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Batubo NP, Nwanze NM, Alikor CA, Auma CI, Moore JB, Zulyniak MA. Empowering healthcare professionals in West Africa-A feasibility study and qualitative assessment of a dietary screening tool to identify adults at high risk of hypertension. PLoS One 2024; 19:e0294370. [PMID: 38662712 PMCID: PMC11045096 DOI: 10.1371/journal.pone.0294370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 02/09/2024] [Indexed: 04/28/2024] Open
Abstract
Dietary risks significantly contribute to hypertension in West Africa. Food frequency questionnaires (FFQs) can provide valuable dietary assessment but require rigorous validation and careful design to facilitate usability. This study assessed the feasibility and interest of a dietary screening tool for identifying adults at high risk of hypertension in Nigeria. Fifty-eight (58) consenting adult patients with hypertension and their caregivers and 35 healthcare professionals from a single-centre Nigerian hospital were recruited to complete a 27-item FFQ at two-time points and three 24-hour recalls for comparison in a mixed method study employing both quantitative questionnaires and qualitative techniques to elicit free form text. Data analyses were conducted using R software version 4.3.1 and NVivo version 14. The trial was registered with ClinicalTrials.gov: NCT05973760. The mean age of patients was 42.6 ± 11.9 years, with an average SBP of 140.3 ± 29.8 mmHg and a BMI of 29.5 ± 7.1 Kg/m2. The adherence rate was 87.9%, and the mean completion time was 7:37 minutes. 96.6% of patients found the FFQ easy to complete, comprehensive, and valuable. A minority reported difficulty (3.4%), discomfort (10.3%), and proposed additional foods (6.9%). Healthcare professionals considered the dietary screening tool very important (82.9%) and expressed a willingness to adopt the tool, with some suggestions for clarification. Patients and healthcare professionals found the screening tool favourable for dietary counselling in hypertension care. The tailored dietary screening tool (FFQ) demonstrated promising feasibility for integration into clinical care as assessed by patients and healthcare professionals. Successful implementation may benefit from proactive time management and addressing training needs. This user-centred approach provided key insights to refine FFQ and set the foundation for ongoing validity testing and evaluation in clinical practice.
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Affiliation(s)
- Nimisoere P. Batubo
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - Nnenna M. Nwanze
- Department of Family Medicine, Rivers State University/Rivers State University of Teaching Hospitals, Port Harcourt, Rivers State, Nigeria
| | - Chizindu A. Alikor
- Department of Internal Medicine, Rivers State University/Rivers State University of Teaching Hospitals, Port Harcourt, Rivers State, Nigeria
| | - Carolyn I. Auma
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - J. Bernadette Moore
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - Michael A. Zulyniak
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
- Food, Nutrition and Health Program, University of British Columbia, Vancouver, British Columbia, Canada
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Bamgboye E, Ayoyemi A, Salawu MM, Akinyemi JO, Ogah OS, Uja UA, Jalo RI, Oyewole O, Sani M, Ajayi IO. Treatment seeking behaviour and associated factors among adults with high blood pressure from three selected states in Nigeria. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002949. [PMID: 38630739 PMCID: PMC11023577 DOI: 10.1371/journal.pgph.0002949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 01/29/2024] [Indexed: 04/19/2024]
Abstract
Management of hypertension is challenging in multi-cultural and multi-ethnic sub-Saharan African countries like Nigeria. This diversity calls for multi-dimensional interventional approaches for hypertension control. This study assessed the treatment seeking behaviour and associated factors among adults with high blood pressure from three ethnic groups in Nigeria. A cross-sectional study was conducted among 762 adults with high blood pressure from three purposively selected States representing the three main tribes in Nigeria. Using a multistage stratified sampling technique, five communities were selected from two Local Government Areas (LGAs) stratified into urban and rural LGAs in each State. All consenting respondents in each community were consecutively screened for hypertension and recruited. A pretested interviewer-administered questionnaire was used to obtain information on socio-demographic characteristics, treatment seeking behaviour and factors affecting their choice. Data were summarized using descriptive statistics. Relationship between individual, health-related factors and treatment seeking behaviour, as well as the predictors were assessed using a binary logistic regression. at p<0.05 Participants' mean age was 55.4 ± 16.6 years, 63.0% were females and most were Igbo speaking (39.9%). About half (368, 48.3%) were unaware of their status. Of those aware, most (58.9%) went to hospital upon diagnosis of hypertension while some sought advice from health care professionals (28.5%) mostly Hausas, others either went to chemists (6.2%) or did nothing (5.1%), predominantly Yorubas. Significant predictors of orthodox treatment seeking practices for hypertension were female gender [(AOR = 2.60; 95%CI (1.18-5.71)], availability of medicine and personnel [(AOR = 8.7; 95%CI (4.15-18.3)] and perceived good quality of care [(AOR = 4.88; 95%CI (1.81-13.1)]. Orthodox treatment was the common choice among adults with high blood pressure. To further encourage patronage of orthodox treatment, the health facilities should be adequately equipped with medications and trained personnel to improve the quality of care. Targeted education on continuous practice of orthodox treatment is recommended.
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Affiliation(s)
- Eniola Bamgboye
- Faculty of Public Health, Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Abiola Ayoyemi
- Faculty of Public Health, Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Mobolaji Modinat Salawu
- Faculty of Public Health, Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Joshua Odunayo Akinyemi
- Faculty of Public Health, Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Okechukwu Samuel Ogah
- Faculty of Clinical Sciences, Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Uzoamaka Alice Uja
- Department of Public Health, Ministry of Health, Abia State, Umuahia, Nigeria
| | | | - Oyediran Oyewole
- Faculty of Public Health, Department of Health Promotion and Education, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Mahmoud Sani
- Department of Community Medicine, Bayero University Kano, Kano, Nigeria
| | - IkeOluwapo Oyeneye Ajayi
- Faculty of Public Health, Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Sani RN, Connelly PJ, Toft M, Rowa-Dewar N, Delles C, Gasevic D, Karaye KM. Rural-urban difference in the prevalence of hypertension in West Africa: a systematic review and meta-analysis. J Hum Hypertens 2024; 38:352-364. [PMID: 35430612 PMCID: PMC11001577 DOI: 10.1038/s41371-022-00688-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/16/2022] [Accepted: 03/30/2022] [Indexed: 12/16/2022]
Abstract
Urbanisation is considered a major contributor to the rising prevalence of hypertension in West Africa, yet the evidence regarding rural-urban differences in the prevalence of hypertension in the region has been mixed. A systematic literature search of four electronic databases: PubMed, Embase, African Journals Online, and WHO's African Index Medicus; and reference lists of eligible studies was carried out. Original quantitative studies describing the rural-urban difference in the prevalence of hypertension in one or more countries in West Africa, and published in English language from the year 2000 to 2021 were included. A random effects meta-analysis model was used to estimate the odds ratio of hypertension in rural compared to urban locations. A limited sex-based random effects meta-analysis was conducted with 16 studies that provided sex-disaggregated data. Of the 377 studies screened, 22 met the inclusion criteria (n = 62,907). The prevalence of hypertension was high in both rural, and urban areas, ranging from 9.7% to 60% in the rural areas with a pooled prevalence of 27.4%; and 15.5% to 59.2% in the urban areas with a pooled prevalence of 33.9%. The odd of hypertension were lower in rural compared to urban dwellers [OR 0.74, 95% CI: 0.66-0.83; p < 0.001]. The pooled prevalence of hypertension was 32.6% in males, and 30.0% in females, with no significant difference in the odds of hypertension between the sexes [OR 0.91, 95% CI: 0.8-1.05, p = 0.196]. Comprehensive hypertension control policies are needed for both rural, and urban areas in West Africa, and for both sexes.
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Affiliation(s)
- Ruqayya Nasir Sani
- Department of Medicine, Aminu kano Teaching Hospital, Kano, Nigeria.
- Center for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK.
| | - Paul J Connelly
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - Mette Toft
- Center for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Neneh Rowa-Dewar
- Center for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Christian Delles
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - Danijela Gasevic
- Center for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Kamilu Musa Karaye
- Department of Medicine, Aminu kano Teaching Hospital, Kano, Nigeria
- Bayero University Kano, Kano, Nigeria
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Minkah Md Fwacp DO, Owusu IK, Kokuro C, Norman BR, Arthur JA, Ogyefo IN, Kweki AG. Prevalence of Increased QTc Dispersion Among Hypertensive Patients and Its Correlation to Clinical Risk Factors: A Hospital-Based Case-Control Study. Cureus 2024; 16:e56423. [PMID: 38505141 PMCID: PMC10948943 DOI: 10.7759/cureus.56423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 03/21/2024] Open
Abstract
Background In Ghana and other sub-Saharan African countries, hypertension (HTN) prevalence is rapidly increasing. Hypertensive left ventricular hypertrophy (LVH) is associated with excess fibrous tissue deposition throughout the myocardium. This could lead to ventricular arrhythmias and sudden cardiac death. Increased corrected QT dispersion (QTcd) can cause ventricular repolarization and be used to identify patients at risk of ventricular tachyarrhythmia. The measurement of increased QTcd among hypertensive patients is a simple screening tool to stratify patients at cardiovascular risk. Methods A case-control hospital-based study was conducted on 200 consecutive hypertensive patients. Age- and sex-matched control groups of 200 normotensive individuals who gave informed consent were also recruited. The baseline clinical and demographic characteristics of participants were acquired using structured questionnaires. A physical examination and a resting 12-lead ECG were performed. Increased QTcd and LVH were determined. Results The mean age of hypertensive patients was 50.99±6.73 and 48.19±7.17 for the controls (p-value 0.63). The study population was predominantly female (1:2.4 male:female ratio). Higher mean values for QTcd and LVH (Sokolow-Lyon) were observed among hypertensive patients compared to controls. The prevalence of increased QTcd was 45.0% among hypertensive patients compared to 16.5% in controls (χ2 =38.14, p-value <0.0000001, odds ratio = 4.14). Conclusion Increased QTcd is prevalent among hypertensive Ghanaians. Its measurement can be an effective non-invasive screening tool to risk-stratify hypertensive patients.
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Affiliation(s)
| | - Isaac K Owusu
- Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, GHA
| | - Collins Kokuro
- Cardiology, Komfo Anokye Teaching Hospital, Kumasi, GHA
- Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, GHA
| | - Betty R Norman
- Internal Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, GHA
- Internal Medicine, Komfo Anokye Teaching Hospital, Kumasi, GHA
| | - Joshua A Arthur
- Epidemiology and Public Health, Ghana Health Service, Accra, GHA
| | - Isaac N Ogyefo
- Medicine and Surgery, Kwame Nkrumah University of Science and Technology, Kumasi, GHA
- Medicine and Surgery, Komfo Anokye Teaching Hospital, Kumasi, GHA
| | - Anthony G Kweki
- Internal Medicine and Cardiology, Colchester Hospital, East Suffolk and North Essex NHS Foundation Trust (ESNEFT), Colchester, GBR
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Ye J, Sanuade OA, Hirschhorn LR, Walunas TL, Smith JD, Birkett MA, Baldridge AS, Ojji DB, Huffman MD. Interventions and contextual factors to improve retention in care for patients with hypertension in primary care: Hermeneutic systematic review. Prev Med 2024; 180:107880. [PMID: 38301908 PMCID: PMC10919242 DOI: 10.1016/j.ypmed.2024.107880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Regular engagement over time in hypertension care, or retention, is a crucial but understudied step in optimizing patient outcomes. This systematic review leverages a hermeneutic methodology to identify, evaluate, and quantify the effects of interventions and contextual factors for improving retention for patients with hypertension. METHODS We searched for articles that were published between 2000 and 2022 from multiple electronic databases, including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, clinicaltrials.gov, and WHO International Trials Registry. We followed the latest version of the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guideline to report the findings for this review. We also synthesized the findings using a hermeneutic methodology for systematic reviews, which used an iterative process to review, integrate, analyze, and interpret evidence. RESULTS From 4686 screened titles and abstracts, 18 unique studies from 9 countries were identified, including 10 (56%) randomized controlled trials (RCTs), 3 (17%) cluster RCTs, and 5 (28%) non-RCT studies. The number of participants ranged from 76 to 1562. The overall mean age range was 41-67 years, and the proportion of female participants ranged from 0% to 100%. Most (n = 17, 94%) studies used non-physician personnel to implement the proposed interventions. Fourteen studies (78%) implemented multilevel combinations of interventions. Education and training, team-based care, consultation, and Short Message Service reminders were the most common interventions tested. CONCLUSIONS This review presents the most comprehensive findings on retention in hypertension care to date and fills the gaps in the literature, including the effectiveness of interventions, their components, and contextual factors. Adaptation of and implementing HIV care models, such differentiated service delivery, may be more effective and merit further study. REGISTRATION CRD42021291368. PROTOCOL REGISTRATION PROSPERO 2021 CRD42021291368. Available at: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=291368.
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Affiliation(s)
- Jiancheng Ye
- Weill Cornell Medicine, NY, New York, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Olutobi A Sanuade
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Population Health Sciences, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Lisa R Hirschhorn
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Northwestern University Robert J Havey Institute for Global Health, Chicago, IL, USA
| | - Theresa L Walunas
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Justin D Smith
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | | | - Abigail S Baldridge
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Northwestern University Robert J Havey Institute for Global Health, Chicago, IL, USA
| | - Dike B Ojji
- Cardiovascular Research Unit, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria; University of Abuja, Abuja, Nigeria
| | - Mark D Huffman
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Washington University in St. Louis, St. Louis, MO, USA; The George Institute for Global Health, Sydney, Australia
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Uwanyirigira D, Biracyaza E, Uzabakiriho I, Omolo J, Hakizayezu F, Nzayirambaho M. Prevalence and Factors Associated with Hypertension Among HIV Positive Patients on Antiretroviral Therapy: A Hospital-Based Cross-Sectional Study in Rwanda. Vasc Health Risk Manag 2023; 19:857-870. [PMID: 38162226 PMCID: PMC10757801 DOI: 10.2147/vhrm.s442108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction The human immunodeficiency virus (HIV) and the use of antiretroviral therapy (ART) are influential elements contributing to hypertension, which is a public health concern particularly in sub-Saharan Africa where its underdiagnosis and limited investigation persist. Moreover, hypertension prevails at higher rates among individuals living with HIV (PLWH) in comparison to the general population. Therefore, our study determined the prevalence of hypertension and its associated factors among PLWH who are undergoing ART treatment at Byumba District Hospital. Methods A cross-sectional study design was conducted among 406 PLWH over the age of 14 years who were undergoing ART within the HIV department. We performed statistical analyses using STATA version 13. Significant independent variables identified in the bivariate analysis were further exported in a multivariable logistic regression model to ascertain their association with hypertension. This model elucidated factors associated with hypertension, presenting outcomes through odds ratios and their respective 95% confidence intervals, with statistical significance set at p < 0.05. Results The prevalence of hypertension was 24.7%, which means that roughly 1 in 4 PLWH were hypertensive. Notably, individuals aged 41 years and above demonstrated a significant association with heightened hypertension [AOR = 4.49; 95% CI = 2.45-8.21, p < 0.001] in contrast to those aged between 14 and 40 years. Additionally, smokers [AOR = 12.12; 95% CI = 4.48-32.74, p < 0.001] and individuals with a family history of hypertension [AOR = 4.28; 95% CI = 1.01-18.13, p = 0.049] demonstrated a higher likelihood of hypertension than their counterparts. Moreover, alcohol consumers [AOR = 5.5; 95% CI = 2.75-10.9, p < 0.001] had an increased likelihoods of hypertension compared to non-drinkers. Lastly, diabetics were almost 6 times more likely to be hypotensive [AOR = 4.50; 95% CI = 2.55-7.95, p = 0.018] when compared to those without diabetes. Conclusion Our findings strongly underscore the urgency for the implementation of targeted programs aimed at enhancing awareness and comprehension of the factors and potential complications tied to hypertension among PLWH. Such programs could be integrated into routine HIV care services to provide patients with the information and skills required to manage their hypertension effectively.
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Affiliation(s)
- Donatha Uwanyirigira
- Department of Epidemiology and Biostatistics, University of Rwanda, Kigali, Rwanda
- Byumba District Hospital, Ministry of Health, Byumba, Rwanda
| | - Emmanuel Biracyaza
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Quebec, Montréal
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut Universitaire Sur la Réadaptation En Déficience Physique de Montréal, Quebec, Canada
| | | | - Jared Omolo
- Field Epidemiology Training Program (FELTP), Centers for Disease Control and Prevention (CDC) in Rwanda, Kigali, Rwanda
| | - François Hakizayezu
- Department of Epidemiology and Biostatistics, University of Rwanda, Kigali, Rwanda
| | - Manasse Nzayirambaho
- Department of Epidemiology and Biostatistics, University of Rwanda, Kigali, Rwanda
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Abubakar IG, Buba F, Oyati AI, Talle MA, Anjorin CO. Prevalence of Doppler-Derived Left Ventricular Diastolic Dysfunction Among Newly Diagnosed Hypertensive Patients. Niger J Clin Pract 2023; 26:1630-1636. [PMID: 38044766 DOI: 10.4103/njcp.njcp_227_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 09/06/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND The initial sign of hypertensive heart disease (HHD) is left ventricular diastolic dysfunction (LVDD), which is caused by remodeling of the left ventricle and left atrium, resulting in impaired relaxation of the left ventricle. LVDD is also partly due to left ventricular hypertrophy (LVH). If left untreated, LVDD can progress to diastolic heart failure and systolic heart failure. In Western countries, the prevalence of LVDD in long-term hypertensive patients ranges from 40.3% to 60%, but it is more common among hypertensive Nigerians. Since systemic hypertension can be asymptomatic in the early stages, it is important to evaluate LVDD early and control blood pressure to slow down its progression. AIMS AND OBJECTIVES The study aims to highlight the prevalence of LVDD and to determine the stages of LVDD among newly diagnosed hypertensive patients at the University of Maiduguri Teaching Hospital (UMTH). METHOD The study design is a hospital-based, cross-sectional, observational study. The study population consists of 352 consecutive treatment Naïve hypertensive adult patients aged 18 years and above who presented to the Cardiology Clinic of UMTH from June 2019 to June 2021. The study used the diagnostic criteria for LVDD and LVH which were based on the American Society of Echocardiography and the European Association of Cardiovascular Imaging. RESULTS A total of 352 newly diagnosed hypertensive patients were recruited, with a mean age of 50.9 ± 11.8 years, and 54.3% were female. The majority of patients (63.6%) were overweight or obese, with a mean body mass index (BMI) of 28.5 ± 4.6 kg/m2. The mean systolic blood pressure (SBP) was 155.7 ± 16.9 mmHg, and the mean diastolic blood pressure (DBP) was 92.8 ± 10.8 mmHg. LVDD was found in 58.5% of the patients, with stage 1 LVDD being the most common (42.6%), followed by stage 2 LVDD (15.9%). The prevalence of LVDD was significantly higher in females compared to males. Patients with LVDD were significantly older and had higher BMI, higher systolic and DBP, higher pulse pressure, higher LAVI, and higher LVMI compared to those without LVDD (P < 0.05). CONCLUSION LVDD is highly prevalent among newly diagnosed hypertensive patients, with stage 1 being the most common. Female gender, older age, higher BMI, higher blood pressure, higher LAVI, and higher LVMI were significant predictors of LVDD. Early detection and appropriate management of LVDD may help to prevent adverse cardiovascular outcomes in hypertensive patients.
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Affiliation(s)
- I G Abubakar
- Department of Medicine, Cardiology Unit, University of Maiduguri Teaching Hospital, Nigeria
| | - F Buba
- Department of Medicine, Cardiology Unit, University of Maiduguri Teaching Hospital, Nigeria
- Department of Medicine, Faculty of Clinical Sciences, College of Medical Sciences, University of Maiduguri, Nigeria
| | - A I Oyati
- Department of Medicine, Faculty of Clinical Sciences, College of Medical Sciences, Ahmadu Bello University, Zaria, Nigeria
- Department of Medicine, Cardiology Unit, Ahmadu Bello University Teaching Hospital, Shika, Nigeria
| | - M A Talle
- Department of Medicine, Cardiology Unit, University of Maiduguri Teaching Hospital, Nigeria
- Department of Medicine, Faculty of Clinical Sciences, College of Medical Sciences, University of Maiduguri, Nigeria
| | - C O Anjorin
- Department of Medicine, Cardiology Unit, University of Maiduguri Teaching Hospital, Nigeria
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Ogboye A, Akpakli JK, Iwuala A, Etuk I, Njoku K, Jackson S, Okoli U, Hill K, Omoera V, Oludara F, Ekong I, Mobisson N. Prevalence of non-communicable diseases and risk factors of pre-eclampsia/eclampsia in four local government areas in Nigeria: a cross-sectional study. BMJ Open 2023; 13:e071652. [PMID: 37813536 PMCID: PMC10565324 DOI: 10.1136/bmjopen-2023-071652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 09/14/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVES To assess the prevalence of non-communicable diseases (NCDs) and risk factors associated with pre-eclampsia and eclampsia (PE/E) in women of reproductive age (WRA) in Nigeria. DESIGN A cross-sectional survey was administered to the entire study population. In the point-of-care testing, physical and biochemical measurements were taken in a subset of the participants. SETTING The study was conducted in the Ikorodu and Alimosho local government areas (LGAs) in Lagos and the Abuja Municipal Area Council and Bwari LGAs in the Federal Capital Territory. PARTICIPANTS Systematic random sampling was used to randomly select and recruit 639 WRA (aged 18-49 years) between May 2019 and June 2019. OUTCOME MEASURES Prevalence of select NCDs (hypertension or raised blood pressure, diabetes or raised blood sugar levels, anaemia, truncal obesity and overweight/obesity) and risk factors associated with PE/E (physical activity, fruit and vegetable consumption, alcohol consumption and smoking). RESULTS The prevalence of raised blood pressure measured among the WRA was 36.0% (95% CI 31.3% to 40.9%). Approximately 10% (95% CI 7.2% to 13.4%) of participants had raised blood sugar levels. About 19.0% (95% CI 15.3% to 23.2%) of the women had moderate or severe anaemia. Excluding WRA who were pregnant, 51.9% (95% CI 45.7% to 58.0%) of the women were either overweight or obese based on their body mass index. Approximately 58.8% (95% CI 53.8% to 63.6%) of WRA surveyed reported three to five risk factors for developing NCDs and PE/E in future pregnancies. CONCLUSIONS The study identified a high prevalence of NCDs and associated PE/E risk factors in surveyed women, signifying the importance of early detection and intervention for modifiable NCD and associated PE/E risk factors in WRA. Further research is necessary to assess the national prevalence of NCDs.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Victoria Omoera
- Lagos State Government Ministry of Health, Ikeja, Lagos, Nigeria
| | - Folashade Oludara
- Federal Capital Territory Health & Human Services Secretariat, Abuja, Nigeria
| | - Iniobong Ekong
- Federal Capital Territory Health & Human Services Secretariat, Abuja, Nigeria
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Farhadi F, Aliyari R, Ebrahimi H, Hashemi H, Emamian MH, Fotouhi A. Prevalence of uncontrolled hypertension and its associated factors in 50-74 years old Iranian adults: a population-based study. BMC Cardiovasc Disord 2023; 23:318. [PMID: 37355590 PMCID: PMC10290783 DOI: 10.1186/s12872-023-03357-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 06/19/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND By the lengthening of life span, the incidence of chronic diseases such as hypertension and uncontrolled hypertension has increased. This study aims to determine the prevalence of uncontrolled hypertension and its related factors in the age group of 50-74 years in Shahroud, northeast Iran. METHODS The data of the third phase of the Shahroud Eye Cohort Study were used in this study. This phase of the cohort study included 4394 participants aged 50 to 74 years from the previous phases. In addition to ophthalmological and optometric examinations, demographic characteristics, blood biochemistry tests, and blood pressure measurements were performed in this phase. Individuals with a blood pressure ≥ 140/90 mm/Hg (being treated or not treated with antihypertensive medicines) were defined as uncontrolled hypertension. In patients with diabetes and chronic kidney disease, blood pressure equal to or higher than 130/80 mm/Hg was considered uncontrolled hypertension. Descriptive statistics and multiple logistic regression were used to analyze the data. FINDINGS Overall, the prevalence of uncontrolled hypertension out of all the participants was 61.7% (95% CI: 60.3-63.2). Multiple regression results showed that the male gender (OR: 2.1, 95% CI: 1.5-2.9), patients with diabetes (OR:3.2, 95% CI: 2.4-4.3), and patients with chronic kidney disease (CKD) (OR: 3.2, 95% CI: 2.5-4.1) increased the risk of uncontrolled hypertension while in patients with cardiovascular disease (OR: 0.6, 95% CI: 0.4-0.8) and polypharmacy (OR: 0.2, 95% CI: 0.1-0.2) reduced the risk of uncontrolled hypertension. CONCLUSION The present study showed that uncontrolled hypertension has a high prevalence, and factors such as male gender, diabetes, and CKD are associated with this disorder. So, it is recommended to take the necessary measures to formulate and implement immediate actions to prevent or control hypertension.
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Affiliation(s)
- Fariba Farhadi
- Student Research Committee, School of Nursing & Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Roqayeh Aliyari
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hossein Ebrahimi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Okafor CN, Obikeze E, Young E, Onwujekwe O. Economic Burden of Diabetes and Hypertension: A Study of Direct and Indirect Cost of Treatment in Southeast Nigeria. INTERNATIONAL JOURNAL OF SOCIAL DETERMINANTS OF HEALTH AND HEALTH SERVICES 2023; 53:168-175. [DOI: : 10.1177/00207314221134035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2024]
Abstract
The prevalence of diabetes mellitus and hypertension is increasing yearly in many low- and middle-income countries such as Nigeria. The increasing burden of these noncommunicable diseases has led to an increase in the overall cost of health care. This study aimed at determining the direct and indirect health care costs of diabetes mellitus and hypertension occurring both singly and in co-morbidity. The study was undertaken in the Enugu State University Teaching Hospital (a tertiary hospital) in Enugu State, Southeast Nigeria. Data were collected using a pre-tested questionnaire. Out of 817 patients interviewed, 37% had only diabetes mellitus, 35% had hypertension, and 28% had both diabetes mellitus and hypertension in co-morbidity. Direct costs of treating diabetes mellitus and hypertension in the month before the survey were $28.40 and $19.35, respectively, while the indirect costs of treatment in the month before the study were $7.36 and $5.51, respectively. Direct and indirect costs for diabetes mellitus and hypertension in co-morbidity were $37.00 and $4.62, respectively. A concentration index showed that diabetes mellitus and hypertension were more evident among the poor than the rich. The economic cost when compared with patients’ income revealed that >25% of their income is spent monthly on health care.
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Affiliation(s)
- Chinyere N. Okafor
- Department of Community Medicine, University of Nigeria Nsukka, Enugu, Nigeria
- Health Policy Research Group, Department of Pharmacology/Therapeutics, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Eric Obikeze
- Health Policy Research Group, Department of Pharmacology/Therapeutics, University of Nigeria, Nsukka, Enugu, Nigeria
- Department of Health Administration and Management, University of Nigeria Nsukka, Enugu, Nigeria
| | - Ekenechukwu Young
- Department of Medicine, University of Nigeria Nsukka, Enugu, Nigeria
| | - Obinna Onwujekwe
- Health Policy Research Group, Department of Pharmacology/Therapeutics, University of Nigeria, Nsukka, Enugu, Nigeria
- Department of Health Administration and Management, University of Nigeria Nsukka, Enugu, Nigeria
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Sodium Content and Labelling of Packaged Foods and Beverages in Nigeria: A Cross-Sectional Study. Nutrients 2022; 15:nu15010027. [PMID: 36615685 PMCID: PMC9823880 DOI: 10.3390/nu15010027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
Increased consumption of unhealthy processed foods, particularly those high in sodium, is a major risk factor for cardiovascular diseases. The nutrition information on packaged foods can help guide consumers toward products with less sodium and support government actions to improve the healthiness of the food supply. The aims of this study were to estimate the proportion of packaged foods displaying nutrition information for sodium and other nutrients specified by Nigerian nutrition labelling regulations and to determine the amount of sodium in packaged foods sold in Nigeria using data from the nutritional information panel. Data were collected from November 2020 to March 2021 from in-store surveys conducted in supermarkets in three states. A total of 7039 products were collected. Overall, 91.5% (n = 6439) provided only partial nutrition information, 7.0% (n = 495) provided no nutritional information, and only 1.5% (n = 105) displayed a nutrient declaration that included all nutrients specified by 2019 Nigerian regulations. Some form of sodium content information was displayed for 86% of all products (n = 6032), of which around 45% (n = 2689) expressed this as 'salt' and 59% (n = 3559) expressed this as 'sodium', while a small number of food products had both 'salt' and 'sodium' content (3.6%). Provision of sodium or salt information on the label varied between food categories, ranging from 50% (vitamins and supplements, n = 2/4) to 96% (convenience foods, n = 44/46). Food categories with the highest median sodium content were 'meat and meat alternatives' (904 mg/100 g), 'sauces, dressings, spreads, and dips' (560 mg/100 g), and 'snack foods' (536 mg/100 g), although wide variation was often observed within categories. These findings highlight considerable potential to improve the availability and consistency of nutrition information on packaged products in Nigeria and to introduce further policies to reduce the amount of sodium in the Nigerian food supply.
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12
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Wieniawski P, Werner B. Prediction of the hypertension risk in teenagers. Cardiol J 2022; 29:994-1003. [PMID: 32515484 PMCID: PMC9788731 DOI: 10.5603/cj.a2020.0079] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 04/30/2020] [Accepted: 05/05/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Creation of a hypertension risk stratification model and development of an algorithm to detect hypertension in teenagers. METHODS The study group consisted of 690 middle and high school students, aged 15-17 years, from the metropolitan area of Warsaw, Poland. Information concerning family history and presence of risk factors for cardiovascular disease was gathered. Three-time blood pressure measurements were taken during at least two separate visits, which were at least a week apart, using the auscultatory method, according to standard procedures. Anthropometric measurements included: body weight, height, arm, hip and abdominal circumference, skin-fold thickness measured on the rear surface of an arm, below the inferior angle of the scapula and at the belly. Following indexes were determined: body mass index, waist to hip ratio (WHR), waist to height ratio, hip to height ratio. RESULTS A logistic regression model, describing the risk of hypertension in adolescents aged 15-17 was invented. p(x) = (e^g(x))/(1+e^g(x)) where ĝ(x) = -0.097 × height+0.085 × weight+7.764 × WHR+1.312 × family hypertension. Family hypertension means presence of hypertension among members of the closest family. The formula was created, allowing the pre-selection of adolescents at risk of hypertension during screening. Next an algorithm for the detection of hypertension for practical use was proposed. CONCLUSIONS Body weight, WHR and incidence of hypertension in the family are the strongest predictors of hypertension in teenagers. Proposed screening algorithm can be a useful tool for selecting teenagers at risk of hypertension and in need of specialized diagnostics and care.
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Sodeinde OA, Adekoya HO, Akintayo JB. Effect of Radio Drama Intervention on Knowledge, Attitude, and Practice-Intention of Hypertension Prevention among the Working Class. AMERICAN JOURNAL OF HEALTH EDUCATION 2022. [DOI: 10.1080/19325037.2022.2142335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Okafor CN, Obikeze E, Young E, Onwujekwe O. Economic Burden of Diabetes and Hypertension: A Study of Direct and Indirect Cost of Treatment in Southeast Nigeria. INTERNATIONAL JOURNAL OF HEALTH SERVICES : PLANNING, ADMINISTRATION, EVALUATION 2022; 53:207314221134035. [PMID: 36285454 DOI: 10.1177/00207314221134035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
The prevalence of diabetes mellitus and hypertension is increasing yearly in many low- and middle-income countries such as Nigeria. The increasing burden of these noncommunicable diseases has led to an increase in the overall cost of health care. This study aimed at determining the direct and indirect health care costs of diabetes mellitus and hypertension occurring both singly and in co-morbidity. The study was undertaken in the Enugu State University Teaching Hospital (a tertiary hospital) in Enugu State, Southeast Nigeria. Data were collected using a pre-tested questionnaire. Out of 817 patients interviewed, 37% had only diabetes mellitus, 35% had hypertension, and 28% had both diabetes mellitus and hypertension in co-morbidity. Direct costs of treating diabetes mellitus and hypertension in the month before the survey were $28.40 and $19.35, respectively, while the indirect costs of treatment in the month before the study were $7.36 and $5.51, respectively. Direct and indirect costs for diabetes mellitus and hypertension in co-morbidity were $37.00 and $4.62, respectively. A concentration index showed that diabetes mellitus and hypertension were more evident among the poor than the rich. The economic cost when compared with patients' income revealed that >25% of their income is spent monthly on health care.
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Affiliation(s)
- Chinyere N Okafor
- Department of Community Medicine, 107769University of Nigeria Nsukka, Enugu, Nigeria
- Health Policy Research Group, Department of Pharmacology/Therapeutics, 107769University of Nigeria, Nsukka, Enugu, Nigeria
| | - Eric Obikeze
- Health Policy Research Group, Department of Pharmacology/Therapeutics, 107769University of Nigeria, Nsukka, Enugu, Nigeria
- Department of Health Administration and Management, 107769University of Nigeria Nsukka, Enugu, Nigeria
| | - Ekenechukwu Young
- Department of Medicine, 107769University of Nigeria Nsukka, Enugu, Nigeria
| | - Obinna Onwujekwe
- Health Policy Research Group, Department of Pharmacology/Therapeutics, 107769University of Nigeria, Nsukka, Enugu, Nigeria
- Department of Health Administration and Management, 107769University of Nigeria Nsukka, Enugu, Nigeria
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Ye J, Orji IA, Baldridge AS, Ojo TM, Shedul G, Ugwuneji EN, Egenti NB, Aluka-Omitiran K, Okoli RCB, Eze H, Nwankwo A, Hirschhorn LR, Chopra A, Ale BM, Shedul GL, Tripathi P, Kandula NR, Huffman MD, Ojji DB. Characteristics and Patterns of Retention in Hypertension Care in Primary Care Settings From the Hypertension Treatment in Nigeria Program. JAMA Netw Open 2022; 5:e2230025. [PMID: 36066896 PMCID: PMC9449788 DOI: 10.1001/jamanetworkopen.2022.30025] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND More than 1.2 billion adults worldwide have hypertension. High retention in clinical care is essential for long-term management of hypertension, but 1-year retention rates are less than 50% in many resource-limited settings. OBJECTIVE To evaluate short-term retention rates and associated factors among patients with hypertension in primary health care centers in the Federal Capital Territory of Nigeria. DESIGN, SETTING, AND PARTICIPANTS In this cohort study, data were collected by trained study staff from adults aged 18 years or older at 60 public, primary health care centers in Nigeria between January 2020 and July 2021 as part of the Hypertension Treatment in Nigeria (HTN) Program. Patients with hypertension were registered. EXPOSURES Follow-up visit for hypertension care within 37 days of the registration visit. MAIN OUTCOMES AND MEASURES The main outcome was the 3-month rolling average 37-day retention rate in hypertension care, calculated by dividing the number of patients who had a follow-up visit within 37 days of their first (ie, registration) visit in the program by the total number of registered patients with hypertension during multiple consecutive 3-month periods. Interrupted time series analyses evaluated trends in retention rates before and after the intervention phase of the HTN Program. Mixed-effects, multivariable regression models evaluated associations between patient-, site-, and area council-level factors, hypertension treatment and control status, and 37-day retention rate. RESULTS In total, 10 686 patients (68.3% female; mean [SD] age, 48.8 [12.7] years) were included in the analysis. During the study period, the 3-month rolling average 37-day retention rate was 41% (95% CI, 37%-46%), with wide variability among sites. The retention rate was higher among patients who were older (adjusted odds ratio [aOR], 1.01 per year; 95% CI, 1.01-1.02 per year), were female (aOR, 1.11; 95% CI, 1.01-1.23), had a higher body mass index (aOR, 1.01; 95% CI, 1.00-1.02), were in the Kuje vs the Abaji area council (aOR, 2.25; 95% CI, 1.25-4.04), received hypertension treatment at the registration visit (aOR, 1.27; 95% CI, 1.07-1.50), and were registered during the postintervention period (aOR, 1.16; 95% CI, 1.06-1.26). CONCLUSIONS AND RELEVANCE The findings suggest that retention in hypertension care is suboptimal in primary health care centers in Nigeria, although large variability among sites was found. Potentially modifiable and nonmodifiable factors associated with retention were identified and may inform multilevel, contextualized implementation strategies to improve retention.
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Affiliation(s)
- Jiancheng Ye
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Ikechukwu A. Orji
- Cardiovascular Research Unit, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | | | - Tunde M. Ojo
- Cardiovascular Research Unit, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Grace Shedul
- Cardiovascular Research Unit, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Eugenia N. Ugwuneji
- Cardiovascular Research Unit, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Nonye B. Egenti
- Cardiovascular Research Unit, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | | | | | - Helen Eze
- Cardiovascular Research Unit, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Ada Nwankwo
- Cardiovascular Research Unit, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | | | - Aashima Chopra
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Boni M. Ale
- Cardiovascular Research Unit, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
- Holo Healthcare, Nairobi, Kenya
| | - Gabriel L. Shedul
- Cardiovascular Research Unit, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Priya Tripathi
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - Mark D. Huffman
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- The George Institute for Global Health, Sydney, New South Wales, Australia
- Washington University in St Louis, St Louis, Missouri
| | - Dike B. Ojji
- Cardiovascular Research Unit, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
- University of Abuja, Abuja, Nigeria
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Ipinnimo TM, Durowade KA. Catastrophic Health Expenditure and Impoverishment from Non-Communicable Diseases: A comparison of Private and Public Health Facilities in Ekiti State, Southwest Nigeria. Ethiop J Health Sci 2022; 32:993-1006. [PMID: 36262712 PMCID: PMC9554780 DOI: 10.4314/ejhs.v32i5.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/15/2022] [Indexed: 11/07/2022] Open
Abstract
Background Catastrophic health expenditure and impoverishment are the outcomes of poor financing mechanisms. Little is known about the prevalence and predictors of these outcomes among non-communicable disease patients in private and public health facilities. Methods A health facility-based comparative cross-sectional study was conducted among 360 patients with non-communicable diseases (180 per group) selected through multistage sampling. Data were collected with a semi-structured, interviewer-administered questionnaire and analyzed with IBM SPSS for Windows, Version 22.0. Two prevalences of catastrophic health expenditure were calculated utilizing both the World Bank (CHE1) and the WHO (CHE2) methodological thresholds. Results The prevalence of CHE1 (Private:42.2%, Public:21.7%, p<0.001) and CHE2 (Private:46.8%, Public:28.0%, p<0.001) were higher in private health facilities. However, there was no significant difference between the proportion of impoverishment (Private:24.3%, Public:30.9%, p=0.170). The identified predictors were occupation, number of complications and clinic visits for catastrophic health expenditure and socioeconomic status for impoverishment in private health facilities. Level of education, occupation, socioeconomic status, number of complications and alcohol predicted catastrophic health expenditure while the level of education, socioeconomic status and the number of admissions predicted impoverishment in public health facilities. Conclusions Catastrophic health expenditure and impoverishment were high among the patients, with the former more prevalent in private health facilities. Therefore, we recommend expanding the coverage and scope of national health insurance among these patients to provide them with financial risk protection. Identified predictors should be taken into account by the government and other stakeholders when designing policies to limit catastrophic health expenditure and impoverishment among them.
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Affiliation(s)
- Tope Michael Ipinnimo
- Department of Community Medicine, Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria
| | - Kabir Adekunle Durowade
- Department of Community Medicine, Afe Babalola University, Ado-Ekiti, Nigeria and Department of Community Medicine, Federal Teaching Hospital, Ido-Ekiti, Nigeria
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Ebrahimi H, Shayestefar M, Talebi SS, Christie J, Ebrahimi MH. Prevalence of hypertension and its associated factors among professional drivers: a population-based study. Acta Cardiol 2022:1-9. [PMID: 35969164 DOI: 10.1080/00015385.2022.2045753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Hypertension is one of the most important causes of cardiovascular disease. It has been found that professional drivers are at high risk of hypertension. This study has been performed to determine the prevalence of hypertension and its associated factors among professional drivers in Shahroud. METHODS AND RESULTS In this study, the prevalence of hypertension was determined according to the definition by the American Heart Association among 1461 professional drivers participating in the first cross-sectional phase of Shahroud drivers' prospective cohort study. The prevalence of elevated blood pressure and hypertension was examined based on the initial age, and gender presented, along with the factors affecting this disease based on multinomial logistic regression. The prevalence of elevated blood pressure, stage 1 and 2 hypertension was 46.9%, 6%, and 1.3%, respectively. In the multivariate multinomial logistic regression model, having diabetes, Body Mass Index ≥25, and driving years was associated with an increased chance of developing elevated blood pressure and hypertension. CONCLUSIONS Attention should be paid to high prevalence of elevated blood pressure and hypertension among professional drivers in Iran as a health priority for drivers. Plans should be made to reduce it as well as to prevent its complications.
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Affiliation(s)
- Hossein Ebrahimi
- Center for Health-Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mina Shayestefar
- School of Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran
| | - Seyedeh Solmaz Talebi
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Janice Christie
- Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Mohammad Hossein Ebrahimi
- Environmental and Occupational Health Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
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Renta V, Walker RJ, Nagavally S, Dawson AZ, Campbell JA, Egede LE. Differences in the relationship between social capital and hypertension in emerging vs. established economies in Sub-Saharan Africa. BMC Public Health 2022; 22:1038. [PMID: 35610591 PMCID: PMC9128267 DOI: 10.1186/s12889-022-13471-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 05/19/2022] [Indexed: 11/29/2022] Open
Abstract
Background The global burden of hypertension is growing, particularly in low- and middle-income countries. This study aimed to investigate differences in the relationship between social capital and hypertension between regions in Sub-Saharan Africa (West vs. South Africa) and within regions (rural vs. urban residence within each country). Methods Data for 9,800 adults were analyzed from the Study on Global Ageing and Adult Health (SAGE) 2007-2010 for Ghana (West African emerging economy) and South Africa (South African established economy). Outcomes were self-reported and measured hypertension. The primary independent variable was social capital, dichotomized into low vs. medium/high. Interaction terms were tested between social capital and rural/urban residence status for each outcome by country. Linear and logistic regression models were run separately for both countries and each outcome. Results Those with low social capital in the emerging economy of Ghana were more likely to have hypertension based on measurement (OR=1.35, 95% CI=1.18,1.55), but the relationship with self-reported hypertension lost significance after adjustment. There was no significant relationship in the relationship between social capital and hypertension in the established economy of South Africa after adjustment. No significant interactions existed by rural/urban residence status in either country. Conclusion Low social capital was associated with worse hypertension outcomes, however, the relationship differed between South Africa and Ghana. Further investigation is needed to understand differences between and within countries to guide development of programs targeted at leveraging and promoting social capital as a positive component of overall health.
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Affiliation(s)
- Vincent Renta
- School of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Rebekah J Walker
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI, USA.,Center for Advancing Population Science (CAPS), Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sneha Nagavally
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI, USA.,Center for Advancing Population Science (CAPS), Medical College of Wisconsin, Milwaukee, WI, USA
| | - Aprill Z Dawson
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI, USA.,Center for Advancing Population Science (CAPS), Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jennifer A Campbell
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI, USA.,Center for Advancing Population Science (CAPS), Medical College of Wisconsin, Milwaukee, WI, USA
| | - Leonard E Egede
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI, USA. .,Center for Advancing Population Science (CAPS), Medical College of Wisconsin, Milwaukee, WI, USA.
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Stage 2 Hypertension and Electrocardiogram Abnormality: Evaluating the Risk Factors of Cardiovascular Diseases in Nigeria. High Blood Press Cardiovasc Prev 2022; 29:197-206. [PMID: 35119685 DOI: 10.1007/s40292-022-00504-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/17/2022] [Indexed: 10/19/2022] Open
Abstract
INTRODUCTION This study evaluated the status of stage 2 hypertension, abnormal ECG and their co-occurrence as possible risk factors of cardiovascular disease and their predictors in a Nigerian University population. METHODS A total of 717 subjects participated in this study. Blood pressure (BP), resting electrocardiogram (ECG) and other clinical parameters were measured and categorised according to standard organisational guidelines. Bivariate correlation and multivariate logistic regression model were used to determine covariates and clinical parameter association at a 95 % significant level. RESULTS Stage 2 hypertension and abnormal ECG respectively occurred in 264 (37 %) and 217 (39.2 %) subjects, with co-occurrence and abnormal BMI in 85 (11.8 %) and 459 (64.8%) subjects, respectively. Sex (p = 0.001) and occupation (p = 0.022) were independently associated with abnormal BP and ECG, respectively, while age was independently associated (p < 0.001) with abnormal BP, ECG and co-occurrence of these conditions. Predictors of stage 2 hypertension and abnormal ECG were sex (adjusted odds ratio [aOR] = 1.652, 95 % CI 1.097-2.488) and occupation (aOR = 0.411, 95 % CI 0.217-0.779), respectively, while age was a predictor for stage 2 hypertension (aOR = 0.065, 95 % CI 0.015-0.283), abnormal ECG (aOR = 0.137, 95 % CI 0.053-0.351) and their co-occurrence (aOR = 0.039, 95 % CI 0.014-0.113). CONCLUSIONS This study shows prevalence rates of these risk factors are on the increase. It also suggests that ECG abnormality is a public health issue among stage 2 hypertensive patients that must be monitored. Therefore, appropriate interventions that prevent and control hypertension and identified risk factors should be put in place in addition to lifestyle changes, regular screening and surveillance.
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20
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Essential medicines and technology for hypertension in primary healthcare facilities in Ebonyi State, Nigeria. PLoS One 2022; 17:e0263394. [PMID: 35113947 PMCID: PMC8812935 DOI: 10.1371/journal.pone.0263394] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 01/18/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Cardiovascular diseases (CVDs) now constitute major cause of morbidity and mortality in middle and low income countries including Nigeria. One of the major efforts at controlling CVDs in Nigeria includes expanding universal access to care through the primary healthcare (PHC) system. The study was to assess essential medicines and technology for control of hypertension in PHC facilities in Ebonyi Nigeria. Methods The study used mixed method cross-sectional survey to assess availability, affordability and accessibility of essential medicines and technology in 45 facilities and among their patients with hypertension (145). Results Most of the PHC facilities (71.1%) assessed were rural. The heads of facilities were mainly community health extension workers (86.7%). One (2.2%) facility had a pharmacy technician. All facilities had been supervised by the regulatory authority in the last one year. Out of 15 anti-hypertensive drugs assessed, 10 were available in some facilities (2.2%–44.4%) but essential drug availability was low (<80%). Only mercury sphygmomanometers were available in all facilities with 82.2% functioning. Stethoscopes were available in all facilities and 95.6% were functional. Glucometers were present in 20.0% of facilities and were all functional. All the respondents (100.0%) reported they could not afford their anti-hypertensive drugs. Median monthly income was 8,000 Nigerian Naira (range = 2,000–52,000). Median monthly cost of anti-hypertensive drugs was 3,500 Naira (range = 1,500–10,000). For 99 (68.3%) of the respondents, the facilities were accessible. Median cost of transportation for care was 400 Naira (range = 100–2,000). Conclusion Gaps still exist in the provision of hypertension control services in PHC facilities in Ebonyi State, Nigeria. The essential drugs were not always available, and cost of the drugs were still a challenge to the patients. There is urgent need to expand health insurance coverage to rural communities to ameliorate the catastrophic out-of-pocket health expenditures and improve control of CVDs.
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Ojifinni OO, Ibisomi L. Health Care Providers Perceptions About Preconception Care in Ibadan, Southwest Nigeria: A Qualitative Study. Matern Child Health J 2022; 26:587-600. [PMID: 34982335 DOI: 10.1007/s10995-021-03305-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Preconception care (PCC) is a recognised strategy for optimising maternal health and improving maternal and neonatal outcomes. PCC services are minimally available and not fully integrated into maternal health services in Nigeria. This study explored perceptions about PCC services among health care providers in Ibadan, Nigeria. METHODS Using a qualitative case study design the perspectives of 26 health care providers-16 specialist physicians and nine nurses covering 10 specialties at the primary, secondary and tertiary health care levels was explored. In-depth interviews were digitally recorded, transcribed verbatim and analysed on MAXQDA using thematic analysis. RESULTS Almost all participants stated that PCC services should be offered at all three levels of health care with referral when needed between lower and higher levels. Participants stated that although all people of reproductive age would benefit from PCC, those who had medical problems like hypertension, sickle cell disease, diabetes and infertility would benefit more. Participants opined that delayed health care seeking observed in the community may influence acceptability of PCC especially for people without known pre-existing conditions. All specialist physicians identified the relevance of PCC to their practice. They identified potential benefits of PCC including opportunity to prepare for pregnancy to ensure positive pregnancy outcomes. CONCLUSIONS FOR PRACTICE Preconception care is perceived as important for promoting positive pregnancy outcomes in people with known medical problems and is relevant to different specialities of medical practice. Provision of the service will require establishment of guidelines and uptake will depend on acceptability to community members who will benefit from the service.
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Affiliation(s)
| | - Latifat Ibisomi
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.,Nigerian Institute of Medical Research, Lagos, Nigeria
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Ayogu RNB, Ezeh MG, Okafor AM. Prevalence and predictors of different patterns of hypertension among adults aged 20-60 years in rural communities of Southeast Nigeria: a cross-sectional study. Arch Public Health 2021; 79:210. [PMID: 34819152 PMCID: PMC8613986 DOI: 10.1186/s13690-021-00724-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/31/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Hypertension, a major cardiovascular disease risk factor exists several years without symptoms. Few data exist on prevalence and predictors of hypertension among apparently healthy Nigerian adults. This makes it difficult for policy-makers to concentrate efforts to control emerging health burden of the disease. This study assessed prevalence and predictors of isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH) and combined systolic and diastolic hypertension (CSDH). METHODS Cross-sectional survey design was employed in the study of 517 adult participants (20-60 years) in a rural setting. Selection of the respondents was through multistage sampling which involved systematic, proportionate and simple random sampling. Data on socio-demographic characteristics, blood pressure, height, weight, and waist circumference were collected. Frequencies, T-test, analysis of variance and Chi square were used in statistical analysis. Bivariate and multivariate logistic regressions were used to evaluate variables associated with different patterns of hypertension with significance accepted at P < 0.05. Frequencies, percentages, crude and adjusted odd ratios were reported. Statistical Product and Service Solutions version 21.0 was used in statistical analysis. RESULTS ISH (10.6%), IDH (18.2%) and CSDH (37.8%) were observed among the participants. ISH was less likely among 20-29 year-olds (adjusted odds ratio (aOR) = 0.35, 95% confidence interval (C.I.) = 0.13-0.94), 30-39 year-olds (aOR = 0.30, 95% C.I. = 0.11-0.82) and those with abdominal obesity (aOR = 0.12, 95% C.I. = 0.03-0.56). Participants who perceived their health status as good (aOR = 3.80, 95% C.I. = 1.29-11.18) and excellent (aOR = 5.28, 95% C.I. = 1.54-18.07) were respectively 3.80 and 5.28 times more likely to have ISH. Those with secondary education had significantly higher likelihood for IDH (aOR = 2.05, 95% = 1.02-4.14) whereas self-perceived poor health status (aOR = 0.24, 95% C.I. = 0.09-0.65), absence of obesity (aOR = 0.10, 95% C.I. = 0.01-0.81) and general obesity (aOR = 0.35, 95% C.I. = 0.17-0.72) were associated with reduced risk for IDH. Secondary (aOR = 0.60, 95% C.I. = 0.36-0.99) and tertiary (aOR = 0.49, 95% C.I. = 0.28-0.85) education were associated with reduced risk for CSDH but combined obesity (aOR = 4.39, 95% C.I. = 2.25-8.58) increased the risk for CSDH by 4. CONCLUSION ISH, IDH and CSDH were problems among the adults with age, obesity, self-perception of good/excellent health status and low education level as significant predictors. Health and nutrition education to prevent comorbidities and cerebrovascular accidents are recommended.
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Affiliation(s)
- Rufina N B Ayogu
- Department of Nutrition and Dietetics, University of Nigeria, Nsukka, Enugu, Enugu State, Nigeria
| | - Mmesoma G Ezeh
- Department of Nutrition and Dietetics, University of Nigeria, Nsukka, Enugu, Enugu State, Nigeria
| | - Adaobi M Okafor
- Department of Nutrition and Dietetics, University of Nigeria, Nsukka, Enugu, Enugu State, Nigeria.
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Okoli RCB, Shedul G, Hirschhorn LR, Orji IA, Ojo TM, Egenti N, Omitiran K, Akor B, Baldridge AS, Huffman MD, Ojji D, Kandula NR. Stakeholder perspectives to inform adaptation of a hypertension treatment program in primary healthcare centers in the Federal Capital Territory, Nigeria: a qualitative study. Implement Sci Commun 2021; 2:97. [PMID: 34462016 PMCID: PMC8404273 DOI: 10.1186/s43058-021-00197-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 08/05/2021] [Indexed: 12/01/2022] Open
Abstract
Background Implementing an evidence-based hypertension program in primary healthcare centers (PHCs) in the Federal Capital Territory, Nigeria is an opportunity to improve hypertension diagnosis, treatment, and control and reduce deaths from cardiovascular diseases. This qualitative research study was conducted in Nigerian PHCs with patients, non-physician health workers, administrators and primary care physicians to inform contextual adaptations of Kaiser Permanente Northern California's hypertension model and the World Health Organization’s HEARTS technical package for the system-level, Hypertension Treatment in Nigeria (HTN) Program. Methods Purposive sampling in 8 PHCs identified patients (n = 8), non-physician health workers (n = 12), administrators (n = 3), and primary care physicians (n = 6) for focus group discussions and interviews. The Primary Health Care Performance Initiative (PHCPI) conceptual framework and Consolidated Framework for Implementation Research (CFIR) domains were used to develop semi-structured interviews (Appendix 1, Supplemental Materials) and coding guides. Content analysis identified multilevel factors that would influence program implementation. Results Participants perceived the need to strengthen four major health system inputs across CFIR domains for successful adaptation of the HTN Program components: (1) reliable drug supply and blood pressure measurement equipment, (2) enable and empower community healthcare workers to participate in team-based care through training and education, (3) information systems to track patients and medication supply chain, and (4) a primary healthcare system that could offer a broader package of health services to meet patient needs. Specific features of the PHCPI framework considered important included: accessible and person-centered care, provider availability and competence, coordination of care, and proactive community outreach. Participants also identified patient-level factors, such as knowledge and beliefs about hypertension, and financial and transportation barriers that could be addressed with better communication, home visits, and drug financing. Participants recommended using existing community structures, such as village health committees and popular opinion leaders, to improve knowledge and demand for the HTN Program. Conclusions These results provide information on specific primary care and community contextual factors that can support or hinder implementation and sustainability of an evidence-based, system-level hypertension program in the Federal Capital Territory, Nigeria, with the ultimate aim of scaling it to other parts of the country. Supplementary Information The online version contains supplementary material available at 10.1186/s43058-021-00197-8.
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Affiliation(s)
| | - Gabriel Shedul
- University of Abuja Teaching Hospital Gwagwalada, Abuja, Nigeria
| | - Lisa R Hirschhorn
- Feinberg School of Medicine, Northwestern University, 420 E Superior, 6th Floor, Chicago, IL, 60611, USA
| | - Ikechukwu A Orji
- University of Abuja Teaching Hospital Gwagwalada, Abuja, Nigeria
| | - Tunde M Ojo
- University of Abuja Teaching Hospital Gwagwalada, Abuja, Nigeria
| | - Nonye Egenti
- University of Abuja Teaching Hospital Gwagwalada, Abuja, Nigeria
| | | | - Blessing Akor
- University of Abuja Teaching Hospital Gwagwalada, Abuja, Nigeria
| | - Abigail S Baldridge
- Feinberg School of Medicine, Northwestern University, 420 E Superior, 6th Floor, Chicago, IL, 60611, USA
| | - Mark D Huffman
- Feinberg School of Medicine, Northwestern University, 420 E Superior, 6th Floor, Chicago, IL, 60611, USA
| | - Dike Ojji
- University of Abuja Teaching Hospital Gwagwalada, Abuja, Nigeria
| | - Namratha R Kandula
- Feinberg School of Medicine, Northwestern University, 420 E Superior, 6th Floor, Chicago, IL, 60611, USA.
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Osei-Yeboah J, Owusu-Dabo E, Owiredu WKBA, Lokpo SY, Agode FD, Johnson BB. Community burden of hypertension and treatment patterns: An in-depth age predictor analysis: (The Rural Community Risk of Non-Communicable Disease Study - Nyive Phase I). PLoS One 2021; 16:e0252284. [PMID: 34383770 PMCID: PMC8360602 DOI: 10.1371/journal.pone.0252284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 05/12/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND This study aimed to describe the burden, treatment patterns and, age threshold for predicting hypertension among rural adults in Nyive in the Ho Municipality of the Volta Region, Ghana. METHODS A population-based cross-sectional study design was employed. A total of 417 adults aged 20 years and above were randomly selected from households within the Nyive community. The WHO STEPwise approach for non-communicable diseases risk factor surveillance (STEPS) instrument was used to obtain socio-demographic and clinical information including age, gender, educational background, marital status, and occupation as well as hypertension treatment information. Blood pressure was measured using standard methods. The risk of hypertension and the critical age at risk of hypertension was determined using binary logistic regression model and the receiver-operator characteristics (ROC) analysis. RESULTS The direct and indirect age-standardized hypertension prevalence was higher in males (562.58/487.34 per 1000 residents) compared to the females (489.42/402.36 per 1000 residents). The risk of hypertension among the study population increased by 4.4% (2.9%-5.9% at 95% CI) for one year increase in age while the critical age at risk of hypertension was >39 years among females and >35 years among males. About 64(46.72%) of the hypertensive participants were not on treatment whereas only 42(30.66%) had their blood pressure controlled. CONCLUSION Rural hypertension is high among adults in Nyive. The critical age at risk of hypertension was lower among males. The estimated annual increase of risk of hypertension was 4.7% for females and 3.1% for males. High levels of undiagnosed and non-treatment of hypertension and low levels of blood pressure control exist among the rural folks.
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Affiliation(s)
- James Osei-Yeboah
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ellis Owusu-Dabo
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - William K. B. A. Owiredu
- Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Clinical Biochemistry, Diagnostic Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Sylvester Yao Lokpo
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Francis Delali Agode
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
- Laboratory Department, Akatsi South District Hospital, Akatsi, Ghana
| | - Beatrice Bella Johnson
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
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Oyetayo FL, Akomolafe SF, Balogun GB. Effects of Chrysophyllum albidum fruit pulp on haemodynamic parameters, pro-inflammatory markers, antioxidant parameters and critical biomolecules associated with hypertension-in vivo. Inflammopharmacology 2021; 29:825-839. [PMID: 34120250 DOI: 10.1007/s10787-021-00830-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/29/2021] [Indexed: 12/31/2022]
Abstract
The effects of Chrysophyllum albidum fruit pulp on haemodynamic parameters, pro-inflammatory markers, antioxidant parameters and critical biomolecules associated with hypertension in vivo were determined. Feeding with supplemented diet with pulp reduced heart rate, mean arterial pressure, systolic and diastolic blood pressure levels of hypertensive-treated groups. Moreover, hypertensive-treated groups fed with fruit pulp supplemented diets had significantly (p < 0.05) lower level of serum pro-inflammatory markers when compared to untreated hypertensive group. Furthermore, feeding with supplemented diet with pulp and captopril administration reduced AChE, BChE, ACE, and arginase activities of hypertensive-treated groups. The fruit pulp supplemented diet also increased antioxidant status of hypertensive-treated groups. This was supported by the histopathological examination of the kidney and heart tissues. These beneficial effects could in part be the explanations of ethnomedicinal uses of the fruit pulp in the management of hypertension. Nevertheless, the higher percentage inclusion of the pulp showed higher antihypertensive effects.
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Affiliation(s)
- Folake Lucy Oyetayo
- Department of Biochemistry, Faculty of Science, Ekiti State University, Ekiti State, P.M.B. 5363, Ado Ekiti, Nigeria
| | - Seun Funmilola Akomolafe
- Department of Biochemistry, Faculty of Science, Ekiti State University, Ekiti State, P.M.B. 5363, Ado Ekiti, Nigeria.
| | - Gbemisola Beulah Balogun
- Department of Biochemistry, Faculty of Science, Ekiti State University, Ekiti State, P.M.B. 5363, Ado Ekiti, Nigeria
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Anyanti J, Akuiyibo SM, Fajemisin O, Idogho O, Amoo B. Assessment of the level of knowledge, awareness and management of hypertension and diabetes among adults in Imo and Kaduna states, Nigeria: a cross-sectional study. BMJ Open 2021; 11:e043951. [PMID: 34006029 PMCID: PMC7942260 DOI: 10.1136/bmjopen-2020-043951] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES This study was designed to assess levels of awareness, knowledge, attitude and practices relating to hypertension and diabetes among adults aged 35 years resident in selected communities in Imo and Kaduna states, Nigeria. DESIGN A descriptive cross-sectional study. SETTING Selected communities across 14 local government areas in Imo and Kaduna states were included. PARTICIPANTS In total, 824 adults, aged 35 years or older and resident in selected communities where the Access-N project was being implemented in Imo and Kaduna states participated in the study. PRIMARY AND SECONDARY OUTCOME MEASURES The study assessed the level of hypertension and diabetes knowledge among the participants. Regular blood pressure (BP) and glucose screening practices were also examined as outcome measures. RESULTS The mean age of the respondents was 48.32 years. In total, 778 (94.4%) and 746 (90.5%) of the respondents were aware of hypertension and diabetes, respectively. The mean hypertension and diabetes knowledge scores (±SD) were 4.99 (±1.99) and 8.02 (±2.61), respectively. A total of 326 (41.9%) respondents aware of hypertension had a good knowledge of hypertension while 477 (63.9%) of those aware of diabetes had a good knowledge of diabetes. Levels of hypertension and diabetes knowledge were found to be associated with physical activity and the level of education of the respondents. About two-thirds (62.6%) and less than half (41.5%) of the respondents, respectively check their BP and blood glucose (BG) levels regularly (at least once yearly). Statistically significant associations were observed between age and regular BP and BG level checks. CONCLUSIONS Despite the high awareness rate of hypertension and diabetes observed in this study and a relatively good knowledge about the two conditions, unhealthy lifestyle practices and non-regular routine screening abounds among the respondents. Thus, there is a need to improve access to quality information about hypertension and diabetes aimed at motivating adoption of healthy behaviours.
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Wieniawski P, Werner B. Epidemiology of Obesity and Hypertension in School Adolescents Aged 15-17 from the Region of Central Poland-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052394. [PMID: 33804520 PMCID: PMC7967734 DOI: 10.3390/ijerph18052394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/19/2021] [Accepted: 02/22/2021] [Indexed: 02/07/2023]
Abstract
The aim of this cross-sectional study was to assess the prevalence of abnormal weight and anthropometric parameters along with abnormal blood pressure values in adolescents in Poland. Anthropometric measurements were taken in the studied age group and the correlation between these values and blood pressure values and the diagnosis of hypertension was analyzed. The main aim of the study was to characterize the particular age group in the selected population: 690 students aged 15–17 years were examined. Blood pressure and anthropometric values including height, weight, circumferences of the hips, abdomen and arms, as well as skinfolds on the back of the arm, below the scapula and the stomach, were taken. The following indexes were calculated: WHR (waist to hip ratio), WHtR (waist to height ratio), BAI (body adiposity index-hip to height ratio) and BMI (body mass index). Mean SBP (systolic blood pressure) was 112.3 (standard deviation (SD) 12.2) mmHg, and DBP (diastolic blood pressure) was 66.9 (SD 6.9) mmHg. The prevalence of hypertension in the studied group was 5.8% (3.2% boys, 2.6% girls) and prehypertension was present in 4.4% (1.6% boys, 2.8% girls). The prevalence of excess body weight was 23.6%-obesity 11.3% (40 girls, 27 boys) and overweight 12.3% (50 girls, 34 boys). Correlations between BMI and waist, hip and arm circumference, subscapular and abdominal skinfold thickness, WHtR and BAI were r = 0.86, r = 0.84, r = 0.88, r = 0.81, r = 0.75, r = 0.88 and r = 0.81, respectively (p < 0.05). Significant differences (p < 0.05) of SBP and DBP values, depending on weight category, as defined by BMI, were observed. Abnormal blood pressure values occur in one tenth and abnormal body weight in almost a quarter of the studied population. Obese and overweight children have higher SBP and DBP values compared to children with normal body weight.
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Opreh OP, Olajubu TO, Akarakiri KJ, Ligenza V, Amos JT, Adeyeye AV, Oyelade OZ, Oyewole FC. Prevalence and factors associated with hypertension among rural community dwellers in a local government area, South West Nigeria. Afr Health Sci 2021; 21:75-81. [PMID: 34394284 PMCID: PMC8356611 DOI: 10.4314/ahs.v21i1.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Many African countries including Nigeria are said to be at various stages of an epidemiological transition from communicable to non-communicable diseases (NCD). Objective This study determined the current pattern and correlates of hypertension among adults in some rural communities in South West Nigeria. Methods It was a descriptive cross-sectional study of 1012 individuals across 16 rural communities. The respondents' blood pressure, weight, height and waist circumference were measured. Bivariate and multivariate analyses were done. Results Among the participants, 461 (45.6%) had hypertension out of whom 217 (47.1%) and 244 (52.9%) had stage 1 and stage 2 hypertension respectively. The systolic, diastolic and mean arterial blood pressures increased with age. The significant predictors of hypertension were; increasing age (p<0.001), higher waist circumference (p = 0.01) and overweight / obesity (p = 0.03). While systolic blood pressure (SBP) had the strongest correlation with age, waist circumference (WC) was the strongest correlate of diastolic blood pressure (DBP). Conclusion Despite being a rural population, there was a high prevalence of hypertension in the study area.
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Affiliation(s)
- Owigho P Opreh
- Department of Family Medicine, Seventh Day Adventist Hospital, Lagere, Ile-Ife
| | - Temitope O Olajubu
- Department of Family Medicine, Seventh Day Adventist Hospital, Lagere, Ile-Ife
| | - Kunmi J Akarakiri
- Department of Family Medicine, Seventh Day Adventist Hospital, Lagere, Ile-Ife
| | - Vojtech Ligenza
- Department of Family Medicine, Seventh Day Adventist Hospital, Lagere, Ile-Ife
| | - John T Amos
- Department of Family Medicine, Seventh Day Adventist Hospital, Lagere, Ile-Ife
| | - Adebanke V Adeyeye
- Department of Family Medicine, Seventh Day Adventist Hospital, Lagere, Ile-Ife
| | - Olufunke Z Oyelade
- Department of Family Medicine, Seventh Day Adventist Hospital, Lagere, Ile-Ife
| | - Funmilayo C Oyewole
- Department of Family Medicine, Seventh Day Adventist Hospital, Lagere, Ile-Ife
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A Scoping Review of Selected Studies on Predictor Variables Associated with the Malaria Status among Children under Five Years in Sub-Saharan Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042119. [PMID: 33671594 PMCID: PMC7927088 DOI: 10.3390/ijerph18042119] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/15/2021] [Accepted: 02/18/2021] [Indexed: 11/21/2022]
Abstract
Background/Purpose: In recent times, Sub-Saharan Africa (SSA) had been rated by the World Health Organization (WHO) as the most malaria-endemic region in the world. Evidence synthesis of the factors associated with malaria among children aged under-five in SSA is urgently needed. This would help to inform decisions that policymakers and executors in the region need to make for the effective distribution of scarce palliative resources to curb the spread of the illness. This scoping review is aimed at identifying studies that have used multivariate classical regression analysis to determine the predictors associated with malaria among children under five years old in SSA. Methods/Design: The search terms followed population, intervention, comparator, outcome, timing, setting (PICOTS), and were used in searching through the following databases: PubMed, MEDLINE, Web of Science, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus, and Measure DHS. The databases were searched for published articles from January 1990 to December 2020. Results: Among the 1154 studies identified, only thirteen (13) studies met the study’s inclusion criteria. Narrative syntheses were performed on the selected papers to synchronize the various predictors identified. Factors ranging from child-related (age, birth order and use of a bed net), parental/household-related (maternal age and education status, household wealth index) and community-related variables (community wealth status, free bed net distribution) were some of the identified significant predictors. Conclusions: It is timely to have a synthesis of predictors that influence the malaria status of children under-five in SSA. The outcome of the review will increase the knowledge of the epidemiology of morbidity that will form the basis for designing efficient and cost-effective distribution of palliatives and control of malaria in SSA.
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Adeloye D, Owolabi EO, Ojji DB, Auta A, Dewan MT, Olanrewaju TO, Ogah OS, Omoyele C, Ezeigwe N, Mpazanje RG, Gadanya MA, Agogo E, Alemu W, Adebiyi AO, Harhay MO. Prevalence, awareness, treatment, and control of hypertension in Nigeria in 1995 and 2020: A systematic analysis of current evidence. J Clin Hypertens (Greenwich) 2021; 23:963-977. [PMID: 33600078 PMCID: PMC8678849 DOI: 10.1111/jch.14220] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/27/2021] [Accepted: 01/31/2021] [Indexed: 12/12/2022]
Abstract
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.
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Affiliation(s)
- Davies Adeloye
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Eyitayo O Owolabi
- Centre for Global Surgery, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | - Dike B Ojji
- Department of Medicine, Faculty of Clinical Sciences, University of Abuja, Gwagwalada, Abuja, Nigeria
| | - Asa Auta
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, UK
| | | | - Timothy O Olanrewaju
- Department of Medicine, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | | | | | | | | | - Muktar A Gadanya
- Department of Community Medicine, Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria
| | | | | | | | - Michael O Harhay
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Oguntade AS, Ajayi IO. Risk factors of heart failure among patients with hypertension attending a tertiary hospital in Ibadan, Nigeria: The RISK-HHF case-control study. PLoS One 2021; 16:e0245734. [PMID: 33493215 PMCID: PMC7833138 DOI: 10.1371/journal.pone.0245734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 01/06/2021] [Indexed: 11/20/2022] Open
Abstract
Aim Hypertension is the leading cause of heart failure (HF) in sub-Saharan Africa. Preventive public health approach to reduce the scourge of HF must seek to understand the risk factors of HF in at-risk populations. The aim of this study was to characterize the risk factors of HF among patients with hypertension attending a cardiology clinic. Methods and results One hundred and one (101) case-control age- and sex-matched pairs were recruited. The study population were adults with a clinical diagnosis of hypertensive HF (cases) and individuals with systemic hypertension without HF. They were interviewed and evaluated for cardiovascular risk factors. Associations between variables were tested with chi square test, Fisher’s exact test and independent sample t test as appropriate. Logistic regression modelling was used to determine the independent risk factors of hypertensive HF (HHF) in the study population while ‘punafcc’ package in stata12 was used to calculate the population attributable fraction (PAF) of the risk factors. Suboptimal medication adherence was the strongest adverse risk factor of HHF (medium adherence aOR: 3.53, 95%CI: 1.35–9.25; low adherence aOR: 9.44, 95%CI: 3.41–26.10) with a PAF of 67% followed by dipstick proteinuria (aOR: 4.22, 95%CI: 1.62–11.02; PAF: 34%) and alcohol consumption/day per 10grams (aOR: 1.23, 95%CI: 1.02–1.49; PAF: 22%). The protective risk factors of HHF were use of calcium channel blockers (aOR 0.25, 95%CI: 0.11–0.59; PAF: 59%), then daily fruits and vegetable consumption (aOR 0.41, 95%CI: 0.17–1.01; PAF: 46%), and eGFR (aOR 0.98, 95%CI: 0.96–0.99; PAF: 5.3%). Conclusions The risk factors of HHF are amenable to lifestyle and dietary changes. Public health interventions and preventive cardiovascular care to improve medication adherence, promote fruit and vegetable consumption and reduce alcohol consumption among patients with hypertension are recommended. Renoprotection has utility in the prevention of HF among hypertensives.
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Affiliation(s)
- Ayodipupo S. Oguntade
- Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria
- Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Oyo State, Nigeria
- * E-mail:
| | - IkeOluwapo O. Ajayi
- Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Oyo State, Nigeria
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Analyzing Trio-Anthropometric Predictors of Hypertension: Determining the Susceptibility of Blood Pressure to Sexual Dimorphism in Body Stature. Int J Hypertens 2021; 2021:5129302. [PMID: 33532094 PMCID: PMC7837789 DOI: 10.1155/2021/5129302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 08/15/2020] [Accepted: 01/11/2021] [Indexed: 11/25/2022] Open
Abstract
Background Several studies had suggested that complex body stature could be a risk factor of hypertension. Objectives We aim to correlate body mass index (BMI), waist-hip ratio (WHR), and waist-height ratio (WHtR) of rural dwellers in Afikpo community, Ebonyi State, Nigeria, with blood pressure parameters. Furthermore, we aim to ascertain how each of the anthropometric variables affects blood pressure in men and women, respectively. Materials and Methods A sample of 400 (200 males and 200 females) adults aged 18–89 years were selected for the correlation cross-sectional study. Data for weight, height, waist, and hip circumferences were collected by means of anthropometric measurement protocol with the aid of a calibrated flexible tape and health scale and mercury sphygmomanometer for measurement of blood pressure. A participant was classified as being hypertensive if systolic blood pressure (SBP) was >140 mmHg and diastolic blood pressure (DBP) >90 mmHg. Pulse pressure was recorded as the numeric difference of SBP and DBP. Results The result revealed that male BMI and WHR were higher than those of females while female WHtR was higher than that of males (P < 0.01). The prevalence of hypertension failed to correlate with sex among participants in the study (χ2 = 0.567; P < 0.05). Variation in SBP and DBP of both sexes was dependent on BMI, WHtR, and waist and hip circumference, but not on WHR. The SBP of both sexes and female pulse pressure did correlate with age (P < 0.001). Waist circumference, BMI, and WHtR correctly predicted the variations in SBP, DBP, and pulse pressure. Conclusion The strength of association of BMI, WHtR, and waist girth with SBP and DBP of both sexes was robust and similar, but inconsistent with WHR. Thus, a simple estimation of the trio-anthropometric predictors could serve as a means for routine check or preliminary diagnosis of a patient with hypertension.
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Ngwa MC, Ihekweazu C, Okwor T, Yennan S, Williams N, Elimian K, Karaye NY, Bello IW, Sack DA. The cholera risk assessment in Kano State, Nigeria: A historical review, mapping of hotspots and evaluation of contextual factors. PLoS Negl Trop Dis 2021; 15:e0009046. [PMID: 33465091 PMCID: PMC7846125 DOI: 10.1371/journal.pntd.0009046] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 01/29/2021] [Accepted: 12/07/2020] [Indexed: 11/18/2022] Open
Abstract
Nigeria is endemic for cholera since 1970, and Kano State report outbreaks annually with high case fatality ratios ranging from 4.98%/2010 to 5.10%/2018 over the last decade. However, interventions focused on cholera prevention and control have been hampered by a lack of understanding of hotspot Local Government Areas (LGAs) that trigger and sustain yearly outbreaks. The goal of this study was to identify and categorize cholera hotspots in Kano State to inform a national plan for disease control and elimination in the State. We obtained LGA level confirmed and suspected cholera data from 2010 to 2019 from the Nigeria Centre for Disease Control (NCDC) and Kano State Ministry of Health. Data on inland waterbodies and population numbers were obtained from online sources and NCDC, respectively. Clusters (hotspots) were identified using SaTScan through a retrospective analysis of the data for the ten-year period using a Poisson discrete space-time scan statistic. We also used a method newly proposed by the Global Task Force on Cholera Control (GTFCC) to identify and rank hotspots based on two epidemiological indicators including mean annual incidence per 100 000 population of reported cases and the persistence of cholera for the study period. In the ten-year period, 16,461 cholera cases were reported with a case fatality ratio of 3.32% and a mean annual incidence rate of 13.4 cases per 100 000 population. Between 2010 and 2019, the most severe cholera exacerbations occurred in 2014 and 2018 with annual incidence rates of 58.01 and 21.52 cases per 100 000 inhabitants, respectively. Compared to 2017, reported cases and deaths increased by 214.56% and 406.67% in 2018. The geographic distribution of outbreaks revealed considerable spatial heterogeneity with the widest in 2014. Space-time clustering analysis identified 18 out of 44 LGAs as high risk for cholera (hotspots) involving both urban and rural LGAs. Cholera clustered around water bodies, and the relative risk of having cholera inside the hotspot LGA were 1.02 to 3.30 times higher than elsewhere in the State. A total of 4,894,144 inhabitants were in these hotspots LGAs. Of these, six LGAs with a total population of 1.665 million had a relative risk greater than 2 compared to the state as a whole. The SaTScan (statistical) and GTFCC methods were in agreement in hotspots identification. This study identified cholera hotspots LGAs in Kano State from 2010-2019. Hotspots appeared in both urban and rural settings. Focusing control strategies on these hotspots will facilitate control and eliminate cholera from the State.
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Affiliation(s)
- Moise Chi Ngwa
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | | | - Tochi Okwor
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | | | | | - Kelly Elimian
- Department of Microbiology, University of Benin, Nigeria
| | - Nura Yahaya Karaye
- Department of Public Health and Disease Control, Kano State Ministry of Health, Kano, Nigeria
| | - Imam Wada Bello
- Department of Public Health and Disease Control, Ministry of Health Kano, Kano, Nigeria
| | - David A. Sack
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
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Oparah S, Ukweh O, Ukweh I, Iya-Benson J. Undiagnosed hypertension and diabetes: concordance between self-reported and actual profile among traders in Nigerian market. NIGERIAN JOURNAL OF MEDICINE 2021. [DOI: 10.4103/njm.njm_175_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Oguntade AS, Ajayi IO, Aje A, Adebiyi AA, Ogah OS, Adeoye AM. Development and Validation of a Electrocardiographic Diagnostic Score of Heart Failure Among Patients with Hypertension Attending a Tertiary Hospital in Ibadan, Nigeria: The RISK-HHF Case-Control Study. J Saudi Heart Assoc 2020; 32:383-395. [PMID: 33299780 PMCID: PMC7721454 DOI: 10.37616/2212-5043.1156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/02/2020] [Accepted: 06/23/2020] [Indexed: 01/14/2023] Open
Abstract
Objectives Hypertension is the leading cause of HF in sub-Saharan Africa. Electrocardiography (ECG) is a cheap and easily available stratification tool for the diagnosis and prognostication of individuals with hypertension. The aim of this study was to develop an ECG-based HF diagnostic score among patients with hypertension attending a specialist cardiology clinic. Methods One hundred and one (101) case-control age- and sex-matched pairs were recruited. The study population were adults with a clinical diagnosis of hypertensive HF failure (cases) and systemic hypertension without HF (controls). Participants underwent clinical assessment and ECG. Associations between ECG variables and HF risk were tested with chi square test. Logistic regression modelling (age- and sex adjusted) was trained on a random subset of participants and tested on the remaining participants to determine the ECG abnormalities that are diagnostic of HF and develop a HF diagnostic score. The HF diagnostic score was then validated in an independent dataset of the ECG-Hypertension Audit. Goodness of fit and c-statistics of the HF summed diagnostic score in the training, testing and validation datasets are presented. A two-sided p value of <0.05 was considered statistically significant. Results The independent ECG diagnostic markers of HF among hypertensive patients in this study in decreasing order of effect size were sinus tachycardia (aOR: 7.72, 95% CI: 2.31-25.85). arrhythmia (aOR: 7.14, 95% CI: 2.57-19.86), left ventricular hypertrophy (aOR: 4.47; 1.85-10.77) and conduction abnormality (aOR: 3.41, 95% CI: 1.21-9.65). The HF summed diagnostic score showed excellent calibration and discrimination in the training (Hosmer Lemeshow p = 0.90; c-statistic 0.82; 95% CI 0.76–0.89) and test samples (Hosmer Lemeshow p=0.31; c-statistic 0.73 95% CI 0.60 to 0.87) of the derivation cohort and an independent validation audit cohort (Hosmer Lemeshow p = 0.17; c-statistic 0.79 95% CI 0.74 to 0.84) respectively. The model showed high diagnostic accuracy in individuals with different intermediate pre-test probabilities of HF. Conclusions A ECG based HF score consisting of sinus tachycardia, arrhythmia, conduction abnormality and left ventricular hypertrophy is diagnostic of HF especially in those with intermediate pre-test probability of HF. This has clinical importance in the stratification of individuals with systemic hypertension.
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Affiliation(s)
- Ayodipupo S Oguntade
- Department of Medicine, University College Hospital, Ibadan, Nigeria.,Department of Epidemiology and Medical Statistics, University of Ibadan, Nigeria
| | - IkeOluwapo O Ajayi
- Department of Epidemiology and Medical Statistics, University of Ibadan, Nigeria
| | - Akinyemi Aje
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Adewole A Adebiyi
- Department of Medicine, University College Hospital, Ibadan, Nigeria.,Department of Medicine, University of Ibadan, Nigeria
| | - Okechukwu S Ogah
- Department of Medicine, University College Hospital, Ibadan, Nigeria.,Department of Medicine, University of Ibadan, Nigeria
| | - Abiodun M Adeoye
- Department of Medicine, University College Hospital, Ibadan, Nigeria.,Department of Medicine, University of Ibadan, Nigeria
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Bintabara D, Ngajilo D. Readiness of health facilities for the outpatient management of non-communicable diseases in a low-resource setting: an example from a facility-based cross-sectional survey in Tanzania. BMJ Open 2020; 10:e040908. [PMID: 33177143 PMCID: PMC7661355 DOI: 10.1136/bmjopen-2020-040908] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 08/30/2020] [Accepted: 09/23/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE This study assessed the readiness of health facilities to provide outpatient management of non-communicable diseases using a nationally representative sample of health facilities from Tanzania as an example of a low-resource country. DESIGN Facility-based cross-sectional survey. SETTING This study analysed data collected from public and private-owned dispensaries/clinics, health centres and hospitals during the 2014-2015 Tanzania Service Provision Assessment survey. PRIMARY OUTCOME MEASURES Three outcome variables are included in this study, namely readiness of facilities to provide outpatient management for diabetes, hypertension and chronic respiratory diseases. These were composite variables measured based on availability of indicators identified in the WHO-Service Availability and Readiness Assessment manual. These indicators were grouped into three domains, viz staff training and guidelines, basic diagnostic equipment and basic medicines. Readiness was measured by assessing the presence of required indicators in each of these domains. RESULTS Out of 1188 health facilities assessed, 52.1%, 64.8% and 60.9% reported providing services related to diabetes, hypertension and chronic respiratory diseases, respectively. A few facilities reported having treatment guidelines (33.2%) or staff trained to provide non-communicable disease services (10.4%). The availability of basic diagnostic equipment and medicines for these diseases was significantly lower in public lower level facilities than in their private counterparts (p<0.05). Facilities located in urban settings as well as higher level (health centre and hospitals) and publicly owned facilities were significantly associated with increased service readiness index for providing outpatient management of non-communicable diseases. CONCLUSION A fair distribution of resources through the 'push' system of refresher training, treatment guidelines, medicines and diagnostic equipment from higher authorities or other agencies may be one way of strengthening the readiness of lower level and public facilities to cope with the increasing burden of non-communicable diseases in low-resource countries such as Tanzania.
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Affiliation(s)
- Deogratius Bintabara
- Department of Community Medicine, School of Medicine, The University of Dodoma, Dodoma, Tanzania
| | - Dorothy Ngajilo
- Ministry of Health, Community Development, Gender Elderly and Children, Dodoma, Tanzania
- Occupational Medicine Division/Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Olanrewaju TO, Aderibigbe A, Popoola AA, Braimoh KT, Buhari MO, Adedoyin OT, Kuranga SA, Biliaminu SA, Chijioke A, Ajape AA, Grobbee DE, Blankestijn PJ, Klipstein-Grobusch K. Prevalence of chronic kidney disease and risk factors in North-Central Nigeria: a population-based survey. BMC Nephrol 2020; 21:467. [PMID: 33167899 PMCID: PMC7654149 DOI: 10.1186/s12882-020-02126-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/26/2020] [Indexed: 01/24/2023] Open
Abstract
Background Chronic kidney disease (CKD) is a growing challenge in low- and middle-income countries, particularly in sub-Saharan Africa. There is insufficient population-based data on CKD in Nigeria that is required to estimate its true burden, and to design prevention and management strategies. The study aims to determine the prevalence of CKD and its risk factors in Nigeria. Methods We studied 8 urban communities in Kwara State, North-Central zone of Nigeria. Blood pressure, fasting blood sugar, urinalysis, weight, height, waist circumference and hip circumference were obtained. Albuminuria and kidney length were measured by ultrasound while estimated glomerular filtration rate (eGFR) was derived from serum creatinine, using chronic disease epidemiology collaboration (CKD-EPI) equation. Associations of risk factors with CKD were determined by multivariate logistic regression and expressed as adjusted odds ratio (aOR) with corresponding 95% confidence intervals. Results One thousand three hundred and fifty-three adults ≥18 years (44% males) with mean age of 44.3 ± 14.4 years, were screened. Mean kidney lengths were: right, 93.5 ± 7.0 cm and left, 93.4 ± 7.5 cm. The age-adjusted prevalence of hypertension was 24%; diabetes 4%; obesity 8.7%; albuminuria of > 30 mg/L 7%; and dipstick proteinuria 13%. The age-adjusted prevalence of CKD by estimated GFR < 60 ml/min/1.73m2 and/or Proteinuria was 12%. Diabetes (aOR 6.41, 95%CI = 3.50–11.73, P = 0.001), obesity (aOR 1.50, 95%CI = 1.10–2.05, P = 0.011), proteinuria (aOR 2.07, 95%CI = 1.05–4.08, P = 0.035); female sex (aOR 1.67, 95%CI = 1.47–1.89, P = 0.001); and age (aOR 1.89, 95%CI = 1.13–3.17, P = 0.015) were the identified predictors of CKD. Conclusions CKD and its risk factors are prevalent among middle-aged urban populations in North-Central Nigeria. It is common among women, fueled by diabetes, ageing, obesity, and albuminuria. These data add to existing regional studies of burden of CKD that may serve as template for a national prevention framework for CKD in Nigeria. One of the limitations of the study is that the participants were voluntary community dwellers and as such not representative for the community. The sample may thus have been subjected to selection bias possibly resulting in overestimation of CKD risk factors.
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Affiliation(s)
- Timothy Olusegun Olanrewaju
- Division of Nephrology, Department of Medicine, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Nigeria. .,Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Ademola Aderibigbe
- Division of Nephrology, Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Ademola Alabi Popoola
- Division of Urology, Department of Surgery, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Kolawole Thomas Braimoh
- Department of Radiology, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Mikhail Olayinka Buhari
- Department of Pathology, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | | | - Sulyman Alege Kuranga
- Division of Urology, Department of Surgery, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Sikiru Abayomi Biliaminu
- Department of Chemical Pathology, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Adindu Chijioke
- Division of Nephrology, Department of Medicine, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Abdulwahab Akanbi Ajape
- Division of Urology, Department of Surgery, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Diederick E Grobbee
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Peter J Blankestijn
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Odukoya O, Badejo O, Sodeinde K, Olubodun T. Behavioral risk factors for hypertension among adults living with HIV accessing care in secondary health facilities in Lagos State, Nigeria. J Family Med Prim Care 2020; 9:3450-3457. [PMID: 33102312 PMCID: PMC7567202 DOI: 10.4103/jfmpc.jfmpc_544_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 04/26/2020] [Accepted: 05/11/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Excess risk for cardiovascular disease, especially hypertension, may exist among human immunodeficiency virus infection (HIV)-positive persons. This study was carried out to assess the prevalence of the behavioral risk factors for hypertension, including their awareness of these factors and their attitudes toward them. Methods: This descriptive cross-sectional study was conducted among 400 HIV-infected adults who accessed care in nine secondary health facilities in Lagos State, Nigeria. Respondents were selected by multistage sampling and data elicited using a structured, interviewer-administered questionnaire. Blood pressure (BP) was measured thrice and a respondent was considered as having raised BP if the mean of the last two measurements is ≥140 mm Hg (systolic BP) or ≥90 mm Hg (diastolic BP) or if respondents are currently taking anti-hypertensive. Results: Prevalence of key behavioral risk factors for hypertension was high. For instance, 82.0% of the respondents were physically inactive. Stress and physical inactivity were the two most known risks of hypertension, identified by 87.3% and 70.5% of the respondents, respectively. Majority (66.0%) had positive attitudes toward hypertension risk factors and 26.7% of them had raised BP. Lower age, that is, 30 years and below (OR = 2.89, 95% CI = 1.26–6.64), BMI of less than 25 (OR = 1.87, 95 CI = 1.16–3.01), and being diagnosed of HIV for 5 years and less (OR = 1.62, 95% CI = 1.006–2.62) were significantly associated with normal BP measurements among respondents. Conclusion: The proportion of people living with HIV/AIDS who show known behaviors that place them at risk for hypertension is high. Measures to address these risk factors among them are warranted.
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Affiliation(s)
- Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idi-Araba, Lagos State, Nigeria.,Department of Community Health and Primary Care, Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | | | - Kolawole Sodeinde
- Department of Community Medicine and Primary Care, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
| | - Tope Olubodun
- Department of Community Health and Primary Care, Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
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Idris IO, Oguntade AS, Mensah EA, Kitamura N. Prevalence of non-communicable diseases and its risk factors among Ijegun-Isheri Osun residents in Lagos State, Nigeria: a community based cross-sectional study. BMC Public Health 2020; 20:1258. [PMID: 32811462 PMCID: PMC7437062 DOI: 10.1186/s12889-020-09349-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/04/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The rapid epidemiologic transition of diseases has adverse implications for low-and middle-income countries (LMICs) like Nigeria due to their limited healthcare, weaker health systems and the westernization of lifestyle. There is a need to evaluate the enormity or otherwise of non-communicable diseases (NCDs) burden in such low resource settings. We performed this survey to determine the prevalence of NCDs and its risk factors among the Ijegun- Isheri Osun community residents of Lagos, Nigeria. METHODS A community-based cross-sectional survey was performed on 215 respondents recruited consecutively during a population preventive health campaign. Prevalence of three NCDs (hypertension, diabetes and dyslipidaemia) were calculated. Associations between each of these NCDs and selected risk factors were determined using chi square test. Multivariable logistic regression was used to estimate the risk factors of each of the three NCDs. RESULTS The prevalence of hypertension was 35.3% (95% CI 29.0-42.1), diabetes 4.6% (95% CI 2.2-8.4) and dyslipidaemia 47.1% (95% CI 41.1-54.8). Among the NCD risk factors, the prevalence of smoking was 41.3% (95% CI 34.2-48.6), alcohol consumption 72.5% (95% CI 65.5-78.7), and physical activity 52.9 (95% CI 45.5-60.2). The independent significant predictors of hypertension were age ≥ 60 years (aOR 4.56; 95% CI: 1.72-12.09) and dyslipidaemia (aOR 5.01; 95% CI: 2.26-11.13). Age ≥ 60 years (aOR 8.83; 95% CI: 1.88-41.55) was an independent predictor of diabetes. Age ≥ 60 years (aOR 29.32; 95% CI: 4.78-179.84), being employed (aOR 11.12; 95% CI: 3.10-39.92), smoking (aOR 2.34; 95% CI: 1.03-5.33) and physical activity (aOR 0.34; 95% CI: 0.15-0.76) were independent predictors of having dyslipidaemia. CONCLUSIONS The prevalence of hypertension, diabetes and dyslipidaemia and their associated risk factors are high among the respondents of Ijegun-Isheri Osun community of Lagos state, Nigeria. This highlights the need for further implementation research and policy directions to tackle NCD burden in urban communities in Nigeria. These strategies must be community specific, prioritizing the various risk factors and addressing them accordingly.
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Affiliation(s)
- Israel Oluwaseyidayo Idris
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, University of London, London, UK
- Disease Control and Surveillance Team, Department of Primary Health Programmes, NAIJAHEALTH Initiative, Lagos, Nigeria
- Department of Social and Preventive Medicine, V. N Karazin Kharkiv National University, Kharkiv, Ukraine
- Health Policy and Governance Unit, Department of State Management and Public Administration, Kharkiv National University of Economics, Kharkiv, Ukraine
| | - Ayodipupo Sikiru Oguntade
- Disease Control and Surveillance Team, Department of Primary Health Programmes, NAIJAHEALTH Initiative, Lagos, Nigeria.
- Department of Medicine, University College Hospital, Ibadan, Nigeria.
- Institute of Cardiovascular Science, University College London, London, UK.
| | - Ekow Adom Mensah
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, University of London, London, UK
- Disease Control and Surveillance Team, Department of Primary Health Programmes, NAIJAHEALTH Initiative, Lagos, Nigeria
- Department of Family Medicine, Korle-Bu Polyclinic, Accra, Ghana
| | - Noriko Kitamura
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, University of London, London, UK
- Disease Control and Surveillance Team, Department of Primary Health Programmes, NAIJAHEALTH Initiative, Lagos, Nigeria
- Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- Department of Disease Control, Graduate School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA
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Adedapo ADA, Ajayi AM, Ekwunife NL, Falayi OO, Oyagbemi A, Omobowale TO, Adedapo AA. Antihypertensive effect of Phragmanthera incana (Schum) Balle on NG-nitro-L-Arginine methyl ester (L-NAME) induced hypertensive rats. JOURNAL OF ETHNOPHARMACOLOGY 2020; 257:112888. [PMID: 32311480 DOI: 10.1016/j.jep.2020.112888] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 04/11/2020] [Accepted: 04/13/2020] [Indexed: 05/28/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Phragmanthera incana (Schum) Balle is a member of the African mistletoes that has been reported to be used in ethnomedicine for the treatment of hypertension. AIM The aim of this study was to investigate the antihypertensive effect of Phragmanthera incana leaf ethanol extract (PILEE) in NG-nitro-L-arginine methyl ester (L-NAME)-induced hypertensive rats. MATERIALS AND METHODS Phytochemical analysis of PILEE was determined using the Gas chromatography - Mass spectrophotometry (GC-MS) method. Antihypertensive activity was investigated in rats that received PILEE (50, 100 and 200 mg/kg) or captopril (40 mg/kg) daily for 28 days together with oral administration of L-NAME (40 mg/kg). Blood pressure parameters were measured on day 7, 14, 21 and 28. Blood was obtained for determination of serum nitrite, interleukin-6 (IL-6) and tumor necrosis factor, TNF-α. The heart, liver and kidneys were used to determine oxidative stress indices (malondialdehyde, reduced glutathione and catalase). The cardiac tissue was processed for histopathological changes. RESULTS The GC-MS profiling of PILEE identified 20 compounds namely fatty acid esters. Administration of PILEE (50, 100 and 200 mg/kg) dose dependently and significantly reduced systolic blood pressure and mean arterial pressure in hypertensive rats. PILEE administration significantly (p < 0.05) reversed elevated IL-6 and TNF-α in hypertensive rats. PILEE demonstrated antioxidant activity by attenuating L-NAME-induced elevated malondialdehyde and depletion of reduced glutathione and catalase activity in rat tissues. PILEE treatment demonstrated cardioprotective effect in L-NAME-induced cardiac hyperplasia and necrosis in rats. CONCLUSION It can be concluded that Phragmanthera incana leaf ethanol extract possess antihypertensive, antioxidant and anti-inflammatory properties, suggesting a protective role in cardiovascular diseases.
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Affiliation(s)
- Aduragbenro D A Adedapo
- Department of Pharmacology & Therapeutics, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Oyo-State, Nigeria.
| | - Abayomi M Ajayi
- Department of Pharmacology & Therapeutics, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Oyo-State, Nigeria.
| | - Nancy Losie Ekwunife
- Department of Pharmacology & Therapeutics, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Oyo-State, Nigeria.
| | - Olufunke O Falayi
- Department of Veterinary Pharmacology and Toxicology, University of Ibadan, Ibadan, Oyo-State, Nigeria.
| | - Ademola Oyagbemi
- Department of Veterinary Physiology and Biochemistry, University of Ibadan, Ibadan, Oyo-State, Nigeria.
| | | | - Adeolu A Adedapo
- Department of Veterinary Pharmacology and Toxicology, University of Ibadan, Ibadan, Oyo-State, Nigeria.
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Prevalence, Awareness, Treatment and Control of Hypertension in Nigeria: Data from a Nationwide Survey 2017. Glob Heart 2020; 15:47. [PMID: 32923341 PMCID: PMC7427662 DOI: 10.5334/gh.848] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background Previous studies that evaluated the prevalence, awareness and treatment of hypertension in Nigeria were either localized to some specific regions of the country or non-standardized thereby making evaluation of trend in hypertension care difficult. Methods We used the World Health Organization (WHO) STEPwise approach to chronic disease risk factor surveillance to evaluate in a nationally representative sample of 4192 adult Nigerians selected from a rural and an urban community in one state in each of the six geo-political zones of the country. Results The overall age-standardized prevalence of hypertension was 38.1% and this varied across the geo-political zones as follows: North-Central, 20.9%; North-East, 27.5%; North-West, 26.8%; South-East, 52.8%; South-South, 44.6%; and South-West, 42.1%. Prevalence rate did not differ significantly (p > 0.05) according to place of residence; 39.2% versus 37.5 %; urban vs rural. Prevalence of hypertension increased from 6.8% among subjects less than 30 years to 63.0% among those aged 70 years and above. Awareness was better (62.2% vs. 56.6%; P = 0.0272); treatment rate significantly higher (40.9 % vs. 30.8%; P < 0.0001) and control similar (14 vs. 10.8%) among urban compared to rural residents. Women were more aware of (63.3% vs. 52.8%; P < 0.0001); had similar (P > 0.05) treatment (36.7 vs. 34.3%) and control (33.9% vs. 35.5%) rates of hypertension compared to men. Conclusion Our results suggest a large burden of hypertension in Nigeria and a closing up of the rural-urban gap previously reported. This calls for a change in public health policies anchored on a primary health care system to address the emerging disease burden occasioned by hypertension.
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Ekholuenetale M, Barrow A. Prevalence and determinants of self-reported high blood pressure among women of reproductive age in Benin: a population-based study. Clin Hypertens 2020; 26:12. [PMID: 32626600 PMCID: PMC7329466 DOI: 10.1186/s40885-020-00145-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 04/15/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Addressing chronic diseases is a challenge for healthcare systems worldwide, which have largely developed to deal with acute episodic care, rather than to provide organized care for people with age-long conditions. Therefore, exploring the prevalence and identifying the risk factors is a major approach to prevention and control of chronic diseases. The aim of this study was to examine the prevalence and factors associated with self-reported high blood pressure among women of reproductive age in Benin. METHODS We utilized population-based cross-sectional data from Benin Demographic and Health Survey (BDHS). BDHS 2017-18 is the round V of the survey. A total of 7712 women of reproductive age were included in this study. The outcome variable was self-reported high blood pressure. Percentages, chi-square test and multivariable logistic regression model were used to analyze the data. Results from the multivariable logistic model were presented as adjusted odds ratio (aOR) and confidence interval (95%CI). The significance level was set at p < 0.05. RESULTS The total prevalence of self-reported high blood pressure among women of reproductive age in The Gambia was about one-tenth (9.9%). Furthermore, geographical region was associated with high blood pressure. Women aged 45-49 years had increased odds of high blood pressure, when compared with women aged 15-19 years (aOR = 2.73; 95%CI: 1.10, 6.79). In addition, increased maternal enlightenment gave higher odds of high blood pressure, when compared to women with low maternal enlightenment (aOR = 1.41; 95%CI: 1.08, 1.84). Women with highest neighbourhood socioeconomic disadvantaged status (poor women) had 30% reduction in the odds of high blood pressure, when compared with women of low neighbourhood socioeconomic disadvantaged status (aOR = 0.70; 0.50, 0.99). Women having increased lifetime number of sex partners (total of 3 lifetime number of sex partners: aOR = 1.40; 95%CI: 1.01, 1.94; more than 3 total lifetime number of sex partners: aOR = 1.53; 95%CI: 1.01, 2.32) were more likely to have high blood pressure, when compared to women with only one lifetime number of sex partner. CONCLUSIONS Emphasis on high blood pressure prevention methods and involvement of multiple sectors could help to disseminate health care interventions widely. Also, a concerted effort from the stakeholders in health care system and decision-makers is needed to address the drivers of high blood pressure while maintaining health system improvement strategies. The findings could prompt appropriate policy responses towards improving the knowledge and control of high blood pressure in Benin.
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Affiliation(s)
- Michael Ekholuenetale
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Amadou Barrow
- Department of Public & Environmental Health, School of Medicine & Allied Health Sciences, University of The Gambia, Kanifing, The Gambia
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Okoye JO. Attitudinal, regional and sex related vulnerabilities to COVID-19: Considerations for early flattening of curve in Nigeria. Med J Islam Repub Iran 2020; 34:61. [PMID: 32974227 PMCID: PMC7500420 DOI: 10.34171/mjiri.34.61] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Indexed: 12/05/2022] Open
Abstract
Background: In Nigeria, the policies and interventions due to the COVID-19 pandemic are majorly directed at businesses and relief. There are no clear plans to identify individuals with comorbidities associated with high morbidity and fatality rates. This paper identifies comorbidities associated with high morbidity and fatalities of COVID-19 across countries and vulnerable groups in Nigeria. Methods: Peer-reviewed articles published between 2010 and 2020 retrieved from Google scholar, African Journal Online, EMBASE, Scopus, and MEDLINE/PubMed (central) were systematically reviewed. Results: The pooled prevalence of hypertension is the lowest in North Central Nigeria (22.0%) and the highest in South-Eastern Nigeria (33.6%) while the pooled prevalence of diabetes mellitus (DM) is lowest in North-Western Nigeria (3.0%) and highest in South-Southern Nigeria (9.8%). Significant differences in the frequency of comorbidities (hypertension, DM, cardiovascular disease, cancer, and chronic kidney disease; CKD) and complications (cardiac injury and acute respiratory disease syndrome; ARDS) were observed between fatal and non-fatal cases of COVID-19 (p<0.0001). There were significant correlations between hypertension and ARDS (p=0.002), DM and ARDS (p=0.010), hypertension and (p<0.0001), DM and CKD (p=0.033), and hypertension and DM (p=0.001). Conclusion: High prevalence of comorbidity may be predictive of high COVID-19 morbidity and mortality. Thus, to flatten the curve early intervention funds should be appropriately allocated based on the prevalence of comorbidities in the geopolitical zones. Such high-risk groups should be identified, stratified and actively monitored during treatment to prevent the development or progression of complications such as cardiac injury and ARDS.
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Affiliation(s)
- Jude Ogechukwu Okoye
- Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria
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Akpa OM, Made F, Ojo A, Ovbiagele B, Adu D, Motala AA, Mayosi BM, Adebamowo SN, Engel ME, Tayo B, Rotimi C, Salako B, Akinyemi R, Gebregziabher M, Sarfo F, Wahab K, Agongo G, Alberts M, Ali SA, Asiki G, Boua RP, Gómez-Olivé FX, Mashinya F, Micklesfield L, Mohamed SF, Nonterah EA, Norris SA, Sorgho H, Tollman S, Parekh RS, Chishala C, Ekoru K, Waddy SP, Peprah E, Mensah GA, Wiley K, Troyer J, Ramsay M, Owolabi MO. Regional Patterns and Association Between Obesity and Hypertension in Africa: Evidence From the H3Africa CHAIR Study. Hypertension 2020; 75:1167-1178. [PMID: 32172619 PMCID: PMC7176339 DOI: 10.1161/hypertensionaha.119.14147] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/12/2020] [Accepted: 02/12/2020] [Indexed: 12/12/2022]
Abstract
Hypertension and obesity are the most important modifiable risk factors for cardiovascular diseases, but their association is not well characterized in Africa. We investigated regional patterns and association of obesity with hypertension among 30 044 continental Africans. We harmonized data on hypertension (defined as previous diagnosis/use of antihypertensive drugs or blood pressure [BP]≥140/90 mmHg/BP≥130/80 mmHg) and obesity from 30 044 individuals in the Cardiovascular H3Africa Innovation Resource across 13 African countries. We analyzed data from population-based controls and the Entire Harmonized Dataset. Age-adjusted and crude proportions of hypertension were compared regionally, across sex, and between hypertension definitions. Logit generalized estimating equation was used to determine the independent association of obesity with hypertension (P value <5%). Participants were 56% women; with mean age 48.5±12.0 years. Crude proportions of hypertension (at BP≥140/90 mmHg) were 47.9% (95% CI, 47.4-48.5) for Entire Harmonized Dataset and 42.0% (41.1-42.7) for population-based controls and were significantly higher for the 130/80 mm Hg threshold at 59.3% (58.7-59.9) in population-based controls. The age-adjusted proportion of hypertension at BP≥140/90 mmHg was the highest among men (33.8% [32.1-35.6]), in western Africa (34.7% [33.3-36.2]), and in obese individuals (43.6%; 40.3-47.2). Obesity was independently associated with hypertension in population-based controls (adjusted odds ratio, 2.5 [2.3-2.7]) and odds of hypertension in obesity increased with increasing age from 2.0 (1.7-2.3) in younger age to 8.8 (7.4-10.3) in older age. Hypertension is common across multiple countries in Africa with 11.9% to 51.7% having BP≥140/90 mmHg and 39.5% to 69.4% with BP≥130/80 mmHg. Obese Africans were more than twice as likely to be hypertensive and the odds increased with increasing age.
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Affiliation(s)
- Onoja M. Akpa
- From the Center for Genomic and Precision Medicine, College of Medicine, (O.M.A., B.S., R.A., M.O.O.), University of Ibadan, Ibadan, Nigeria
- Department of Epidemiology and Medical Statistics, College of Medicine (O.M.A.), University of Ibadan, Ibadan, Nigeria
- Institute of Cardiovascular Diseases, College of Medicine (O.M.A.), University of Ibadan, Ibadan, Nigeria
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (O.M.A., F. Made, S.A.A., M.R.)
| | - Felix Made
- The Epidemiology and Surveillance Section, National Institute for Occupational Health, National Health Laboratory Services, Gauteng Region, South Africa (F. Made)
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (O.M.A., F. Made, S.A.A., M.R.)
| | - Akinlolu Ojo
- Clinical research and global health initiatives, University of Arizona Health Sciences (A.O.)
| | - Bruce Ovbiagele
- Department of Neurology, University of California, San Francisco CA, USA (B.O.)
| | - Dwomoa Adu
- School of Medicine and Dentistry, University of Ghana, Accra, Ghana (D.A.)
| | - Ayesha A. Motala
- Department of Diabetes and Endocrinology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa (A.A.M.)
| | - Bongani M. Mayosi
- Department of Medicine, Groote Schuur Hospital (B.M.M.), University of Cape Town, South Africa
| | - Sally N. Adebamowo
- Department of Epidemiology and Public Health, Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA (S.N.A.)
| | - Mark E. Engel
- Division of Cardiology, Department of Medicine (M.E.E., C.C.), University of Cape Town, South Africa
| | - Bamidele Tayo
- Department of Preventive Medicine and Epidemiology, Loyola University Chicago Stritch School of Medicine, Maywood, IL (B.T.)
| | - Charles Rotimi
- Center for Research on Genomics and Global Health, NHGRI, NIH, Bethesda, MD, USA (C.R.)
| | - Babatunde Salako
- From the Center for Genomic and Precision Medicine, College of Medicine, (O.M.A., B.S., R.A., M.O.O.), University of Ibadan, Ibadan, Nigeria
| | - Rufus Akinyemi
- From the Center for Genomic and Precision Medicine, College of Medicine, (O.M.A., B.S., R.A., M.O.O.), University of Ibadan, Ibadan, Nigeria
| | - Mulugeta Gebregziabher
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC, USA (M.G.)
| | - Fred Sarfo
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (F.S.)
| | - Kolawole Wahab
- Department of Medicine, University of Ilorin, Nigeria (K. Wahab)
| | - Godfred Agongo
- Navrongo Health Research Centre, Ghana (G. Agongo, E.A.N.)
| | - Marianne Alberts
- Department of Pathology and Medical Science, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa (M.A., F. Mashinya)
| | - Stuart A. Ali
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (O.M.A., F. Made, S.A.A., M.R.)
| | - Gershim Asiki
- African Population and Health Research Center, Nairobi, Kenya (G. Asiki, S.F.M.)
| | - Romuald P. Boua
- Institut de Recherche en Sciences de la Sante, Clinical Research Unit of Nanoro, Burkina Faso (R.P.B., H.S.)
| | - F. Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (F.X.G.-O., S.T.)
| | - Felistas Mashinya
- Department of Pathology and Medical Science, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa (M.A., F. Mashinya)
| | - Lisa Micklesfield
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (L.M., S.A.N.)
| | - Shukri F. Mohamed
- African Population and Health Research Center, Nairobi, Kenya (G. Asiki, S.F.M.)
| | | | - Shane A. Norris
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (L.M., S.A.N.)
| | - Hermann Sorgho
- Institut de Recherche en Sciences de la Sante, Clinical Research Unit of Nanoro, Burkina Faso (R.P.B., H.S.)
| | - Stephen Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (F.X.G.-O., S.T.)
| | - Rulan S. Parekh
- Departments of Pediatrics, Medicine and Epidemiology, Hospital for Sick Children, University Health Network and University of Toronto, Canada (R.S.P.)
| | - Chishala Chishala
- Division of Cardiology, Department of Medicine (M.E.E., C.C.), University of Cape Town, South Africa
| | - Kenneth Ekoru
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD (K.E.)
| | - Salina P. Waddy
- Department of Neurology, Atlanta Veterans Affairs Medical Center, Decatur, GA (S.P.W.)
| | - Emmanuel Peprah
- College of Global Public Health, New York University, New York, NY (E.P.)
| | - George A. Mensah
- Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD (G.A.M.)
| | - Ken Wiley
- Division of Genomic Medicine, National Human Genome Research Institute, Bethesda, MD (K. Wiley)
| | - Jennifer Troyer
- Human Heredity and Health in Africa, Division of Genome Sciences (J.T.), National Institutes of Health, Bethesda, MD
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (O.M.A., F. Made, S.A.A., M.R.)
| | - Mayowa O. Owolabi
- From the Center for Genomic and Precision Medicine, College of Medicine, (O.M.A., B.S., R.A., M.O.O.), University of Ibadan, Ibadan, Nigeria
| | - as members of the CVD Working Group of the H3Africa Consortium
- From the Center for Genomic and Precision Medicine, College of Medicine, (O.M.A., B.S., R.A., M.O.O.), University of Ibadan, Ibadan, Nigeria
- Department of Epidemiology and Medical Statistics, College of Medicine (O.M.A.), University of Ibadan, Ibadan, Nigeria
- Institute of Cardiovascular Diseases, College of Medicine (O.M.A.), University of Ibadan, Ibadan, Nigeria
- The Epidemiology and Surveillance Section, National Institute for Occupational Health, National Health Laboratory Services, Gauteng Region, South Africa (F. Made)
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (O.M.A., F. Made, S.A.A., M.R.)
- Clinical research and global health initiatives, University of Arizona Health Sciences (A.O.)
- Department of Neurology, University of California, San Francisco CA, USA (B.O.)
- School of Medicine and Dentistry, University of Ghana, Accra, Ghana (D.A.)
- Department of Diabetes and Endocrinology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa (A.A.M.)
- Department of Medicine, Groote Schuur Hospital (B.M.M.), University of Cape Town, South Africa
- Division of Cardiology, Department of Medicine (M.E.E., C.C.), University of Cape Town, South Africa
- Department of Epidemiology and Public Health, Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA (S.N.A.)
- Department of Preventive Medicine and Epidemiology, Loyola University Chicago Stritch School of Medicine, Maywood, IL (B.T.)
- Center for Research on Genomics and Global Health, NHGRI, NIH, Bethesda, MD, USA (C.R.)
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC, USA (M.G.)
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (F.S.)
- Department of Medicine, University of Ilorin, Nigeria (K. Wahab)
- Navrongo Health Research Centre, Ghana (G. Agongo, E.A.N.)
- Department of Pathology and Medical Science, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa (M.A., F. Mashinya)
- African Population and Health Research Center, Nairobi, Kenya (G. Asiki, S.F.M.)
- Institut de Recherche en Sciences de la Sante, Clinical Research Unit of Nanoro, Burkina Faso (R.P.B., H.S.)
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (F.X.G.-O., S.T.)
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (L.M., S.A.N.)
- Departments of Pediatrics, Medicine and Epidemiology, Hospital for Sick Children, University Health Network and University of Toronto, Canada (R.S.P.)
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD (K.E.)
- Department of Neurology, Atlanta Veterans Affairs Medical Center, Decatur, GA (S.P.W.)
- College of Global Public Health, New York University, New York, NY (E.P.)
- Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD (G.A.M.)
- Division of Genomic Medicine, National Human Genome Research Institute, Bethesda, MD (K. Wiley)
- Human Heredity and Health in Africa, Division of Genome Sciences (J.T.), National Institutes of Health, Bethesda, MD
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Ezenkwa US, Omenai SA, Ogunbiyi JO. Reported Adherence to Antihypertensive Treatment and Outcome at Postmortem in Southwestern Nigerians. Niger Med J 2020; 61:22-26. [PMID: 32317817 PMCID: PMC7113819 DOI: 10.4103/nmj.nmj_99_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/24/2019] [Accepted: 11/14/2019] [Indexed: 11/28/2022] Open
Abstract
Background: Systemic hypertension is referred to as a silent killer. Knowledge of disease and religious use of medication could mitigate against complications in hypertensives. This study evaluated outcome among decedent essential hypertensive patients in southwestern Nigeria in relation to their compliance with prescribed antihypertensive medication. Materials and Methods: This is a 10-year retrospective review of routine postmortem data. Archival postmortem records from January 1, 2008 to December 31, 2017 in the Department of Pathology, University College Hospital, Ibadan, Nigeria, were reviewed. Data extracted from the records included age, gender, knowledge of hypertension status, systolic and diastolic blood pressure at time of diagnosis, reported adherence to medications, complications of systemic hypertension, duration of survival from diagnosis to demise, cause of death, body length, and heart weight at autopsy. Descriptive, Students t-test, Chi-square test, Pearson correlation and Cox proportional-hazards model statistics was conducted using SPSS version 20 (IBM SPSS Statistics for windows, IBM Corp., Armonk, N.Y., USA).P < 0.05 was considered significant. Results: Eighty-one cases met the inclusion criteria, consisting of 60 males and 21 females with overall mean age of 55.65 ± 12.1 years. Seventy-five (91.7%) cases were known hypertensives prior to admission or demise while 6 (8.3%) were not known hypertensives. The duration of survival from diagnosis to death ranged from 1-month (0.08 years) to 31 years with overall mean duration of 5.2 years. Fifty-two (63.4%) of the 75 known hypertensive cases had documented medication compliance. Medication noncompliant cases had lower mean survival interval (5 vs. 8 years), died younger (53.5 ± 10.8 years vs. 54.8 ± 15.5 years), had higher mean blood pressures (systolic blood pressures: 197 ± 45.8 mmHg vs. 180 ± 55.4 mmHg; diastolic blood pressures: 117 ± 27.2 mmHg vs. 101 ± 32.8 mmHg) and heavier heart weights (476 ± 142 g vs. 390.8 ± 107.6 g). However, only the difference in heart weight was statistically significant (P < 0.036). Age and mean systolic blood pressures were correlated with interval from diagnosis to death (r = 0.5, P < 0.000; r = −0.4,P < 0.017, respectively). Death from complications of hypertension and all-cause mortality occurred with higher frequencies among medication noncompliant cases (40 vs. 12). Conclusion: Noncompliance with antihypertensive medication is associated with more cardiovascular and all-cause mortality among Southwestern Nigerians with essential hypertension.
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Soneye MA, Adekanmi AJ, Obajimi MO, Aje A. Intima-media thickness of femoral arteries and carotids among an adult hypertensive Nigerian population: A case-control study to assess their use as surrogate markers of atherosclerosis. Ann Afr Med 2020; 18:158-166. [PMID: 31417017 PMCID: PMC6704813 DOI: 10.4103/aam.aam_57_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Increased intima-media thickness (IMT) is an established and important surrogate marker for atherosclerosis. Intima-media thickening in the femoral arteries occur earlier and reflect the true extent of generalized atherosclerosis better than in the carotids. Aims: To study the ultrasound-detected morphological changes in the common femoral versus carotid artery wall. Patients and Methods: A case-control study design was used, with 61 adult hypertensive as cases and 61 age-, sex- and BMI-matched normotensive as controls. Variables were participants' characteristics, cardiovascular risk factors, and ultrasonographically evaluated IMT of the carotid and femoral arteries. Results: A total of 122 participants were studied. The mean femoral IMT in hypertensives and controls on the right and left was 0.63 ± 0.07mm vs. 0.52 ± 0.06mm [P < 0.0001] and 0.69 ± 0.0 mm vs. 0.55 ± 0.05mm [P < 0.0001]. Also, the mean carotid IMT among hypertensives and controls on the right =0.80 ±0.15mm vs. 0.64 ± 0.06mm [P < 0.0001], and 0.91 ± 0.22mm vs. 0.65 ± 0.06mm [P < 0.0001] on the left. Significant correlation was observed between IMT and age (B = 0.006, P < 0.001 and B = 0.003, P < 0.001), hypertension (B = 0.205, P < 0.001 and B = 0.122, p< 0.001), and duration of hypertension (B = 0.02, P < 0.001 and B = 0.006, P = 0.02) the femoral and carotid arteries respectively. Conclusion: The femoral and the carotid artery show similar significantly increased IMT in hypertensive adults. The femoral IMT appears to be a good surrogate marker of atherosclerosis among hypertensive Nigerians.
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Affiliation(s)
| | | | | | - Akinyemi Aje
- Department of Medicine, Cardiology Unit, University College Hospital, Ibadan, Nigeria
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Impact of dietary patterns, individual and workplace characteristics on blood pressure status among civil servants in Bida and Wushishi communities of Niger State, Nigeria. PLoS One 2019; 14:e0226231. [PMID: 31834906 PMCID: PMC6910664 DOI: 10.1371/journal.pone.0226231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 11/21/2019] [Indexed: 11/20/2022] Open
Abstract
The global burden estimate of hypertension is alarming and results in several million deaths annually. A high incidence of sudden deaths from cardiovascular diseases in the civil workforce in Nigeria is often reported. However, the associations between Dietary Patterns (DPs), individual, and workplace characteristics of hypertension among this workforce have not been fully explored. This study aimed to identify DP in the Bida and Wushishi Communities of Niger State and establish its relationship with hypertension along with other individual and workplace characteristics. Factor analysis was used to establish DP, Chi-square test to identify their relationships with hypertension, and logistic regression to determine the predictor risk factors. The prevalence of hypertension was 43.7%; mean weight, height, and body fat were: 72.8±15 kg, 166±8.9 mm and 30.4%, respectively. Three DPs: “Efficient Diet,” “Local diet,” and “Energy Boost Diet” were identified. The factor loading scores for these factors were divided into quintiles Q1–Q5; none of them had a significant effect on hypertension status. Conversely, increase in age, the Ministry, Department, and Agency (MDA) of employment, frequency of eating in restaurants, and obesity were identified as significant risk factors. After adjusting for confounders (age, body mass index, MDA, and eating habits), a high score (Q5) in “efficient diet pattern” was significantly related to a lower likelihood of hypertension than a low score (Q1). The prevalence of hypertension among the participants was relatively very high. An increase in age and working in educational sector were risk factors associated with hypertension. Therefore, it is recommended that civil servants engage in frequent exercise and undergo regular medical checkups, especially as they get older. These findings highlight the need for large-scale assessment of the impact of variables considered in this study on hypertension, among the civil workforce across Niger state and Nigeria.
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Obiebi IP, Aiwuyo HO. 2017 American College of Cardiology/American Heart Association Clinical Guideline-based Prevalence of Hypertension in a semi-urban community in Nigeria: Public Health Perspective. REVISTA COLOMBIANA DE CARDIOLOGÍA 2019. [DOI: 10.1016/j.rccar.2019.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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49
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Bosu WK, Aheto JMK, Zucchelli E, Reilly ST. Determinants of systemic hypertension in older adults in Africa: a systematic review. BMC Cardiovasc Disord 2019; 19:173. [PMID: 31331284 PMCID: PMC6647089 DOI: 10.1186/s12872-019-1147-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 07/04/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND An estimated 55% of older adults in Africa have systemic hypertension, a major risk factor for stroke, heart failure and dementia in the region. The risk factors associated with hypertension in this population group in Africa have not been systematically evaluated. We, therefore, undertook a systematic review to identify these risk factors. METHODS We searched for population-based studies of adults aged ≥50 years living in Africa and reporting an estimate of hypertension and associated risk factors. We included articles published in any language between January 1980 and May 2018 using a comprehensive search strategy. We extracted data including the sample characteristics, prevalence of hypertension and risk factors with their effect sizes. RESULTS From an initial 10,719 records, we retained 63 eligible full text articles for review out of which we analyzed 23 studies made up of 19 primary and four multiple publications which had data on risk factors from bivariate or multivariable analysis. The primary studies, published from 2010 to 2018, involved a total of 30,500 participants in 12 different countries with mean ages ranging from 62.7 ± 9 years to 76.9 ± 8.4 years. Through narrative synthesis, we found consistent determinants of hypertension (overweight/obesity and history of stroke), less consistent but frequent determinants (including older age group, female sex and urban residence), inconsistent determinants (including education, wealth index, alcohol intake and physical activity) and nonsignificant covariates (marital status and having health insurance). Overall, the highest adjusted odds ratios were those associated with obesity and history of stroke. CONCLUSION The key determinants of systemic hypertension in older adults in Africa are older age group, overweight/obesity, history of stroke and female sex. Health programmes should promote weight reduction throughout the life course, including during the middle and older age of African adults.
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Affiliation(s)
- William Kofi Bosu
- Department of Public Health and Research, West African Health Organisation, Bobo-Dioulasso, 01 BP 153 Burkina Faso
- Division of Health Research, Faculty of Health & Medicine, Furness Building, Lancaster University, Lancaster, LA1 4YG UK
| | - Justice Moses Kwaku Aheto
- Department of Biostatistics, School of Public Health, University of Ghana, PO Box LG 13, Legon, Accra Ghana
| | - Eugenio Zucchelli
- Division of Health Research, Faculty of Health & Medicine, Furness Building, Lancaster University, Lancaster, LA1 4YG UK
- Madrid Institute for Advanced Study (MIAS), Universidad Autonoma de Madrid, C/ Einstein, 13 Pabellón C 1a planta, E-28049 Madrid, Spain
| | - Siobhan Theresa Reilly
- Division of Health Research, Faculty of Health & Medicine, Furness Building, Lancaster University, Lancaster, LA1 4YG UK
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Prevalence of prehypertension and hypertension and its risk factors in Iranian school children: a population-based study. J Hypertens 2019; 36:1816-1824. [PMID: 29847484 DOI: 10.1097/hjh.0000000000001789] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Because of the incidence of a childhood obesity epidemic and the widespread changes in people's lifestyle, the prevalence of high blood pressure in children is increasing. This study was conducted to determine the prevalence of prehypertension and hypertension and its risk factors in Iranian children. METHODS Using random cluster sampling in urban areas and census in rural areas, a total of 5620 schoolchildren aged 6-12 years living in Shahroud, Northeast of Iran, were studied. The prevalence of hypertension was determined on the basis of the fourth report of the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents by age, sex, and place of residence. The factors influencing blood pressure were studied using multivariate regression. RESULTS The prevalence of prehypertension was 7.44% and the prevalence of hypertension was 6.82%. The relative risk ratio (RRR) of prehypertension was 1.17 for BMI, 1.43 for female sex, and 3.71 for residence in rural areas; in addition, the RRR of hypertension was 1.22 for BMI, 6.64 for residence in rural areas, 1.69 for moderate economic status, and 1.89 for low economic status. CONCLUSION The prevalence of prehypertension and hypertension is significant in children and alarming in rural areas and requires urgent intervention. As factors such as high BMI, female sex, residence in rural areas, and moderate and low economic status are associated with increased risk of prehypertension and hypertension, it is recommended to conduct routine care programs at regular intervals in schools to prevent hypertension and its related complications.
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