Prevalence of cardiovascular risk factors in the middle-aged and elderly population of a nigerian rural community

Co-occurrence of Modifiable Risk Factors for Cardiovascular Disease amongst Diabetic Patients in Lagos State, Nigeria

BACKGROUND

Diabetes significantly increases the likelihood of developing cardiovascular disease (CVD). This risk can be reduced by addressing modifiable risk factors. The objectives of this study were to assess the modifiable risks for CVD amongst persons with diabetes and identify the factors associated with multiple risk factors.

METHODS

This cross-sectional study was conducted amongst 357 diabetic patients attending a large tertiary hospital in Southwest Nigeria. Eligible patients were recruited consecutively on clinic days till the minimum sample size was reached. An interviewer-administered survey tool adapted from the World Health Organization STEPS was used to obtain information from study participants. The following risk factors were assessed: tobacco use, obesity, high blood pressure, physical activity, sedentary time and hours of sleep. Data were analysed using the STATA version 15.0 (Stata Corp.) statistical programme.

RESULTS

The mean age of the participants was 61.7 ± 12.6 years, and they were mostly females (63.9%). Of the risk factors assessed, the most prevalent modifiable risk factors amongst the respondents were inadequate sleep - <8 h on average (91.6%), abdominal obesity (82.6%) and high blood pressure (72%). Others were inadequate physical activity (56%) and lifetime tobacco use (21%). Up to 40.3% of the diabetic persons had three or more co-existing CVD risk factors. Age, gender, work and marital status (P ≤ 0.01) were statistically associated with multiple CVD risk factors. Being male, unmarried and increasing age were predictors of multiple CVD risk factors amongst the diabetic patients.

CONCLUSION

A significant proportion of the diabetic patients have multiple co-existing modifiable CVD risks. Abdominal obesity and poor sleep were the most prevalent. Older men who are unmarried were more likely to have multiple risks. Primary and secondary preventive measures to address CVD risks amongst diabetic patients are warranted and should target older unmarried men.

Diabetes Mellitus as a risk factor for stroke among Nigerians: A systematic review and meta-analysis

Background

Diabetes mellitus is one of the modifiable risk factors for stroke. Stroke is common in Nigeria, but there is a paucity of national data on the frequency of diabetes in stroke. This study aimed to estimate to what extent diabetes a risk factor for stroke in Nigeria.

Methods

The study design is a systematic review, and the PRISMA guidelines were strictly followed. African Journal Online (AJOL), PubMed, SCOPUS and Google Scholar were systematically searched. The Newcastle-Ottawa scale was used to assess the quality, heterogeneity was determined with the I² statistic, and the DerSimonian Laird random effect model was selected for the meta-analysis.

Results

The studies were distributed across different regions of the country. The total sample size was 9397. The weighted average age of the patients with stroke was 53.7 years. The attributable risk of diabetes in stroke, among Nigerian patients, was 0.20 (95% CI: 0.17-0.22; p < 0.0001). The attributable risk has been rising steadily since the advent of the new century, and it is relatively higher in southern Nigeria.

Conclusion

The attributable risk of diabetes in stroke, among Nigerian patients is high. This varies across the regions but it is rising progressively nationally.

Knowledge, awareness, and presence of cardiovascular risk factors among college staff of a Nigerian University

Background

Cardiovascular diseases (CVDs) are the leading cause of global morbidity often overlooked. Much of the population risk of CVD is attributable to modifiable risk factors, and the gaps in knowledge of cardiovascular risk factors (CRF) are barriers to the effective prevention and treatment of CVDs.

Aim

To assess the knowledge, awareness, and CVD risk among the staff of the college of health science.

Methods

A cross-sectional study of 70 academic and non-academic staff who consented were given questionnaires for cardiovascular risk factor (CRF) knowledge level, cardiovascular risk awareness (CRA), international physical activity questionnaire (IPAQ), and international stress management association questionnaire (ISMAQ). Selected anthropometric indices, blood pressure, and fasting blood sugar (FBG) were also measured.

Results

The mean knowledge level of CVDs was 23.21 ± 3.230, and the mean CRA was 42.61 ± 4.237. The study participants demonstrated moderate-to-high stress (48%), physical inactivity of 18.9%, overweight/obesity of 62.48%, abdominal obesity of 21.4%, hypertensive (systole and diastole) of 27.2%, hyperglycemic of 7.2%, and smokers of 7.2%. There was a significant relationship between the participants’ knowledge level and awareness of CVDs (p < 0.003) and knowledge of CRFs also increased with an increase in educational level. Participants > 40 years had a 3–9% risk of having a CVD event within 10 years.

Conclusions

The knowledge and awareness of CRFs among the participants was high, and some exhibited risk factors. The staff of the university could improve their risk score by practicing health-promoting behaviors like increased physical activity, blood pressure control, and smoking cessation.

Evaluating the discriminatory power of the velocity field diagram and timed-up-and-go test in determining the fall status of community-dwelling older adults: a cross-sectional observational study

BACKGROUND

Systematic reviews demonstrated that gait variables are the most reliable predictors of future falls, yet are rarely included in fall screening tools. Thus, most tools have higher specificity than sensitivity, hence may be misleading/detrimental to care. Therefore, this study aimed to determine the validity, and reliability of the velocity field diagram (VFD -a gait analytical tool), and the Timed-up-and-go test (TUG)-commonly used in Nigeria as fall screening tools, compared to a gold standard (known fallers) among community-dwelling older adults.

METHOD

This is a cross-sectional observational study of 500 older adults (280 fallers and 220 non-fallers), recruited by convenience sampling technique at community health fora on fall prevention. Participants completed a 7-m distance with the number of steps and time it took determined and used to compute the stride length, stride frequency, and velocity, which regression lines formed the VFD. TUG test was simultaneously conducted to discriminate fallers from non-fallers. The cut-off points for falls were: TUG times ≥ 13.5 s; VFD's intersection point of the stride frequency, and velocity regression lines (E1) ≥ 3.5velots. The receiver operating characteristic (ROC) area under the curves (AUC) was used to explore the ability of the E1 ≥ 3.5velots to discriminate between fallers and non-fallers. The VFD's and TUG's sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined. Alpha was set at p < 0.05.

RESULTS

The VFD versus TUG sensitivity, specificity, PPV and NPV were 71%, 27%, 55%, and 42%, versus 39%, 59%, 55%, and 43%, respectively. The ROC's AUC were 0.74(95%CI:0.597,0.882, p = 0.001) for the VFD. The optimal categorizations for discrimination between fallers/non-fallers were ≥ 3.78 versus ≤ 3.78 for VFD (fallers versus non-fallers prevalence is 60.71% versus 95.45%, respectively), with a classification accuracy or prediction rate of 0.76 unlike TUG with AUC = 0.53 (95% CI:0.353,0.700, p = 0.762), and a classification accuracy of 0.68, and optimal characterization of ≥ 12.81 s versus ≤ 12.81 (fallers and non-fallers prevalence = 92.86% versus 36.36%, respectively).

CONCLUSION

The VFD demonstrated a fair discriminatory power and greater reliability in identifying fallers than the TUG, and therefore, could replace the TUG as a primary tool in screening those at risk of falls.

Diabetes Mellitus and its Risk Factors Among a Suburban Population of Northwestern Nigerians: A Community-Based Survey

Background

Diabetes mellitus is a serious public health problem, and its prevalence is increasing globally. However, there are scanty reports of the scope and burden of the disease among suburban populations of Nigeria. This study aims to determine the prevalence of diabetes mellitus and to determine the associated risk factors of the disease among the suburban population of Northern Nigeria.

Methodology

A community-based descriptive cross-sectional study was conducted in which 1100 subjects were recruited using a multistage random cluster sampling technique. They were screened for diabetes by fasting plasma glucose (FPG) or casual plasma glucose (CPG) estimation. Individuals with FOG >7mmol//l or CPG >7.8mmol/l abnormal glucose levels had a 75 g oral glucose tolerance test (OGTT) and HbA1c done. The prevalence of diabetes was computed with a 95% confidence interval.

Result

The crude prevalence of diabetes from this study is 4.1% (95% CI = 3.3 - 4.9%) and standardized rate of 6.4%. Male gender OR 0.74, (95% CI = 0.569 - 1.982), age >40yrs OR 1.12 (95% CI = 0.851 - 1.463), physical inactivity OR 3.78 (95% CI = 2.881 - 12.726), Hypertension (SBP OR 10.28 (95% CI = 6.319- 29.369), (DBP OR 7.52 (95% CI = 3.928 - 36.914), and family history of DM OR 9.34 (95% CI = 3.890 - 23.481), showed significant independent association with diabetes.

Conclusion

The prevalence of diabetes in the suburban population of Northwestern Nigeria is high and the associated risk factors include overweight and obesity, physical inactivity, family history of diabetes and age.

Cardiovascular event risk estimation among residents of a rural setting in Bayelsa state, Nigeria

Cardiovascular diseases (CVD) are a leading cause of death worldwide. There is a rising prevalence of CVDs in Nigeria, including in rural communities. The present study assessed the total CVD risk among two rural communities in Bayelsa State, South-south Nigeria. Adults aged ≥ 40 years in 264 randomly selected households in two rural communities in Bayelsa State were interviewed in this descriptive cross-sectional survey. Using a structured questionnaire, data on socio-demographic characteristics, anthropometry, blood pressure (BP) and random blood sugar measurements were obtained. The WHO/ISH risk assessment chart for the African sub-region was used to estimate the 10-year total risk of fatal or non-fatal CVD events using five predictor variables: age, gender, smoking, systolic BP, and coexistence of diabetes mellitus (DM). Of the 264 participants, majority was men (70.1%) and married (93.2%). Mean age was 50.9±8.1 years. Most participants were overweight (53.4%), add salt to food on table (97.0%), lead a sedentary lifestyle (79.2%) and greater than a third of participants (36.7%) were known hypertensive patients. Using the WHO/ISH risk prediction chart for Africa, 90.0% and 10.0% of the study population had low and moderate risk, respectively of developing cardiovascular events in 10 years. As the age of participants increases, the 10-year risk of a cardiovascular event increased (X 2-48.9; P-0.001). History of hypertension (X 2-20.0; P-0.001), DM (X 2-5.87; P-0.016) and smoking (X 2-23.42; P-0.001) were significantly related to the level of 10-year cardiovascular event risk. Sex showed no significant relationship. There is a high prevalence of several cardiovascular risk factors in this rural population, though the 10-year risk of CV event is still low. CVD risk in rural communities requires awareness, monitoring and an integrated approach in their prevention, detection, and treatment.

Effect of Arjun Chāl on cardiovascular risk factors - a randomized controlled clinical trial

OBJECTIVES

Cardiovascular diseases have a multifaceted, it causes modern epidemic; Recognizing in the risk factor stage, is crucial, given the risk of progression to cardiovascular disease. Ibn Sīnā, described CVDs as a resultant of gradual derangement of Quwwat ghādhiya (Nutritive faculty); in which management with ghidhā' (diet), tadābīr (regimens), dawā' (drug) has been received. To evaluate the effect of Arjun Chāl (Terminalia arjuna) in CVD risk factors. And to evaluate the drug safety.

METHODS

This is a randomized controlled clinical trial. Total 120 patients were screened at OPD of NIUM hospital, Bangalore during 2018-19, only 48 patients fulfilled the inclusion criteria and signed written informed consent and their detailed medical history was recorded. Arjun Chāl powder (5 gm BD) for eight weeks administered in test group (n=24), Amlodipine (5 mg) and Atorvastatin (10 mg) once a day for same duration administered in control group (n=24). Efficacy of the drug assessed by the Lipid profile, BP and BMI; lipid profile were performed at baseline and at 8 weeks, while BP and BMI performed at baseline, 15, 30, 45, and 60th day intervals. Study was completed by 40 patients. The results of both the therapies were then compared and statistically analyzed.

RESULTS

Totally, both groups reduces assessment parameters i.e. statistically highly significant (p<0.001). Test group showed greater reduction in terms of all assessment parmeters. But, the difference between both the groups was statistically non-significant p>0.05.

CONCLUSIONS

Both test and control drugs were effective, but Arjun Chāl had a slight edge over amlodipne and atorvastatin, and was found to be safe and well tolerated. It has a cardio protective potential and hence effective to delay/prevent CVD in patient with cardiovascular risk factor.Keywords: Unani System of Medicine; T. arjuna; Arjun Chāl; Efficacy; Safety; Cardiovascular risk factor.

Prevalence, awareness, treatment, and control of hypertension in Nigeria in 1995 and 2020: A systematic analysis of current evidence

Improved understanding of the current burden of hypertension, including awareness, treatment, and control, is needed to guide relevant preventative measures in Nigeria. A systematic search of studies on the epidemiology of hypertension in Nigeria, published on or after January 1990, was conducted. The authors employed random‐effects meta‐analysis on extracted crude hypertension prevalence, and awareness, treatment, and control rates. Using a meta‐regression model, overall hypertension cases in Nigeria in 1995 and 2020 were estimated. Fifty‐three studies (n = 78 949) met our selection criteria. Estimated crude prevalence of pre‐hypertension (120‐139/80‐89 mmHg) in Nigeria was 30.9% (95% confidence interval [CI]: 22.0%‐39.7%), and the crude prevalence of hypertension (≥140/90 mmHg) was 30.6% (95% CI: 27.3%‐34.0%). When adjusted for age, study period, and sample, absolute cases of hypertension increased by 540% among individuals aged ≥20 years from approximately 4.3 million individuals in 1995 (age‐adjusted prevalence 8.6%, 95% CI: 6.5‐10.7) to 27.5 million individuals with hypertension in 2020 (age‐adjusted prevalence 32.5%, 95% CI: 29.8‐35.3). The age‐adjusted prevalence was only significantly higher among men in 1995, with the gap between both sexes considerably narrowed in 2020. Only 29.0% of cases (95% CI: 19.7‐38.3) were aware of their hypertension, 12.0% (95% CI: 2.7‐21.2) were on treatment, and 2.8% (95% CI: 0.1‐5.7) had at‐goal blood pressure in 2020. Our study suggests that hypertension prevalence has substantially increased in Nigeria over the last two decades. Although more persons are aware of their hypertension status, clinical treatment and control rates, however, remain low. These estimates are relevant for clinical care, population, and policy response in Nigeria and across Africa.

Trends in cardiovascular diseases and associated risks in sub-Saharan Africa: a review of the evidence for Ghana, Nigeria, South Africa, Sudan and Tanzania

Background: Sub-Saharan Africa (SSA) countries are facing an epidemiological shift from infectious disease to chronic diseases, such as cardiovascular diseases (CVDs). CVDs incidence in SSA are frequently attributed to the prevalence of hypertension, diabetes, and overweight/obesity. Nevertheless, some researchers contend that CVDs are not a priority public health problem in SSA. Method: This paper systematically reviews the evidence on CVDs and their relation with hypertension, diabetes mellitus and obesity/overweight in Ghana, Nigeria, South Africa, Sudan and Tanzania. The publication's content was analyzed qualitatively using the directed content analysis method and the results were presented in a tabular format. Result: The paper illustrates the rising prevalence of CVDs as well as the three related risk conditions in the selected SSA countries. Conclusion: The review indicates a poor health system response to the increasing risk of CVDs in SSA. The conditions and major drivers that contribute to this underlying increasing trend need to be further studied.

Biological risk factors for coronary artery disease among adults residing in rural area of North Karnataka, India

BACKGROUND

Coronary artery disease (CAD) accounts for 60% of all deaths and 47% of burden of diseases which is progressively increasing in rural population in terms of absolute numbers. Biological risk factors contribute significantly to the cardiovascular burden. Hence, this study was undertaken to assess the biological risk factors among adults residing in rural area.

MATERIALS AND METHODS

A community-based cross-sectional study conducted among 980 adults aged between 20 and 60 years residing in rural area of Belagavi district, India. World Health Organization-STEPS-based predesigned questionnaire was used for data collection by house-to-house visit after obtaining written informed consent. Sociodemographic variables and biological risk factors which included hypertension, self-reported diabetes mellitus, overweight, and obesity were assessed. Statistical analysis was done using Pearson's Chi-square test and P value less than 0.05 was considered significant.

RESULTS

In the present study, 48.8% were men and 51.2% were women. Prevalence of hypertension was 26.6%, self-reported diabetes mellitus 6.3%, overweight 26.7%, and obesity was 7.0%. Men had higher prevalence of hypertension and overweight, whereas women had higher prevalence of diabetes and obesity. A significant gender difference was noted with the biological risk factors for CAD (P < 0.05). Advancing age, lesser education, and retirement from the job were the contributors for the increasing prevalence of these risk factors (P < 0.05); however, the socioeconomic status did not show any influence (P > 0.05).

CONCLUSION

Biological risk factors, which included hypertension, diabetes, and overweight, were observed in a significantly higher proportion among men, whereas women were more obese with a significant higher proportion. Advancing age, lesser education, and retirement from the job were the contributors for the increasing prevalence of these risk factors.

Trends of mortality attributable to child and maternal undernutrition, overweight/obesity and dietary risk factors of non-communicable diseases in sub-Saharan Africa, 1990-2015: findings from the Global Burden of Disease Study 2015

OBJECTIVE

To assess trends of mortality attributable to child and maternal undernutrition (CMU), overweight/obesity and dietary risks of non-communicable diseases (NCD) in sub-Saharan Africa (SSA) using data from the Global Burden of Disease (GBD) Study 2015.

DESIGN

For each risk factor, a systematic review of data was used to compute the exposure level and the effect size. A Bayesian hierarchical meta-regression analysis was used to estimate the exposure level of the risk factors by age, sex, geography and year. The burden of all-cause mortality attributable to CMU, fourteen dietary risk factors (eight diets, five nutrients and fibre intake) and overweight/obesity was estimated.

SETTING

Sub-Saharan Africa.ParticipantsAll age groups and both sexes.

RESULTS

In 2015, CMU, overweight/obesity and dietary risks of NCD accounted for 826204 (95 % uncertainty interval (UI) 737346, 923789), 266768 (95 % UI 189051, 353096) and 558578 (95 % UI 453433, 680197) deaths, respectively, representing 10·3 % (95 % UI 9·1, 11·6 %), 3·3 % (95 % UI 2·4, 4·4 %) and 7·0 % (95 % UI 5·8, 8·3 %) of all-cause mortality. While the age-standardized proportion of all-cause mortality accounted for by CMU decreased by 55·2 % between 1990 and 2015 in SSA, it increased by 63·3 and 17·2 % for overweight/obesity and dietary risks of NCD, respectively.

CONCLUSIONS

The increasing burden of diet- and obesity-related diseases and the reduction of mortality attributable to CMU indicate that SSA is undergoing a rapid nutritional transition. To tackle the impact in SSA, interventions and international development agendas should also target dietary risks associated with NCD and overweight/obesity.

Audit of insulin prescription patterns and associated burden among diabetics in a tertiary health institution in Nigeria

BACKGROUND

Insulin is one of the most important anti-diabetic agents in the management of diabetes even among type 2 diabetic.

OBJECTIVE

There was need to assess insulin adherence, mode of insulin delivery and burden of insulin usage among diabetics.

METHODS

A cross-sectional, prospective questionnaire, orally administered at a Diabetes Clinic of a University Teaching Hospital, SouthWest, Nigeria. Participants were consecutive patients with diabetes who were 18 years or older presently on insulin either alone or in combination with other anti-diabetic agents for at least 3 months. Baseline demographic and insulin treatment information were obtained.

RESULTS

Two hundred and thirteen (213) participants were studied. Of these, 21 (9.9%) had T1DM and 192 (90.1%) had T2DM, (means age, 58.6 ± 13.1 years, mean duration of diabetes, 7.0 ± 6.9 years). Insulin adherence was noted in 72.8% with better adherence among those who self-injected insulin compared to those who were injected by health care professionals (HCPs) or relations. Among the respondents, 80.8% were on human insulin and pre-mixed insulin was the most commonly used form of insulin (52.6%). Most participants (52.6%) were taking 10-20 units per day, only 22 (10.3%) were on >40units/day. Reuse of insulin needle was found in 74.6% of the participants. Major reasons for insulin omission were non-availability of insulin and patients being tired of insulin injection.

CONCLUSION

The insulin adherence among diabetics in this study was high. Non-availability of insulin, insulin injection pain and being tired of continual insulin usage were some of the reasons for non-adherent to insulin usage.

Diabetes and complications of the heart in Sub-Saharan Africa: An urgent need for improved awareness, diagnostics and management

Type 2 diabetes mellitus is no longer a disease of high income countries but a global health pandemic. With the continued and rapid increase in its prevalence worldwide it is forecasted that diabetes will be a leading cause of morbidity and mortality. A major concern stems from its role in development and progression of cardiovascular disease, including cardiac dysfunction and heart failure. Within low- and middle-income areas such as Sub-Saharan Africa the burden of diabetes is already significant driven by many factors, including, socioeconomic (urbanisation), nutritional (high-calorie "western-diet", obesity) and lifestyle (physical inactivity) changes. Insufficient economic and community resources, poor health care system development and chronic disease management, poor education, and a lack of preventative and diagnostic measures further aggravate the severity of the diabetes problem. This review outlines the burden of type 2 diabetes mellitus in Sub-Saharan Africa and highlights the need for improved community health care and regulations to reduce its epidemiological spread and devastating impact on health.

Comparing indications for cardiovascular admissions into a Nigerian and an Israeli Hospital

Background:

Changing epidemiologic profile with increase in cardiovascular risk factors is well documented in literature. Our study sought to see how this is reflected in cardiovascular admissions into medical wards of a Nigerian and an Israeli hospital.

Objective:

To compare the range and pattern of cardiovascular admissions encountered in a Nigerian hospital and an Israel hospital.

Methods:

This was a retrospective study of admission records of patients admitted into both Federal Medical Centre (FMC), Umuahia, Abia State, Nigeria, and Sheba Medical Centre, Israel.

Results:

Ischemic heart disease (IHD) was the most prevalent among the Israeli hospital's admissions but ranks very low as an indication for admission in Nigeria. The most common causes of admission in Nigeria were hypertension and heart failure (HF). The spectrum of cardiovascular diseases (CVDs) was very limited in the Nigerian hospital, indicating disparity in diagnostic capacity.

Conclusion:

There were more patients with CVD as a cause of medical admission in the Israel hospital as compared to the Nigerian hospital. Hypertension and HF were prevalent indications for CVD in FMC, Umuahia, Nigeria, while hypertension and IHD were the prevalent indications for admission in Sheba Medical Centre, Israel. Future studies are needed to monitor spectrum and frequency of cardiovascular admissions in view of evolving epidemiological transition in developing countries.

ASSESSMENT OF MEASURES OF ADIPOSITY THAT CORRELATE WITH BLOOD PRESSURE AMONG HYPERTENSIVE AFRICANS

BACKGROUND

Studies differ on which anthropometric measure of adiposity shows good correlation with cardiovascular diseases. In this study, we evaluated the effects of common epidemiological measures of adiposity as a correlate of elevated blood pressure in an African population.

METHODOLOGY

The study was carried out between June 2009 and December 2011 at the medical out-patient department of a tertiary healthcare center in Nigeria. Correlation analysis was used to assess the relationship between blood pressure and body mass index (BMI), waist to height ratio (WHtR), and waist circumference (WC).

RESULTS

A total of 1,416 Hypertensives comprising 1090 (77%) adult females recruited over two and half years. Women were significantly older (49.2±8.1 vs. 48.0±10.0 years, p=0.039) and shorter (1.6±6.3 vs 1.7±6.8 meters, p<0.0001) when compared with men. Blood pressure parameters were comparable between women and men. Approximately 1 out of 5 participants had good blood pressure control with no gender difference. Anthropometric measurements showed that 446(32%) were overweight, 404(29%) obese and 40(3%) were morbidly obese. Compared with their male counterparts, females were significantly more likely to be obese (P<0.0001). Similarly, 51.6% of the subjects had abdominal obesity, with female preponderance (P<0.0001). Likewise, a greater proportion of women had substantially higher measured waist circumference risk. Compared with other measures of adiposity, body mass index correlated best with diastolic blood pressure in both gender (P< 0.05).

CONCLUSION

This study adds to the evidence that obesity is a major cardiovascular risk factor. BMI, as a measure of adiposity, was found to correlate best with blood pressure. These findings support other observations in other populations that BMI rather than waist to height ratio (WHtR), and waist circumference (WC) is a better correlate of hypertension.

Estimating the prevalence, hospitalisation and mortality from type 2 diabetes mellitus in Nigeria: a systematic review and meta-analysis

BACKGROUND

There is not yet a comprehensive evidence-based epidemiological report on type 2 diabetes mellitus (T2DM) in Nigeria. We aimed to estimate country-wide and zonal prevalence, hospitalisation and mortality rates of T2DM in Nigeria.

METHODS

We searched MEDLINE, EMBASE, Global Health, Africa Journals Online (AJOL) and Google Scholar for population and hospital-based studies on T2DM in Nigeria. We conducted a random-effects meta-analysis on extracted crude estimates, and applied a meta-regression epidemiological model, using the United Nations demographics for Nigeria in 1990 and 2015 to determine estimates of diabetes in Nigeria for the two years.

RESULTS

42 studies, with a total population of 91 320, met our selection criteria. Most of the studies selected were of medium quality (90.5%). The age-adjusted prevalence rates of T2DM in Nigeria among persons aged 20-79 years increased from 2.0% (95% CI 1.9% to 2.1%) in 1990 to 5.7% (95% CI 5.5% to 5.8%) in 2015, accounting for over 874 000 and 4.7 million cases, respectively. The pooled prevalence rate of impaired glucose tolerance was 10.0% (95% CI 4.5% to 15.6%), while impaired fasting glucose was 5.8% (95% CI 3.8% to 7.8%). Hospital admission rate for T2DM was 222.6 (95% CI 133.1 to 312.1) per 100 000 population with hyperglycaemic emergencies, diabetic foot and cardiovascular diseases being most common complications. The overall mortality rate was 30.2 (95% CI 14.6 to 45.8) per 100 000 population, with a case fatality rate of 22.0% (95% CI 8.0% to 36.0%).

CONCLUSION

Our findings suggest an increasing burden of T2DM in Nigeria with many persons currently undiagnosed, and few known cases on treatment.

Prevalence of diabetes mellitus among children and adolescents in the district of Abidjan in Cote d'Ivoire: a population-based study

BACKGROUND

World Health Organization has predicted a worldwide rise in the prevalence of diabetes mellitus. Cote d'Ivoire is not exempted as evidenced by such factors as obesity and sedentary life style amongst others. The objective of the study was to determine the prevalence of diabetes mellitus (DM) among children and adolescents in the district of Abidjan in Cote d'Ivoire.

METHODS

A cross-sectional descriptive survey using a multi-stage sampling approach was conducted from March to April 2013. 1572 children and adolescents aged 02-19 years were surveyed in 687 randomly selected households in three municipalities. Capillary fasting glucose was performed in all subjects, and when abnormal was followed by an Oral Glucose Tolerance Test (OGTT). Definitions of Impaired Fasting Glucose (IFG) and DM (Diabetes Mellitus) were according to International Society for Paediatric and Adolescent Diabetes (ISPAD) Guidelines.

RESULTS

The prevalence of DM and IFG were 0.4 % and 14.5 % respectively. There was no significant differences between patients with different glycemic status in terms of ethnicity/nationality (p = 0.98) or gender (0.079). In the rural areas, 565 (81.1 %) subjects were normoglycaemic and 132 (18.9 %) subjects hyperglycaemic while there were 773 (88.3 %) normoglycaemic subjects and 102 (11.7 %) hyperglycaemic subjects respectively from the urban areas of residence and this difference was statistically significant (p = 0.000). The prevalence of diabetes mellitus was identical (0.4 %) in the two age groups (2-9 years and 10-19 years). Seventy-seven (4.9 %) children who participated in the study had at least one diabetic parent. The proportion of participants with a diabetic father (59, 3.8. %) was twice the proportion with a diabetic mother (30,1.9 %) and this was statistically significant (p = 0.002). Only 10 out of 228 patients with IFG reported for the follow up OGTT and no impaired glucose tolerance was identified in these patients.

CONCLUSION

The prevalence rate of DM among children and adolescents was 0.4 %. Nationwide awareness campaigns and prevention programmes about diabetes in childhood should be instituted and existing ones strengthened. Adequate commitment from the relevant stakeholders especially the country's ministry of health is also advocated to stem this looming epidemic.

Metabolic Syndrome and Framingham Risk Score: Observation from Screening of Low-Income Semi-Urban African Women

Background: The heightened cardiovascular risk associated with metabolic syndrome (MetS) has been documented by several researchers. The Framingham risk score (FRS) provides a simple and efficient method for identifying individuals at cardiovascular risk. The objective was to describe the prevalence of MetS and its association with FRS in predicting cardiovascular disease among a cohort of semi-urban women; Method: Clinical and laboratory parameters were evaluated among 189 healthy women. The International Diabetes Federation definition was used to diagnose metabolic syndrome. FRS was calculated for each participant; Result: About two thirds of the participant make less than $US 90 per month. The mean systolic blood pressure was 131.80 ± 30. Eighty (42.3%) participants were overweight with a mean waist circumference of 91.64 ± 11.19 cm. MetS was present in 46 (24.3%). Individuals with MetS were more likely to have increased FRS, p = 0.012. One hundred and eighty seven (98.9%) were in the low risk category according to FRS. There was a significant difference in the mean FRS between participants with and without MetS (13.52 versus 10.29 p = 0.025); Conclusion: Prevalence of MetS in this study was comparable to the global rate, despite a low economic status. Individuals with MetS were more likely to have cardiovascular disease than persons without MetS, thus emphasizing the need for risk stratification and prompt management.

Epidemiology and patterns of hypertension in semi-urban communities, south-western Nigeria

Objective

To determine the prevalence and subtypes of hypertension among semi-urban residents in south-western Nigeria.

Methods

All adults aged 18 years or older in 10 semi-urban communities were recruited for the study. The blood pressure (BP) reading taken with a validated electronic BP monitor after at least 10 minutes of rest was used in the analysis. Hypertension was defined as BP ≥ 140/90 mmHg.

Results

Seven hundred and fifty subjects with a mean age of 61.7 ± 18.2 years participated in the study. The prevalence of hypertension was 55.5%. Stage 2 hypertension was the most common, present among 225 (54.1%) of the participants with hypertension, and 191 (45.9%) had stage 1 hypertension. Of those with hypertension, systolic–diastolic hypertension (SDH) was present among 198/416 (47.6%), while isolated systolic hypertension (ISH) and isolated diastolic hypertension (IDH) were present among 181/416 (43.6%) and 37/416 (8.9%), respectively. The prevalence of hypertension increased significantly with age.

Conclusion

The prevalence of hypertension was high in these semi-urban communities. Hence, increased awareness and integrating hypertension care into primary healthcare and other community health services in these areas may prove beneficial in ameliorating its adverse effects.

An estimate of the prevalence of hypertension in Nigeria: a systematic review and meta-analysis

BACKGROUND

Hypertension is a leading cause of morbidity and mortality in Africa, and Nigeria, the most populous country in the continent, hugely contributes to this burden.

OBJECTIVE

To provide an improved estimate of the prevalence and number of cases of hypertension in Nigeria based on the cut-off 'at least 140/90  mmHg', towards ensuring better awareness, control and policy response in the country.

METHODS

We conducted a systematic search of Medline, EMBASE and Global Health from January 1980 to December 2013 for population-based studies providing estimates on the prevalence of hypertension in Nigeria. From the extracted crude prevalence rates, we conducted a random-effects meta-analysis, and further estimated the overall awareness rate of hypertension in Nigeria, expressed as percentage of all hypertension cases. We applied a meta-regression epidemiological modelling, using United Nations population demographics for the years 2010 and 2030, to determine the prevalence and number of cases of hypertension in Nigeria for the 2 years.

RESULTS

Our search returned 2260 publications, 27 of which met our selection criteria. From the random-effects meta-analysis, we estimated an overall hypertension prevalence of 28.9% (25.1, 32.8), with a prevalence of 29.5% (24.8, 34.3) among men and 25.0% (20.2, 29.7) among women. We estimated a prevalence of 30.6% (24.5, 36.6) and 26.4% (19.4, 33.4) among urban and rural dwellers, respectively. The pooled awareness rate of hypertension was 17.4% (11.4, 23.3). The overall mean SBP was 128.6 (125.5, 130.8) mmHg, and the DBP was 80.6 (78.5, 82.7) mmHg. From our modelling, we estimated about 20.8 million cases of hypertension in Nigeria among people aged at least 20 years in 2010, with a prevalence of 28.0% (24.6, 31.9) in both sexes - 30.7% (24.9, 33.7) among men and 25.2% (22.7, 31.9) among women. By 2030, we projected an increase to 39.1 million cases of hypertension among people aged at least 20 years with a prevalence of 30.8% (24.5, 33.7) in both sexes - 32.6% (27.3, 38.2) among men and 29.0% (21.9-32.2) among women.

CONCLUSIONS

Our findings suggest the prevalence of hypertension is high in Nigeria, and the overall awareness of raised blood pressure among hypertension cases is low in the country. We hope this study will inform appropriate public health response towards reducing this burden.

Sex Disparity in Blood Pressure Levels Among Nigerian Health Workers

Sex disparity in hypertension prevalence is well established in developed nations; however, there is paucity of data on the distribution of hypertension prevalence between the sexes in developing countries. Therefore, the authors examined sex differences in hypertension prevalence and cardiovascular risk factors in a sample of 352 healthy hospital workers in Nigeria. The mean ages of the men and women were 37.2±7.9 and 44.7±9.1 years, respectively. Thirty-five percent of participants were hypertensive, with 54% on treatment and 70% with controlled blood pressure. Men had a higher prevalence of hypertension (38.4% vs 33.0%) and prehypertension (37.6% vs 29.7%). Women had significantly higher odds of developing hypertension and of being on treatment. Mean blood pressure and fasting plasma glucose values were higher in men, while women were more often older, obese, and dyslipidemic and had a lower mean estimated glomerular filtration rate (P<.0001). These findings indicate sex disparity in blood pressure among hospital employees. Sex-focused management of hypertension is therefore advocated for hospital employees.

Diabetes Burden in Urban and Rural Senegalese Populations: A Cross-Sectional Study in 2012

Diabetes represents a challenging global health issue in the 21st century. Data from sub-Saharan African populations are scarce and are usually restricted to urban settings. The objective of this study was to compare prevalence and risk factors of diabetes in rural and urban areas in Senegal. Methods. In a community-based survey between January and May 2012, we included 1027 adults aged ≥18 years living in northern Senegal. Sociodemographic, clinical, and biological data were collected during household visits. Multivariate logistic regression was performed to identify factors associated with diabetes. Results. Mean age of participants was 48.0 ± 16.9 years and 65.7% were female. Participants from urban area represented 55.7%. The age-standardized prevalence of diabetes was 7.6% (6.0% in men versus 9.0% in women). Prevalence of diabetes was higher in urban areas (8.1%) compared to rural areas (4.6%). Disease awareness rate was 43%. After multivariate analysis, age (OR = 1.63, p = 0.001), familial history of diabetes (OR = 1.42, p = 0.001), and abdominal obesity (OR = 1.17, p = 0.05) were associated with diabetes. Conclusion. Diabetes is frequent in urban and rural areas in Senegal. Awareness rate is very low among populations. Age, family history of diabetes, and abdominal obesity are the main risk factors identified.

Sociodemographic correlates of modifiable risk factors for hypertension in a rural local government area of oyo state South west Nigeria

Modifiable risk factors of hypertension contribute significantly to all-cause morbidity and mortality worldwide. The study aimed to determine the prevalence of and the association of modifiable risk factors with hypertension in rural community. A cross-sectional study was conducted among 166 male and 201 female adults of 18 years and above using cluster sampling technique. Data were collected using modified WHO STEPS instrument and hypertensive subjects were defined as those with systolic greater than or equal to 140 and diastolic of 90 mmHg. Data were analyzed with SPSS version 17 with level of significance at P < 0.05. The mean age of the subjects was 36.36 (±16.88) years and mean systolic and diastolic pressures were 124 (±16.93) and 76.32 (±11.85) mmHg, respectively. The prevalence of hypertension was high (22.9%) in this rural communities but awareness was low, 10.71%. The prevalence of alcohol consumption, sedentary lifestyle, abnormal weight, inadequate sleep, smoking, significant stress, and female use of hormonal contraceptives was 149 (40.6%), 91 (24.8%), 88 (24.0%), 122 (33.2%), 14 (3.8%), 65 (17.7%), and 53 (26.5%), respectively. Overweight, sex, inadequate sleep, and stress were established as positive predictors of hypertension. The rising prevalence of hypertension and its modifiable risk factors in rural communities require prompt interventions directed at reversing these trends.

Prevalence of diabetes in Zimbabwe: a systematic review with meta-analysis

OBJECTIVE

Diabetes appears to be a growing problem in the African region. This study aims to estimate the prevalence of diabetes in Zimbabwe by collating and analyzing previously published data.

METHODS

Systematic review and meta-analysis of data reporting prevalence of diabetes in Zimbabwe was conducted based on the random effects model. We searched for studies published between January 1960 and December 2013 using MEDLINE, EMBASE and Scopus and University of Zimbabwe electronic publication libraries. In the meta-analysis, sub-groups were created for studies conducted before 1980 and after 1980, to understand the potential effect of independence on prevalence.

RESULTS

Seven studies were included in the meta-analysis with a total of 29,514 study participants. The overall pooled prevalence of diabetes before 1980 was 0.44% (95% CI 0.0-1.9%), after 1980 the pooled prevalence was 5.7% (95% CI 3.3-8.6%).

CONCLUSIONS

This study showed that the prevalence of diabetes in Zimbabwe has increased significantly over the past three decades. This poses serious challenges to the provision of care and prevention of disabling co-morbidities in an already disadvantaged healthcare setting.

Hypertension Subtypes among Hypertensive Patients in Ibadan

Background. Certain hypertension subtypes have been shown to increase the risk for cardiovascular morbidity and mortality and may be related to specific underlying genetic determinants. Inappropriate characterization of subtypes of hypertension makes efforts at elucidating the genetic contributions to the etiology of hypertension largely vapid. We report the hypertension subtypes among patients with hypertension from South-Western Nigeria. Methods. A total of 1858 subjects comprising 76% female, hypertensive, aged 18 and above were recruited into the study from two centers in Ibadan, Nigeria. Hypertension was identified using JNCVII definition and was further grouped into four subtypes: controlled hypertension (CH), isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic-diastolic hypertension (SDH). Results. Systolic-diastolic hypertension was the most prevalent. Whereas SDH (77.6% versus 73.5%) and IDH (4.9% versus 4.7%) were more prevalent among females, ISH (10.1% versus 6.2%) was higher among males (P = 0.048). Female subjects were more obese (P < 0.0001) and SDH was prevalent among the obese group. Conclusion. Gender and obesity significantly influenced the distribution of the hypertension subtypes. Characterization of hypertension by subtypes in genetic association studies could lead to identification of previously unknown genetic variants involved in the etiology of hypertension. Large-scale studies among various ethnic groups may be needed to confirm these observations.

Cardiovascular risk factors in semi-urban communities in southwest Nigeria: Patterns and prevalence

Introduction: Over 80% of cardiovascular deaths take place in low- and middle-income countries; most of these deaths are due to modifiable risk factors. The study aimed at estimating the prevalence and pattern of major cardiovascular risk factors in both men and women older than 18 years.

Methods: This is a cross-sectional study of cardiovascular risk factors among semi-urban dwellers in Ekiti State, south-western, Nigeria. 750 participants were drawn from 10 communities. The instrument used was the standard WHO STEPS (II) questionnaire, while blood samples were obtained for analysis.

Results: There were 750 participants with 529 (70.53%) females. The mean age of participants was 61.7 ± 18.50 years and participants’ ⩾65 years comprised 38.3%. There were 0.8%, 24.9% and 12.4%, who at the time of this study smoked cigarettes, consumed alcohol, and ate a high salt diet, respectively. The prevalence of hypertension, diabetes, generalized and abdominal obesity was 47.2%, 6.8%, 8.5% and 32.0%, respectively, with only 48.9% receiving hypertension treatment. Elevated total cholesterol, LDL-cholesterol, and low HDL was seen in 4.4%, 16.7% and 56.3% respectively.

Conclusion: High prevalence of cardiovascular risk factors call for an urgent need for more public health attention and reinforcement of primary preventive strategies to curb its menace.

The wits appraisal using three reference planes and its interaction with the ANB angle among a sub-set of Nigerians"

AIMS

Conjoint analysis of orthodontic patients using the Subspinale (A-point) Nasion-Supramentale (B point) (ANB) angle and the Wits appraisal is popular in many practices. This study aimed to present reference values for the Wits appraisal among Nigerians using three horizontal reference planes namely the bisected occlusal plane (BOP), the functional occlusal plane (FOP) and the maxillomandibular angle bisector (MM° bisector) plane. It also assessed the relationship of the Wits appraisal with the ANB angle and its interaction with clinical measures of sagittal skeletal relations among subjects with malocclusion.

METHODOLOGY

One hundred participants with normal occlusion and 120 with malocclusion were recruited in the study. Cephalometric radiographs were taken for all participants. Each radiograph was manually traced on a 0.003 matted cellulose acetate tracing paper using a sharpened 2H pencil. The Wits appraisal and ANB angle were determined. Data was analyzed using SPSS version 19.

RESULTS

The mean age was 20.7 ± 4.9 years for those with normal occlusion and 18.8 ± 6.5 years in the malocclusion group. There were 91 (41.4%) males and 129 (58.6%) females. Mean values for the Wits appraisal using the BOP as reference, was--1.27 ± 2.91mm, with the FOP, it was -3.54 ± 3.24mm, while with the MM° bisector plane, it was--.75? ± .94mm. The ANB angle showed highest correlation with the MM'°bisector plane Wits value(P< 0 .001). CCONCLUSION: hen the clinical and angular cephalometric findings are at variance, the ANB angle is best moderated by the MM'° isector plane Wits appraisal.

Estimating the prevalence and awareness rates of hypertension in Africa: a systematic analysis

Background

The burden of hypertension is high in Africa, and due to rapid population growth and ageing, the exact burden on the continent is still far from being known. We aimed to estimate the prevalence and awareness rates of hypertension in Africa based on the cut off “≥140/90 mm Hg”.

Methods

We conducted a systematic search of Medline, EMBASE and Global Health. Search date was set from January 1980 to December 2013. We included population-based studies on hypertension, conducted among people aged ≥15 years and providing numerical estimates on the prevalence of hypertension in Africa. Overall pooled prevalence of hypertension in mixed, rural and urban settings in Africa were estimated from reported crude prevalence rates. A meta-regression epidemiological modelling, using United Nations population demographics for the years 1990, 2000, 2010 and 2030, was applied to determine the prevalence rates and number of cases of hypertension in Africa separately for these four years.

Results

Our search returned 7680 publications, 92 of which met the selection criteria. The overall pooled prevalence of hypertension in Africa was 19.7% in 1990, 27.4% in 2000 and 30.8% in 2010, each with a pooled awareness rate (expressed as percentage of hypertensive cases) of 16.9%, 29.2% and 33.7%, respectively. From the modelling, over 54.6 million cases of hypertension were estimated in 1990, 92.3 million cases in 2000, 130.2 million cases in 2010, and a projected increase to 216.8 million cases of hypertension by 2030; each with an age-adjusted prevalence of 19.1% (13.9, 25.5), 24.3% (23.3, 31.6), 25.9% (23.5, 34.0), and 25.3% (24.3, 39.7), respectively.

Conclusion

Our findings suggest the prevalence of hypertension is increasing in Africa, and many hypertensive individuals are not aware of their condition. We hope this research will prompt appropriate policy response towards improving the awareness, control and overall management of hypertension in Africa.

Differences by sex in the prevalence of diabetes mellitus, impaired fasting glycaemia and impaired glucose tolerance in sub-Saharan Africa: a systematic review and meta-analysis

OBJECTIVE

To assess differences between men and women in the prevalence of diabetes mellitus, impaired fasting glycaemia and impaired glucose tolerance in sub-Saharan Africa.

METHODS

In September 2011, the PubMed and Web of Science databases were searched for community-based, cross-sectional studies providing sex-specific prevalences of any of the three study conditions among adults living in parts of sub-Saharan Africa (i.e. in Eastern, Middle and Southern Africa according to the United Nations subregional classification for African countries). A random-effects model was then used to calculate and compare the odds of men and women having each condition.

FINDINGS

In a meta-analysis of the 36 relevant, cross-sectional data sets that were identified, impaired fasting glycaemia was found to be more common in men than in women (OR: 1.56; 95% confidence interval, CI: 1.20-2.03), whereas impaired glucose tolerance was found to be less common in men than in women (OR: 0.84; 95% CI: 0.72-0.98). The prevalence of diabetes mellitus - which was generally similar in both sexes (OR: 1.01; 95% CI: 0.91-1.11) - was higher among the women in Southern Africa than among the men from the same subregion and lower among the women from Eastern and Middle Africa and from low-income countries of sub-Saharan Africa than among the corresponding men.

CONCLUSION

Compared with women in the same subregions, men in Eastern, Middle and Southern Africa were found to have a similar overall prevalence of diabetes mellitus but were more likely to have impaired fasting glycaemia and less likely to have impaired glucose tolerance.

Prevalence and pattern of overweight and obesity in three rural communities in southwest Nigeria

BACKGROUND

Limited data exist on the prevalence of overweight and obesity in the Nigerian adult rural population. This study therefore assessed the prevalence and pattern of overweight and obesity in adults in three rural communities of the Ife North Local Government Area, Nigeria.

MATERIALS AND METHODS

A total of 777 adults between 20 and 90 years of age were recruited into this cross-sectional study, which was performed over a 6-month period using a multistage proportional stratified random sampling technique. Sociodemographic data and anthropometric variables were obtained.

RESULTS

A total of 385 (49.5%) men and 395 (50.5%) women participated in the study. The mean age and body mass index of the participants were 36.3±14.3 years and 23.53±4.6 kg/m(2), respectively. The overall crude prevalence of overweight and obesity in the total population were 20.8% and 8.4%, respectively. Obesity increased across the age gradient, peaking in the 51- to 60-year age-group in men and women. Among the overweight and obese subjects (n=227), 70.9% of them were overweight and the remaining 29.1% were obese, with class I obesity accounting for 20.7% of these overweight and obese subjects.

CONCLUSION

The prevalence of overweight and obesity in these communities was 20.8% and 8.4% respectively, indicating a trend towards increased prevalence. Class I obesity is the most common obesity pattern, and obesity increased across the age gradient, peaking in the 51- to 60-year age-group. There is a need for regular community education on healthy lifestyles, and regular health screening to control the rising prevalence of overweight and obesity, as well as to prevent or reduce the risk of obesity comorbidities in these communities.

Prevalence of abdominal obesity in Abia State, Nigeria: results of a population-based house-to-house survey

BACKGROUND AND OBJECTIVE

Abdominal obesity is associated with the risk of developing disorders, such as diabetes and hypertension. The objective of this study was to investigate the prevalence of abdominal obesity in Abia State, Nigeria.

MATERIALS AND METHODS

We carried out a cross-sectional study aimed at ascertaining the prevalence of abdominal obesity in Abia State, Nigeria. Participants in the study were recruited from communities in the three senatorial zones in the state. Screening for abdominal obesity was carried out in these subjects using waist circumference (the National Cholesterol Education Program Third Adult Treatment Panel criteria were used). The World Health Organization Stepwise Approach to Surveillance of chronic disease risk factors was used. Body mass index, anthropometric measurements, and other relevant data were also collected.

RESULTS

Data on waist circumference were obtained from 2,807 subjects. The prevalence of obesity using body mass index in the population was 11.12%. In men and women, it was 7.73%, and 14.37%, respectively. The prevalence of abdominal obesity in the population was 21.75%. In men and women, it was 3.2% and 39.2%, respectively.

CONCLUSION

The prevalence of abdominal obesity is high in Nigeria, and needs to be monitored because it is associated with increased cardiovascular risk.

New insights on diabetes mellitus and obesity in Africa-part 1: prevalence, pathogenesis and comorbidities

Evidence continues to accumulate on the rising burden of diabetes mellitus at a higher pace in Africa. In a series of two papers, we sought to summarise recent evidence on diabetes and obesity in Africa based on a systematic review of studies published between January 2002 and October 2012. This first paper on the prevalence, pathogenesis and comorbidities shows that the increase in diabetes prevalence has paralleled that of obesity in Africa. Recent surveys on diabetes and obesity have been largely suboptimal. Hence, the need for more representative and robust continent-wide prevalence figures, which may be somehow achieved through pooling of existing data. Prospective studies linking environmental risk factors to disease occurrence and outcomes remain scarce, and genetic factors for diabetes or obesity have not been extensively assessed. The health consequences of diabetes are manifold, and include a complex interaction with other conditions like HIV infection and sickle cell disease/trait.

Epidemiology of ischaemic heart disease in sub-Saharan Africa

BACKGROUND

The epidemiology of ischaemic heart disease (IHD) in sub-Saharan Africa (SSA) remains largely enigmatic. Major obstacles to our understanding of the condition include lack of reliable health statistics, particularly cause-specific mortality data, inadequate diagnostic capabilities, shortage of physicians and cardiologists, and misguided opinions.

METHODS

This review of the epidemiology of ischaemic heart disease in sub-Saharan Africa involved a systematic bibliographic MEDLINE search of published data on IHD in SSA over the past century. Search words included epidemiology, ischaemic (coronary) heart disease, myocardial infarction, cardiovascular risk factors and sub-Saharan Africa. Selected data are presented on the prevalence of cardiovascular risk factors and mortality from ischaemic heart disease from different countries representing the main regions of the continent.

RESULTS

Although IHD in SSA remains relatively uncommon, its prevalence is predicted to rise in the next two decades due to the rising prevalence of risk factors, especially hypertension, diabetes, overweight and obesity, physical inactivity, increased tobacco use and dyslipidaemia. It is estimated that age-standardised mortality rates for IHD will rise by 27% in African men and 25% in women by 2015, and by 70 and 74%, respectively by 2030.

CONCLUSION

Ischaemic heart disease remains relatively uncommon in SSA, despite an increasing prevalence of risk factors, but its incidence is rising. The pace and direction of economic development, rates of urbanisation, and changes in life expectancy resulting from the impact of pre-transitional diseases and violence will be major determinants of the IHD epidemic in SSA. The best window of opportunity for prevention of the emerging epidemic of ischaemic heart disease in sub-Saharan Africa is now.

Prevalence of overweight and obesity in adult Nigerians - a systematic review

BACKGROUND

Obesity is a major health problem, and there is an increasing trend of overweight and obese individuals in developing countries. Being overweight or obese is known to contribute significantly to morbidity and mortality rates in various countries around the world. We therefore aimed to identify and discuss current epidemiological data on the prevalence of obesity in Nigeria.

METHOD

A systematic review of papers published on the prevalence of obesity among adults in the country was carried out. We covered work published in MEDLINE, PubMed, Google, and African Journals Online using the terms "prevalence of overweight and obesity in Nigeria" or "overweight and obesity in Nigeria." In addition, personal inquiries were made. The search limits were articles published from January 2001 to September 2012. Only studies that used the body mass index to assess for overweight and obesity were included.

RESULTS

Four studies met the inclusion criteria out of the 75 studies reviewed. In Nigeria, the prevalence of overweight individuals ranged from 20.3%-35.1%, while the prevalence of obesity ranged from 8.1%-22.2%.

CONCLUSION

The prevalence of overweight and obese individuals in Nigeria is of epidemic proportions. There is a need to pay closer attention to combating these health disorders.

Blood pressure, prevalence of hypertension and hypertension related complications in Nigerian Africans: A review

To review studies on hypertension in Nigeria over the past five decades in terms of prevalence, awareness and treatment and complications. Following our search on Pubmed, African Journals Online and the World Health Organization Global cardiovascular infobase, 1060 related references were identified out of which 43 were found to be relevant for this review. The overall prevalence of hypertension in Nigeria ranges from 8%-46.4% depending on the study target population, type of measurement and cut-off value used for defining hypertension. The prevalence is similar in men and women (7.9%-50.2% vs 3.5%-68.8%, respectively) and in the urban (8.1%-42.0%) and rural setting (13.5%-46.4%).The pooled prevalence increased from 8.6% from the only study during the period from 1970-1979 to 22.5% (2000-2011). Awareness, treatment and control of hypertension were generally low with attendant high burden of hypertension related complications. In order to improve outcomes of cardiovascular disease in Africans, public health education to improve awareness of hypertension is required. Further epidemiological studies on hypertension are required to adequately understand and characterize the impact of hypertension in society.