12.0% and 18.3% respectively, and the prevalence of household IPA was 58.1%. IPA was significantly higher in households with members who smoke (75.2% vs. 54.3%) and among household heads who were current smokers (79.7% vs. 55.2%). No predictive association was found between smoking by household heads or members and intimate partner abuse (IPA).

Conclusion: Household IPA is prevalent and significantly associated with smoking in household. While smoking alone may not predict IPA prevalence, integrating routine screenings for smoking and other addictive behaviors during IPA assessments at facilities or community levels is recommended.

Key message: Household intimate partner abuse (IPA) in northern Nigeria is influenced by factors such as smoking, which significantly correlates with higher IPV risk as revealed in the current study. There is a need to understand these dynamics while exploring other factors for effective screening and intervention strategies.

Background: Metabolic syndrome (MetS) is defined by a set of components including hyperglycemia, dyslipidemia, hypertension, and central obesity. Despite the well-established association between MetS and chronic kidney disease (CKD), a significant gap remains in our understanding of the relationship of kidney dysfunction with individual components of MetS, particularly in Nigeria.

Objectives: To determine the prevalence of kidney dysfunction among adults with MetS and to examine the relationship of key components of MetS with kidney dysfunction in Nigeria.

Methods: This cross-sectional study involved randomly selected adult outpatients with MetS attending a tertiary hospital in Nigeria. Kidney function was assessed using estimated glomerular filtration rate (eGFR). Descriptive and inferential statistical analyses were performed and statistical significance was set at p < .05.

Results: A total of 75 adults with MetS (mean age 53.33 ± 13.94 years, 65.3% female) were included. The prevalence of kidney dysfunction (eGFR < 60 mL/min/1.73 m²) was 36.0%, with no significant difference between genders. Blood pressure, serum high-density lipoprotein, and triglyceride were the components of MetS that significantly correlated with eGFR and were identified as independent predictors of kidney function.

Conclusion: The study highlights the considerable burden of kidney dysfunction among individuals with metabolic syndrome in Nigeria. Hypertension and dyslipidemia were the components of metabolic syndrome significantly associated with kidney dysfunction. Early detection and targeted interventions including lifestyle modification and appropriate drug management are important to mitigate the impact of metabolic syndrome on kidney health, resulting in improved health outcomes and reduced burden of chronic kidney disease.

Background: The Olobiri Health Programme (OHP), is a flagship project of the Shell Petroleum Development Company in Ogbia LGAs in Bayelsa States (Ogbia and Sagbama). Phase one of the program provided universal health coverage, a remodeled and fully equipped General Hospital in Kolo; fully equipped laboratories in the College of Health Technology, Otuogidi; and solar-powered water treatment facilities for the communities. Phase 2 includes the Oloibiri Health Campus, the Drug Distribution Centre at Emeyal II, a 400-metre Oloibiri access road to the health campus, and the Ogbia Safe Maternal and Infant Care Programme." This study compares client satisfaction at the Intervention LGA (Ogbia) with Sagbama LGA where the intervention was not provided.

Objectives: To compare the quality of care and patient satisfaction with healthcare service delivery among OHP supported health facilities in Ogbia with facilities in Sagbama local government areas (LGA) of Bayelsa State.

Methods: An analytical cross-sectional survey involving 156 facility exit interviews was conducted in three secondary healthcare facilities in the two LGAs. A validated patient satisfaction questionnaire (PSQ-18) comprising 18 questions in six satisfaction domains was administered. Data was collected via Open Data Kit, downloaded as an MS Excel 365 document, and exported to SPSS v25 for data analysis with t-test and ANOVA comparisons (with a p-value set at 0.05).

Results: Overall satisfaction was significantly higher among healthcare facilities supported by the OHP in Ogbia LGA compared to Sagbama LGA (t=3.21; p=0.002). Also higher were technical quality of care (t=3.44; p=0.001), interpersonal manner of the health workers (t=3.07; p=0.003), financial aspects (t=2.58; p=0.005), time spent with the doctor (t=2.01; p=0.046) and accessibility to care (t=2.16; p=0.033). In Ogbia LGA, the highest mean satisfaction was identified among patients at the Otuasega Cottage Hospital. Satisfaction with technical quality was highest in Kolo General Hospital (F=3.97; P=0.03), and satisfaction with communication was highest in Otuasega Cottage Hospital (F=3.62, P=0.04).

Conclusion: Clients accessing care in Ogbia LGA showed significantly higher satisfaction scores than Sagbama LGA. This highlights the role of health system strengthening activities in improving the quality of healthcare service delivery.

Background: Sickle cell disease (SCD) is highly prevalent in Africa, especially in Nigeria, the most populous country, and is associated with a high mortality rate. Depression, common among individuals with SCD, correlates with increased pain intensity and opioid misuse, leading to poorer outcomes and diminished quality of life in these patients.

Aim: To determine whether major depressive disorder is a predictor of opioid use disorder among patients with sickle cell disease.

Materials and methods: This cross-sectional study was conducted at UDUTH Sokoto and employed psychometric instruments to evaluate patients with SCD. A systematic sampling technique was utilized, and data analyzed using SPSS version 25. Chi-square tests and regression analysis were employed to assess associations and identify predictors, respectively.

Results: The study found statistically significant associations between opioid use disorder (OUD) and the lack of insurance services (p-value = 0.008), major depressive disorder (p-value < 0.001), and elevated pain scores (p-value = 0.003), but not with hemoglobin type (p-value = 0.229). OUD was also more prevalent among respondents with moderate to severe depression (p-value = 0.017). However, only major depressive disorder was identified as a predictor of OUD (AOR: 0.174, 95% CI: 0.067-0.452, p-value < 0.001).

Conclusion: The study identified major depressive disorder as a predictor of among patients with SCD, this underscores the necessity for routine depression screening and timely intervention in this population.

Background: Intimate partner violence in pregnancy (IPVP) is a serious and ubiquitous problem with cultural roots that have severe consequences on both the mother and the unborn child, and affects the general population's well-being. Understanding the dynamics of disclosure and coping strategies employed by pregnant women facing IPV is crucial for developing effective interventions and facilitating positive maternal and foetal outcomes.

Objective: The study investigated the disclosure pattern and coping strategies of Antenatal attendees who experienced IPVP.

Methods: The study was descriptive cross-sectional with mixed method data collection conducted among 400 antenatal attendees at the Ante-Natal clinics of the Nnamdi Azikiwe University Teaching Hospital. In-depth interviews were conducted among 20 antenatal attendees that experienced IPVP.

Results: The overall prevalence of IPV in pregnancy was 27.3%. Among the respondents who experienced IPV, 53.4% did not report it to anybody. Among those that reported, 29.3% reported to health workers, 20.0% reported to their parents/siblings 19.0% committed their spouse to God by praying; 74.3% said they are coping fine; 13.3% said they are managing to cope and 5.7% find it stressful coping with IPVP. Among the 20 respondents in the in-depth interviews, 25% of respondents reported to their parents, sibling, and pastors; 3% reported to in-laws and 60% did not disclose to anybody but prayed to God.

Conclusion: Awareness creation, screening of pregnant women for IPVP, the political will and effective interventions will ameliorate IPVP. This cannot be achieved without proper reporting or disclosure for intervention.

Competing interests: The authors declare that they have no competing interests.

Introduction: Appendicitis is a common cause of acute abdomen. Although many guidelines exist to aid in the preoperative diagnosis of appendicitis in children, histology remains the definitive diagnostic method. Histological diagnosis is premised on the presence of inflammatory infiltrates beyond the mucosa and involving the submucosa and muscularis propria. Involvement of the serosa is often associated with peritonitis. Appendices with no pathology have uncommonly been reported with the clinical diagnosis of appendicitis.

Objective: We present the pathological features of appendicitis in 32 children over two years.

Methods: Pathology Department records of consecutive appendectomies in children were retrieved over two years. The gross descriptions were documented and histological assessment of the H&E stained slides was done. Notes were made on the appendix length, obvious gross abnormalities and perforation; histological presence of mucosal lymphoid hyperplasia and ulceration, predominant inflammatory cell type, presence of reparative changes in the submucosa, and involvement of the peritoneum. Appendectomy performed as an addition to other therapies were excluded.

Result: Thirty-two children had appendectomies for acute appendicitis, their ages ranged from 4 months to 17 years (median 14.5 years) and there were 12 females (37.5%) and 20 males (62.5%). Appendicitis could be grouped into simple (acute appendicitis without perforation, suppuration, or peritonitis) 11 (34.4%), complicated (acute appendicitis with perforation, gangrene, and/or suppuration) 14 (43.7%), subacute/ chronic (acute appendicitis with reparative changes or non-specific chronic inflammation) 7 (21.9%). All cases had associated mucosal lymphoid hyperplasia. No negative appendix was seen.

Conclusion: Appendicitis in children is often complicated before surgical intervention.