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Onyia CP, Asogwa P, Adiri W, Obienu O, Ijoma UN, Nwokediuko SC, Okeke EN. Nonalcoholic Fatty Liver Disease and Associated Risk Factors in Obese Nigerians: A Cross-Sectional Study. Niger J Clin Pract 2024; 27:352-360. [PMID: 38528356 DOI: 10.4103/njcp.njcp_365_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 02/05/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is now adjudged the most common liver disease in the world, contributing to the rising incidence of hepatocellular carcinoma worldwide. However, the true prevalence of nonalcoholic fatty liver disease among obese individuals and its contribution to the burden of liver disease in Nigeria is unknown. AIM To determine the prevalence of nonalcoholic fatty liver disease and associated risk factors in obese subjects. METHODS This was a cross-sectional analytical study of 280 obese subjects and 280 nonobese age and sex-matched controls seen at our health facility. Data collection was done using an interviewer-administered questionnaire and anthropometric parameters were obtained. Fasting blood samples were collected for blood glucose, lipid profile, and liver biochemistry. Abdominal ultrasound was used to screen for NAFLD. The results were subjected to relevant statistical analysis using SPSS version 20. RESULTS A higher prevalence of NAFLD was found in obese subjects, compared with nonobese controls (36.4% versus 0.4% P < 0.001). The degree of obesity, transaminases, total cholesterol, diastolic hypertension, fasting blood glucose, and waist circumference was significantly associated with a higher prevalence of NAFLD. However, using multivariate logistic regression analysis, diabetes mellitus and hypertension were significant associations for NAFLD. Individuals with NAFLD had a significantly higher prevalence of metabolic syndrome 65.9%, compared with 34.1% in obese individuals without NAFLD (P < 0.001). CONCLUSION The prevalence of NAFLD in obese subjects was significant. NAFLD in obese subjects was associated with degree of obesity, hyperlipidemia, hypertension, and diabetes mellitus.
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Affiliation(s)
- C P Onyia
- Gastroenterology Unit, Department of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - P Asogwa
- Gastroenterology Unit, Department of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - W Adiri
- Gastroenterology Unit, Department of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - O Obienu
- Gastroenterology Unit, Department of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - U N Ijoma
- Gastroenterology Unit, Department of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
- Department of Medicine, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
| | - S C Nwokediuko
- Gastroenterology Unit, Department of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
- Department of Medicine, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
| | - E N Okeke
- Department of Medicine, Jos University Teaching Hospital, Plateau State, Nigeria
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Abene EE, Ocheke AN, Ozoilo KN, Gimba ZM, Okeke EN, Agbaji OO, Agaba EI. Knowledge, attitudes and practices towards Covid-19 among Nigerian healthcare workers during the Covid-19 pandemic: A single centre survey. Niger J Clin Pract 2021; 24:1846-1851. [PMID: 34889795 DOI: 10.4103/njcp.njcp_365_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background The COVID-19 pandemic has led to hundreds of thousands of deaths worldwide. Aims Being a novel viral disease, we sought to evaluate the knowledge and practice of doctors and nurses in a tertiary hospital regarding the disease. Subjects and Methods Using a self-administered questionnaire, respondents were asked questions on the cause, clinical features, and prevention of COVID-19. Results : We studied 409 respondents (238 doctors and 171 nurses) with a mean age of 34 ± 7 years and a median length of experience of five (IQR 2-9) years. The mean knowledge score was 9.6 ± 1.2 out of a maximum of 12 points with 337 (82.4%) respondents having good knowledge. The majority of respondents (62.8%) had not been trained on infection prevention and control since the outbreak of the pandemic. Only 95 (23.2%) had seen COVID-19 Standard Operating Procedures (SOP) displayed in the hospital. The use of the personal protective equipment (PPE) kit comprising the N-95 mask, face shield, gown, and shoes was seen by 194 (47.4%) respondents in recent times. A total of 397 (97.0%) respondents felt they were at an increased risk of contracting COVID-19 relative to the general populace. Measures taken to prevent COVID-19 included: wearing of face mask (68.7%), hand gloves (78.2%), frequent use of hand sanitizers (84.1%), frequent hand washing (84.8%), the daily wash of uniforms and ward coats (44.5%), daily cleaning of footwear (31.7%), and avoidance of taking home clothing and footwear worn in the hospital (54.2%). Conclusion Despite having good knowledge of transmission and clinical features of SARS-CoV 2, the utilization of protective measures by HCW in this study is unsatisfactory.
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Affiliation(s)
- E E Abene
- Department of Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - A N Ocheke
- Department of O and G, University of Jos and Jos University Teaching Hospital, Jos, Nigeria
| | - K N Ozoilo
- Department of Surgery, University of Jos and Jos University Teaching Hospital, Jos, Nigeria
| | - Z M Gimba
- Department of Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - E N Okeke
- Department of Medicine, University of Jos and Jos University Teaching Hospital, Jos, Nigeria
| | - O O Agbaji
- Department of Medicine, University of Jos and Jos University Teaching Hospital, Jos, Nigeria
| | - E I Agaba
- Department of Medicine, University of Jos and Jos University Teaching Hospital, Jos, Nigeria
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Osaigbovo GO, Amusa GA, Salaam AJ, Imoh LC, Okeke EN, Zoakah AI, Kanki P, Sagay SA. Predictors and Prognosis of Stroke in Jos, North-Central Nigeria. West Afr J Med 2021; 38:478-485. [PMID: 34051721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Stroke is the second leading cause of death worldwide. Stroke mortality has been shown to be higher in blacks in multiracial studies. It is also a very important cause of disability with its attendant deterioration in the quality of life in survivors. OBJECTIVE The study sought to determine the risk and prognostic factors associated with stroke in Jos, North Central Nigeria. METHODS A prospective cohort study of stroke patients that were followed up for 90 days to determine outcomes. The stroke patients were admitted into the neurology unit of Jos University Teaching Hospital between September 2016 and August 2018. RESULTS We recruited a total of 246 subjects comprising 131 (53.3%) males aged 59.5 ± 13.1 years and 115 (46.6%) females aged 56.7 ± 14.2 years. Obesity, hypertension, dyslipidaemia and alcohol consumption were the commonest risk factors identified. The 90-day case fatality rate of stroke was 22%. Elevated glycated haemoglobin (p = 0.001), loss of consciousness at presentation (p <0.001), atrial fibrillation (p= 0.022), cardiac disease (p < 0.001) and HIV infection (p = 0.001) were significantly associated with poor outcome for stroke. Furthermore, subjects with a high NIHSS had three times the risk of death compared with those with low scores (RR = 2.93; 95% CI = 2.38 - 3.61, p <0.001). CONCLUSION The prognosis of stroke was poor. The predictors of poor stroke outcome were coma, HIV infection, cardiac disease, high NIHSS and total cholesterol.
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Affiliation(s)
- G O Osaigbovo
- Department of Medicine, Faculty of Clinical Sciences, College of Health Sciences, University of Jos/ Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - G A Amusa
- Department of Medicine, Faculty of Clinical Sciences, College of Health Sciences, University of Jos/ Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - A J Salaam
- Department of Radiology, Faculty of Clinical Sciences, College of Health Sciences, University of Jos/ Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - L C Imoh
- Department of Chemical Pathology, Faculty of Clinical Sciences, College of Health Sciences, University of Jos/Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - E N Okeke
- Department of Medicine, Faculty of Clinical Sciences, College of Health Sciences, University of Jos/ Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - A I Zoakah
- Department of Community Medicine, Faculty of Clinical Sciences, College of Health Sciences, University of Jos/ Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - P Kanki
- Department of Immunology and Infectious Diseases, Harvard T.H. School of Public Health, Boston, Massachusetts, USA
| | - S A Sagay
- Obstetrics and Gynaecology, Faculty of Clinical Sciences, College of Health Sciences, University of Jos/Jos University Teaching Hospital, Jos, Plateau State, Nigeria
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Dunga J, Zawaya K, Adamu Y, Bathnna S, Liman H, Musa J, Yusuf S, Vakkai I, Adabe R, Okeke EN, Agaba EI. Helicobacter pylori infection a risk for upper gastrointestinal diseases among patients in North Central Nigeria. Niger J Med 2021. [DOI: 10.4103/njm.njm_45_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Egesie OJ, Agaba PA, Silas OA, Achenbach C, Zoakah A, Agbaji OO, Madaki JA, Okeke EN, Hou L, Sagay AS, Murphy R. Presentation and survival in patients with hematologic malignancies in Jos, Nigeria: A retrospective cohort analysis. ACTA ACUST UNITED AC 2018; 20:49-56. [PMID: 29963503 DOI: 10.4103/jomt.jomt_8_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Haematologic malignancies cause significant morbidity and mortality and are not uncommon in resource-limited-low income countries. However, the types, pattern of presentation and treatment outcomes vary across regions. We assessed the presentation and overall survival over an 11-year period in adult patients presenting with haematologic cancers in Jos, North Central Nigeria. Materials and Methods This retrospective outcome study evaluated patients who presented with haematologic malignancies between 2005-2015 at the Jos University Teaching Hospital (JUTH), Jos. Variables of interest were abstracted through chart reviews. Descriptive statistics were used to evaluate baseline and follow-up parameters. Overall survival (OS) was assessed using Kaplan-Meier method. Results Sixty patients, contributing 25,994 person-days of follow-up were evaluated. The mean age was 43+17 years and 61.7% were males. Thirty-one patients (51.7%) presented with leukemia, 45.0% with lymphoma, and 3.3% with multiple myeloma. Forty-two (70.0%) presented with advanced disease, 5 (5.2%) were HIV positive and 4 (6.7%) had died at the end of follow-up. OS was 84.3% (95% CI: 58.1-94.7). Survival differed by disease group (p=0.01) and having fever at presentation (p=0.02). Conclusion We found long-term OS to be impacted by disease type and status of fever at presentation. Disease-specific Strategies to improve early diagnosis and therapies are needed to ensure optimal outcomes in Nigerian patients.
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Affiliation(s)
- Ochaka J Egesie
- Department of Haematology and Blood Transfusion, Jos University Teaching Hospital, Jos, Nigeria
| | - Patricia A Agaba
- Department of Family Medicine, University of Jos/Jos University Teaching Hospital, Nigeria
| | - Olugbenga A Silas
- Department of Histopathology, Jos University Teaching Hospital, Jos, Nigeria
| | - Chad Achenbach
- Department of Medicine and Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago IL, USA
| | - Ayuba Zoakah
- Department of Community Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - Oche O Agbaji
- Department of Internal Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - Jeremiah A Madaki
- Department of Family Medicine, University of Jos/Jos University Teaching Hospital, Nigeria
| | - Edith N Okeke
- Department of Internal Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - Lifang Hou
- Department of Medicine and Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago IL, USA.,Center for Population Epigenetics, Robert H. Lurie Comprehensive Cancer Center and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago IL, USA
| | - Atiene S Sagay
- Department of Obstetrics and Gynaecology, Jos University Teaching Hospital, Jos, Nigeria
| | - Robert Murphy
- Department of Medicine and Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago IL, USA
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Agaba EI, Akanbi MO, Agaba PA, Ocheke AN, Gimba ZM, Daniyam S, Okeke EN. A survey of non-communicable diseases and their risk factors among university employees: a single institutional study. Cardiovasc J Afr 2017; 28:377-384. [PMID: 28820539 PMCID: PMC5885043 DOI: 10.5830/cvja-2017-021] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 04/04/2017] [Indexed: 11/07/2022] Open
Abstract
Background The incidence of non-communicable diseases(NCDs) is rising globally, with its attendant morbidity andmortality, especially in developing countries. This study evaluatedthe prevalence of NCDs and their risk factors amongmembers of a university community. Methods All employees of the university were invited to the University health clinic for screening, using the World Health Organisation’s STEPwise approach to NCDs. Results A total of 883 (521; 59.0% males) employees with a mean age of 44 ± 10 years were studied. The median (IQR) number of NCD risk factors was three (two to three) per participant. The most common NCD risk factors were inadequate intake of fruit and vegetables (94.6%; 95% CI: 92.8–95.9), physical inactivity (77.8%; 95% CI: 74.9–80.5%) and dyslipidaemia (51.8%; 95% CI: 48.4–51.6%). Others included obesity (26.7%; 95% CI: 23.9–29.8%), alcohol use (24.0%; 95% CI: 21.3–27.0%) and cigarette smoking (2.9%; 95% CI: 2.0–4.3). Hypertension was the most common NCD (48.5%; 95% CI: 45.1–51.8%), followed by chronic kidney disease (13.6%; 95% CI: 11.4–16.1) and diabetes mellitus (8.0%; 95% CI: 6.4–10.1). There was no gender-specific difference in the prevalence of NCDs. Conclusion This study identified that NCDs and their modifiable risk factors are highly prevalent in this community. Workplace policy to support the adoption of healthy living is needed.
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Affiliation(s)
| | | | | | - Amaka N Ocheke
- Department of Obstetrics and Gynaecology, University of Jos, Nigeria
| | - Zumnan M Gimba
- Department of Medicine, Jos University Teaching Hospital, Nigeria
| | - Steve Daniyam
- University Health Centre, University of Jos, Nigeria
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Yang JD, Mohamed EA, Aziz AOA, Shousha HI, Hashem MB, Nabeel MM, Abdelmaksoud AH, Elbaz TM, Afihene MY, Duduyemi BM, Ayawin JP, Gyedu A, Lohouès-Kouacou MJ, Ndam AWN, Moustafa EF, Hassany SM, Moussa AM, Ugiagbe RA, Omuemu CE, Anthony R, Palmer D, Nyanga AF, Malu AO, Obekpa S, Abdo AE, Siddig AI, Mudawi HMY, Okonkwo U, Kooffreh-Ada M, Awuku YA, Nartey YA, Abbew ET, Awuku NA, Otegbayo JA, Akande KO, Desalegn HM, Omonisi AE, Ajayi AO, Okeke EN, Duguru MJ, Davwar PM, Okorie MC, Mustapha S, Debes JD, Ocama P, Lesi OA, Odeghe E, Bello R, Onyekwere C, Ekere F, Igetei R, Mah'moud MA, Addissie B, Ali HM, Gores GJ, Topazian MD, Roberts LR. Characteristics, management, and outcomes of patients with hepatocellular carcinoma in Africa: a multicountry observational study from the Africa Liver Cancer Consortium. Lancet Gastroenterol Hepatol 2016; 2:103-111. [PMID: 28403980 DOI: 10.1016/s2468-1253(16)30161-3] [Citation(s) in RCA: 130] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/29/2016] [Accepted: 09/30/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND Hepatocellular carcinoma is a leading cause of cancer-related death in Africa, but there is still no comprehensive description of the current status of its epidemiology in Africa. We therefore initiated an African hepatocellular carcinoma consortium aiming to describe the clinical presentation, management, and outcomes of patients with hepatocellular carcinoma in Africa. METHODS We did a multicentre, multicountry, retrospective observational cohort study, inviting investigators from the African Network for Gastrointestinal and Liver Diseases to participate in the consortium to develop hepatocellular carcinoma research databases and biospecimen repositories. Participating institutions were from Cameroon, Egypt, Ethiopia, Ghana, Ivory Coast, Nigeria, Sudan, Tanzania, and Uganda. Clinical information-demographic characteristics, cause of disease, liver-related blood tests, tumour characteristics, treatments, last follow-up date, and survival status-for patients diagnosed with hepatocellular carcinoma between Aug 1, 2006, and April 1, 2016, were extracted from medical records by participating investigators. Because patients from Egypt showed differences in characteristics compared with patients from the other countries, we divided patients into two groups for analysis; Egypt versus other African countries. We undertook a multifactorial analysis using the Cox proportional hazards model to identify factors affecting survival (assessed from the time of diagnosis to last known follow-up or death). FINDINGS We obtained information for 2566 patients at 21 tertiary referral centres (two in Egypt, nine in Nigeria, four in Ghana, and one each in the Ivory Coast, Cameroon, Sudan, Ethiopia, Tanzania, and Uganda). 1251 patients were from Egypt and 1315 were from the other African countries (491 from Ghana, 363 from Nigeria, 277 from Ivory Coast, 59 from Cameroon, 51 from Sudan, 33 from Ethiopia, 21 from Tanzania, and 20 from Uganda). The median age at which hepatocellular carcinoma was diagnosed significantly later in Egypt than the other African countries (58 years [IQR 53-63] vs 46 years [36-58]; p<0·0001). Hepatitis C virus was the leading cause of hepatocellular carcinoma in Egypt (1054 [84%] of 1251 patients), and hepatitis B virus was the leading cause in the other African countries (597 [55%] of 1082 patients). Substantially fewer patients received treatment specifically for hepatocellular carcinoma in the other African countries than in Egypt (43 [3%] of 1315 vs 956 [76%] of 1251; p<0·0001). Among patients with survival information (605 [48%] of 1251 in Egypt and 583 [44%] of 1315 in other African countries), median survival was shorter in the other African countries than in Egypt (2·5 months [95% CI 2·0-3·1] vs 10·9 months [9·6-12·0]; p<0·0001). Factors independently associated with poor survival were: being from an African countries other than Egypt (hazard ratio [HR] 1·59 [95% CI 1·13-2·20]; p=0·01), hepatic encephalopathy (2·81 [1·72-4·42]; p=0·0004), diameter of the largest tumour (1·07 per cm increase [1·04-1·11]; p<0·0001), log α-fetoprotein (1·10 per unit increase [1·02-1·20]; p=0·0188), Eastern Cooperative Oncology Group performance status 3-4 (2·92 [2·13-3·93]; p<0·0001) and no treatment (1·79 [1·44-2·22]; p<0·0001). INTERPRETATION Characteristics of hepatocellular carcinoma differ between Egypt and other African countries. The proportion of patients receiving specific treatment in other African countries was low and their outcomes were extremely poor. Urgent efforts are needed to develop health policy strategies to decrease the burden of hepatocellular carcinoma in Africa. FUNDING None.
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Affiliation(s)
- Ju Dong Yang
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Essa A Mohamed
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Ashraf O Abdel Aziz
- Endemic Medicine and Hepatogastroenterology Department, University of Cairo, Cairo, Egypt
| | - Hend I Shousha
- Endemic Medicine and Hepatogastroenterology Department, University of Cairo, Cairo, Egypt
| | - Mohamed B Hashem
- Endemic Medicine and Hepatogastroenterology Department, University of Cairo, Cairo, Egypt
| | - Mohamed M Nabeel
- Endemic Medicine and Hepatogastroenterology Department, University of Cairo, Cairo, Egypt
| | - Ahmed H Abdelmaksoud
- Department of Diagnostic and Interventional Radiology, University of Cairo, Cairo, Egypt
| | - Tamer M Elbaz
- Endemic Medicine and Hepatogastroenterology Department, University of Cairo, Cairo, Egypt
| | - Mary Y Afihene
- Department of Internal Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Babatunde M Duduyemi
- Department of Pathology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joshua P Ayawin
- Department of Internal Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Adam Gyedu
- Department of Surgery, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Marie-Jeanne Lohouès-Kouacou
- Department of Hepatology and Gastroenterology, Centre Hospitalier Universitaire de Cocody, Abidjan, Côte d'Ivoire
| | - Antonin W Ndjitoyap Ndam
- Department of Hepatology and Gastroenterology, Centre Hospitalier Universitaire de Cocody, Abidjan, Côte d'Ivoire
| | - Ehab F Moustafa
- Department of Tropical Medicine and Gastroenterology, Assiut University Hospital, Assiut Governorate, Egypt
| | - Sahar M Hassany
- Department of Tropical Medicine and Gastroenterology, Assiut University Hospital, Assiut Governorate, Egypt
| | - Abdelmajeed M Moussa
- Department of Tropical Medicine and Gastroenterology, Assiut University Hospital, Assiut Governorate, Egypt
| | - Rose A Ugiagbe
- Department of Medicine, University of Benin Teaching Hospital, Benin City, Nigeria
| | - Casimir E Omuemu
- Department of Medicine, University of Benin Teaching Hospital, Benin City, Nigeria
| | - Richard Anthony
- Department of Internal Medicine, Effia Nkwanta Regional Hospital, Sekondi, Ghana
| | - Dennis Palmer
- Department of Internal Medicine, Mbingo Baptist Hospital, Bamenda, Cameroon
| | - Albert F Nyanga
- Department of Internal Medicine, Mbingo Baptist Hospital, Bamenda, Cameroon
| | - Abraham O Malu
- Department of Medicine, Benue State University Teaching Hospital, Benue, Nigeria
| | - Solomon Obekpa
- Department of Medicine, Benue State University Teaching Hospital, Benue, Nigeria
| | | | | | - Hatim M Y Mudawi
- Department of Internal Medicine, University of Khartoum, Khartoum, Sudan
| | - Uchenna Okonkwo
- Department of Internal Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Mbang Kooffreh-Ada
- Department of Internal Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Yaw A Awuku
- Department of Internal Medicine, School of Medical Sciences, Cape Coast, Ghana
| | - Yvonne A Nartey
- Department of Internal Medicine, School of Medical Sciences, Cape Coast, Ghana
| | - Elizabeth T Abbew
- Department of Internal Medicine, School of Medical Sciences, Cape Coast, Ghana
| | - Nana A Awuku
- Department of Internal Medicine, School of Medical Sciences, Cape Coast, Ghana
| | | | | | - Hailemichael M Desalegn
- Department of Internal Medicine, St. Paul's Hospital Millenium Medical College, Addis Ababa, Ethiopia
| | - Abidemi E Omonisi
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Akande O Ajayi
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Edith N Okeke
- Department of Medicine, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Mary J Duguru
- Department of Medicine, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Pantong M Davwar
- Department of Medicine, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Michael C Okorie
- Department of Medicine, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Shettima Mustapha
- Department of Medicine, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria
| | - Jose D Debes
- Department of Medicine, University of Minnesota, MN, USA; Department of Medicine, Arusha Lutheran Medical Center, Arusha, Tanzania
| | - Ponsiano Ocama
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Olufunmilayo A Lesi
- Division of Gastroenterology and Hepatology, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Emuobor Odeghe
- Division of Gastroenterology and Hepatology, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Ruth Bello
- Department of Medicine, Dalhatu Araf Specialist Hospital, Lafia, Nigeria
| | - Charles Onyekwere
- Department of Medicine, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Francis Ekere
- Department of Medicine, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Rufina Igetei
- Department of Medicine, Lagos State University Teaching Hospital, Lagos, Nigeria
| | | | - Benyam Addissie
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Hawa M Ali
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Gregory J Gores
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Mark D Topazian
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Lewis R Roberts
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
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Iroezindu MO, Daniyam CA, Agbaji OO, Isa ES, Okeke EN, Imade GE. Prevalence of hepatitis B e antigen among human immunodeficiency virus and hepatitis B virus co-infected patients in Jos, Nigeria. J Infect Dev Ctries 2013; 7:951-9. [PMID: 24334942 DOI: 10.3855/jidc.2747] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Revised: 04/29/2013] [Accepted: 04/27/2013] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Human immunodeficiency virus (HIV) negatively impacts the natural history of hepatitis B virus (HBV) infection, including replication. We determined the prevalence of HBeAg in HIV/HBV co-infected patients compared to HBV mono-infected controls and further investigated the relationship between HBeAg seropositivity and the degree of HIV-induced immunosuppression in co-infected patients. METHODOLOGY The study design was cross-sectional. One hundred HBsAg-positive HIV-infected adults and 100 age and sex matched HBsAg-positive HIV negative controls were consecutively recruited between May and November 2010. Relevant demographic and HBV-related information was obtained. HBeAg was assayed by semi-quantitative third generation ELISA. The HIV/HBV co-infected patients also had CD4+ cell and HIV viral load quantification measured using flow cytometry and polymerase chain reaction techniques respectively. RESULTS In each group, the mean age was 34 ± 8 years and the majority (61%) was female. The prevalence of HBeAg was significantly higher among co-infected patients (n = 28; 28%) than in the controls (n = 15; 15%; p = 0.03). HBeAg seropositivity was independently associated with age < 40 years (AOR = 2.83, 95% = CI 1.29-6.17) and HIV seropositivity (AOR = 2.44, 95% C.I = 1.17-5.07). The prevalence of HBeAg was significantly higher in co-infected patients with CD4 cell count < 200 cell/µL (41.3%) compared to those with 200-499 cell/µL (18.6%) and ≥500 cell/µL (9.1%), p = 0.006. CONCLUSION HIV/HBV co-infected patients have a significantly higher prevalence of HBeAg than HBV mono-infected individuals. HBV-infected patients should be routinely assessed for HBeAg, especially if they are co-infected with HIV.
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Affiliation(s)
- Michael O Iroezindu
- Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria.
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Iroezindu MO, Agaba EI, Daniyam CA, Okeke EN, Agbaji OO, Agaba PA, Imade GE, Idoko JA. Association of HIV-Induced Immunosuppression and Clinical Malaria in Nigerian Adults. Afr J Infect Dis 2013; 6:48-53. [PMID: 23878715 DOI: 10.4314/ajid.v6i2.4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Despite the growing body of evidence on the interaction between HIV and malaria in sub-Saharan Africa, there is a dearth of data on clinical malaria in HIV-infected patients in Nigeria. We determined the burden of clinical malaria in HIV-infected adult Nigerians and further investigated the association between their immunological status and the rates of clinical malaria. Ninety seven antiretroviral treatment-naïve HIV-infected adults were enrolled in a cross-sectional study from August to December, 2009. The participants had a complete clinical evaluation, thick and thin blood films for malaria parasites and CD4 cell count quantification. Clinical malaria was defined as having fever (temperature ≥ 37.5°C or history of fever within 48 hours) and a malaria parasite density above the median value obtained for subjects with co-existing fever and parasitaemia. Clinical malaria was diagnosed in 10 out of 97 patients (10.3%). Lower CD4 cell counts were associated with increasing rates of clinical malaria which was 0% at CD4 cell count of ≥ 500, 2.6% at 200-499 and 30% at <200 cells/µL (χ(2) = 18.3, p = 0.0001). This association remained significant after controlling for other factors in a multivariate analysis (AOR=22.98, 95% C.I: 2.62-20.14, p = 0.005). An inverse relationship between CD4 cell count and parasite density was demonstrated (regression co-efficient = - 0.001, p = 0.0002). More aggressive malaria control measures are highly needed in severely immunosuppressed HIV-infected patients.
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Agaba PA, Agaba EI, Ocheke AN, Daniyam CA, Akanbi MO, Okeke EN. Awareness and knowledge of human immunodeficiency virus post exposure prophylaxis among Nigerian Family Physicians. Niger Med J 2013; 53:155-60. [PMID: 23293417 PMCID: PMC3531036 DOI: 10.4103/0300-1652.104386] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background: To determine the level of awareness and knowledge of HIV postexposure prophylaxis (HIV PEP) and determinants of adequate knowledge among Family Physicians in Nigeria. Materials and Methods: This was a cross-sectional questionnaire-based survey conducted among 175 Family Physicians at two national conferences. Results: Majority (97.7%) of the respondents was aware of the concept of HIV PEP and 99.4% believed it was effective in preventing HIV transmission. Over two third of our respondents had been exposed to NSI; however, less than 25% of those exposed received PEP. There was high level of knowledge of the various high-risk body fluids as well as types of high-risk exposures. 93.9% of our respondents knew that HIV PEP should commence within 1 h of exposure, 83.3% knew the correct duration of HIV PEP, but only 57.0% knew the ideal PEP regimen for high-risk exposures. The total mean score for our respondents was 17.8±2.9 with 79.4% having an adequate score. Being a junior doctor and male sex were associated with adequate knowledge. Conclusion: This study shows that despite high levels of awareness and knowledge of HIV PEP, access to its use among family physicians in Nigeria is still sub-optimal.
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Affiliation(s)
- Patricia A Agaba
- Department of Family Medicine, University of Jos, Jos, Nigeria ; Department of Family Medicine, AIDS Prevention Initiative Nigeria Plus, Jos University Teaching Hospital, Jos, Nigeria
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Iroezindu MO, Agaba EI, Okeke EN, Daniyam CA, Obaseki DO, Isa SE, Idoko JA. Prevalence of malaria parasitaemia in adult HIV-infected patients in Jos, North-central Nigeria. Niger J Med 2012; 21:209-213. [PMID: 23311193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV) and malaria co-infection has become an important public health problem in sub-Saharan Africa. Data on HIV and malaria interaction in Nigerian adults is scanty. We determined the prevalence of malaria parasitaemia in HIV-infected adults and further investigated the role of immune status in the HIV/malaria association. METHODS This was a cross-sectional study involving 100 newly-diagnosed HIV-infected adults and 100 age and sex-matched HIV negative controls. Malaria parasitaemia was diagnosed by blood film microscopy using Giemsa staining technique and was defined as the presence of malaria parasites irrespective of species or parasite density. HIV infection was confirmed by western blot assay and CD4 T-lymphocyte count of the HIV-infected patients was quantified by flow cytometry. RESULTS The prevalence of malaria parasitaemia was higher in HIV-infected adults (24%) than in the controls (9%) (chi2 = 8.17, p = 0.04). Participants residing in rural areas had higher prevalence of malaria parasitaemia than urban dwellers both for HIV-infected patients (34.1% Vs. 16.1%, chi2 = 4.3, p = 0.04) and controls (18.4%, Vs. 6.5%, chi2 = 3.4, p = 0.04). HIV-infected male patients tended to have malaria parasitemia more than their female counterparts (33.3% Vs. 17.2%, chi2 = 3.4, p = 0.06). Among HIV-infected patients, the prevalence of malaria parasitaemia progressively increased at lower CD4 cell counts, 10.3% for CD4 cell count of = 500, 17.5% for 200-499 and 45.2% for < 200 cells/microL (chi2 = 11.5, p = 0.003). CONCLUSION HIV is likely to fuel malaria infection in tropical countries where both diseases are endemic. Malaria control practices should be further intensified in HIV-infected populations.
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Akanbi MO, Ocheke AN, Agaba PA, Daniyam CA, Agaba EI, Okeke EN, Ukoli CO. Use of Electronic Health Records in sub-Saharan Africa: Progress and challenges. J Med Trop 2012; 14:1-6. [PMID: 25243111 PMCID: PMC4167769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND The Electronic Health Record (EHR) is a key component of medical informatics that is increasingly being utilized in industrialized nations to improve healthcare. There is limited information on the use of EHR in sub-Saharan Africa. This paper reviews availability of EHRs in sub-Saharan Africa. METHODS Searches were performed on PubMed and Google Scholar databases using the terms 'Electronic Health Records OR Electronic Medical Records OR e-Health and Africa'. References from identified publications were reviewed. Inclusion criterion was documented use of EHR in Africa. RESULTS The search yielded 147 publications of which 21papers from 15 sub-Saharan African countries documented the use of EHR in Africa and were reviewed. About 91% reported use of Open Source healthcare software, with OpenMRS being the most widely used. Most reports were from HIV related health centers. Barriers to adoption of EHRs include high cost of procurement and maintenance, poor network infrastructure and lack of comfort among health workers with electronic medical records. CONCLUSION There has been an increase in the use of EHRs in sub-Saharan Africa, largely driven by utilization by HIV treatment programs. Penetration is still however very low.
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Affiliation(s)
- Maxwell O. Akanbi
- Department of Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - Amaka N. Ocheke
- Department of Obstetrics and Gynecology, University of Jos, Nigeria
| | - Patricia A. Agaba
- AIDS Prevention Initiative Nigeria Plus, Jos University Teaching Hospital, Jos, Nigeria
| | | | - Emmanuel I. Agaba
- Department of Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - Edith N. Okeke
- Department of Medicine, Jos University Teaching Hospital, Jos, Nigeria
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Daniyam CA, Malu AO, Okeke EN, Lawal OO. Bowel habits of urban and rural populations on the Jos, Plateau, Nigeria. West Afr J Med 2011; 30:182-187. [PMID: 22120483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Constipation and diarrhoea are frequent complaints amongst patients attending Gastroenterology Clinics. The normal bowel habits may vary among populations. OBJECTIVE To characterise and compare the bowel habits of rural and urban dwellers in a Nigerian population. METHODS Questionnaires were administered to 1236 adults aged 16 years and above recruited from two communities (rural and urban) using a two stage cluster sampling scheme based on existing administrative set up in a cross-sectional study. Information sought included socio-demographics, alcohol consumption, bowel habits and level of physical activity. RESULTS Adequate data for analysis were available in 1017 subjects giving a response rate of 509(93.1%) and 508(87.7%) for rural and urban populations respectively. The mean weekly bowel frequencies for the rural and urban populations were 10.8 ± 5.1 and 9.7 ± 4.9 (p=0.09) respectively. Four hundred and ninety-four (97%) subjects from the rural community and 493 (97%) from the urban opened their bowels between three times per day to three times per week. Constipation as identified by the passage of three or less motions per week was present in 14 (2.8%) of urban dwellers compared to 4 (0.8%) of the rural (p = 0.01). Bowel motions were more frequent in males than in females. CONCLUSION Bowel opening appears slightly more frequent among rural plateaus inhabitants than in urban dwellers. Constipation is more common in the urban than in the rural area.
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Affiliation(s)
- C A Daniyam
- Department of Medicine, Jos University Teaching Hospital, Jos, Nigeria.
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Okeke EN, Ladep NG, Adah S, Bupwatda PW, Agaba EI, Malu AO. Prevalence of irritable bowel syndrome: a community survey in an African population. Ann Afr Med 2010; 8:177-80. [PMID: 19884695 DOI: 10.4103/1596-3519.57241] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) has been reported to be common in the West. Community surveys are lacking in the African setting. We determined the prevalence of IBS in a rural community setting in Nigeria. METHOD Questionnaires were administered to consenting individuals. Subjects satisfying the Rome II criteria for IBS were invited for physical examination at a health center to identify the presence of "alarm factors." RESULTS One hundred forty (31.6%) of the 443 evaluated individuals fulfilled the Rome II criteria for IBS, with a male-to-female ratio of 1.37:1 (P= .11). The prevalence of IBS was highest (39.3%) in the third decade, followed by 25% in the fourth decade (P= .009). Ninety-six (67%) IBS individuals had the alternating pattern of diarrhea and constipation, whereas 28 (20%) and 19 (13%) had constipation and diarrhea subtypes, respectively. CONCLUSION IBS as diagnosed by the Rome II criteria has a high prevalence in the African rural population, as obtained elsewhere.
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Affiliation(s)
- Edith N Okeke
- Department of Medicine, Faculty of Medical Sciences, University of Jos, Plateau State, Nigeria.
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Ladep NG, Ugiagbe RA, Okonkwo U, Okeke EN, Malu AO. Early virologic response to pegylated interferon in chronic hepatitis B infection. Niger J Med 2010; 18:330-1. [PMID: 20120656 DOI: 10.4314/njm.v18i3.51209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Early virologic response to pegylated interferon in the treatment of chronic hepatitis B infection is not frequently reported. METHOD The case notes of the patients was retrieved and relevant data extracted, literature review was done using Medline. RESULT A report of a case of early virologic response in a 62 year old man with chronic hepatitis B infection, receiving pegylated interferon is presented with a review of the relevant literature. He had HBV DNA level assessed by PCR and histology of liver biopsy specimen. CONCLUSION Clinicians should be on the lookout for early virologic response to pegylated interferon and the eventual outcome of such early response.
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Affiliation(s)
- N G Ladep
- Department of Medicine, University of Jos/JUTH
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Samaila AA, Malu AO, Okeke EN, Agatha EA. <i>Helicobacer pylori</i> detection using local (in-house) rapid Urease reagent in Jos, Nigeria. Sahel Med J 2009. [DOI: 10.4314/smj2.v11i3.12978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Okeke EN, Ladep NG, Agaba EI, Malu AO. Hepatitis B vaccination status and needle stick injuries among medical students in a Nigerian university. Niger J Med 2008; 17:330-2. [PMID: 18788262 DOI: 10.4314/njm.v17i3.37404] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Hepatits B virus (HBV) is the most common blood borne pathogen that poses an occupational risk to Health-care workers. The incidence of infection following needle stick injury has been reported to be high among medical students. Effective vaccines against HBV are available. The aim of this study was to determine the vaccination status and prevalence of needlestick injury among medical students in a tertiary institution in a developing country (Nigeria). METHOD Information regarding hepatitis B status, history of needlestick injury and awareness of risk factors for HBV were obtained from clinical medical students using a self administered questionnaire. Three hundred and forty six students responded. RESULTS Three hundred and five (88.7%) agreed that medical education exposes one to HBV infection and 315 (91.6%) were aware of the availability of vaccine against HBV. Only 42 (47.7%) were vaccinated against HBV. Majority (57.4%) gave lack of opportunity as reason for non immunization while 34.7% had never given it a thought. One hundred and sixty-six (48%) of the respondents admitted to a previous needlestick injury and only 17 (10.2%) of those who reported history of needlestick injury had post-exposure prophylaxis against HBV infection. CONCLUSION HBV vaccination status is very low among medical students in Nigeria and the prevalence of needle stick injuries is high. Universities must not only provide HBV vaccination free of charge but also enforce its use by these students.
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Affiliation(s)
- E N Okeke
- Department of Medicine, Jos University Teaching Hospital, Jos, Nigeria.
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Ladep NG, Sule J, Umar SM, Obienu O, Anyanechi C, Okeke EN. Oesophageal variceal band ligation using a saeed six-shooter multiband ligator; experience at Jos University Teaching Hospital, Nigeria: case report. Niger J Med 2008; 17:110-1. [PMID: 18390146 DOI: 10.4314/njm.v17i1.37368] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Oesophageal varices are common sequelae of cirrhosis, which when they bleed can be difficult to control. Oesophageal variceal band ligation, being the best modality for controlling variceal bleeding has not been common practice in West Africa, a region recognized to have a high prevalence of liver diseases. We present a case of band ligation of the varices of a patient that presented to our hospital with variceal haemorrhage, secondary to liver cirrhosis. METHOD We started by presenting a summary of the presentation of a 31 year old man at the Jos University Teaching Hospital and how we established the diagnosis of grade IV bleeding oesophageal varices. The subject had four bands applied to the oesophageal varices using a saeed six shooter oesophageal Multi-band ligator (North Carolina, USA) using a forward-viewing GIF P30 gastroscope (Tokyo, Japan) with the bands mounted on an Opti-vu barrel-shaped piece. He had a total of three sessions after which he was maintained on propranolol. RESULT The last recheck endoscopy demonstrated obliterated varices after which he was maintained on propranolol. CONCLUSION We present a case of successful variceal band ligation of a cirrhotic with extensive oesophageal varices presenting in a resource-constraint medical setting.
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Affiliation(s)
- N G Ladep
- Department of Medicine, Jos University Teaching Hospital, Jos, Plateau State, Nigeria.
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Ladep NG, Okeke EN, Samaila AA, Agaba EI, Ugoya SO, Puepet FH, Malu AO. Irritable bowel syndrome among patients attending General Outpatients' clinics in Jos, Nigeria. Eur J Gastroenterol Hepatol 2007; 19:795-9. [PMID: 17700266 DOI: 10.1097/meg.0b013e3282202ba5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Irritable bowel syndrome (IBS) is a common disorder in the Western world. Its prevalence is yet to be fully determined in the African setting. This was a cross-sectional study of patients attending three General Outpatient clinics in Jos, Nigeria. Four hundred and eighteen randomly selected patients were interviewed using a structured questionnaire based on the Rome II diagnostic criteria for IBS. Excluded from the study were patients with established organic disease, memory problems, and pregnant women. Eighteen patients were excluded based on these criteria and 400 were analysed using Epi Info 2000 (Atlanta, Georgia, USA) statistical computer software. One hundred and thirty-two (33%) out of the 400 patients fulfilled the criteria for the diagnosis of IBS, the female to male ratio being 1.13 : 1. IBS was significantly associated with increasing age (P=0.03) and depression (P<0.001). The prevalence of IBS is high among patients attending primary care in the African setting with depression being the likely reason for seeking care.
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Affiliation(s)
- Nimzing G Ladep
- Department of Medicine, University of Jos and Jos University Teaching Hospital, Plateau State, Nigeria.
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Echejoh GO, Mandong BM, Tanko MN, Manasseh AN, Okeke EN, Agaba EI. Hepatic histopathological findings in HIV patients at postmortem in Jos university teaching hospital, Nigeria. Trop Doct 2006; 36:228-31. [PMID: 17034701 DOI: 10.1258/004947506778604832] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Multi-organ involvement by opportunistic infections and neoplasms is the major cause of morbidity and mortality in people living with HIV/AIDS. We determined the spectrum/frequency of hepatic histopathological lesions in a prospective study of postmortem liver biopsies from 100 patients (50 females and 50 males, age range 18-55 years) who died from HIV/AIDS in Jos university teaching hospital, Nigeria. The majority of the patients, 65 (65%), had clinical tuberculosis. Granulomatous hepatitis, chronic hepatitis, non-specific reactive hepatitis (NSRH) and steatosis were the commonest hepatic histopathologic lesions occurring in 34, 20,15 and 12% of patients, respectively. Seven (7%) had normal histological features. This study shows that the liver is affected in HIV/AIDS as reported elsewhere in the world. Therefore, liver biopsy in HIV patients may be helpful in the management of these patients.
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Affiliation(s)
- Godwins O Echejoh
- Department of Anatomic Pathology, Jos University Teaching Hospital, Jos, Plateau State, Nigeria.
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Abstract
BACKGROUND To investigate the prevalence of oral manifestations of HIV/AIDS involving HIV positive Plateau State indigenous adults attending a Special Treatment Clinic serving referred cases and in-patient cases hospitalized in the Medical wards in JUTH, Jos. STUDY DESIGN A cross-sectional study. RESULTS A total of 261 patients confirmed for HIV infection were examined. The age range was 17 - 80 years, mean = 35.6 +/- 9.27 (SD). 59.4% were females and 40.6% were males. Oral lesions attributable to HIV/ AIDS infection were found in 109 (41.8%) patients, 38 (34.9%) of these patients had multiple lesions. Oral lesions were diagnosed more frequently in women (59.6%) than in men (p=0.945). Oral candidiasis was the most common presentation (35.7%) with pseudomembraneous candidiasis (23%) and angular cheilitis (10%) being the most common variants. All the cases of erythematous candidiasis (n=7) were exclusively seen in the female population. Oral hairy leukoplakia and xerostomia were present in 4.6% and 3.8% of cases respectively. Kaposi's Sarcoma was in 5 (1.9%) patients. CONCLUSION The prevalence of HIV-related oral lesions (HIV-ROL) in a hospital based adult population of Plateau State indigenes in Jos is 41.8%. Oral Candidiasis is the most common HIV-ROL detected and this agrees with most reported findings.
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Affiliation(s)
- O O Taiwo
- Regional Centre for Oral Health Research and Training Initiatives for Africa, Jos, P.M.B. 2067, Jos, Plateau State, Nigeria.
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Abstract
BACKGROUND Human immunodeficiency virus (HIV) infection affects an increasing number of women throughout the world. Oral lesions are among the earliest clinical manifestations of HIV infection and are associated with its progression. We describe the oral manifestations of HIV/AIDS in Nigerian women and its clinical correlates. METHODS Nigerian women with HIV/AIDS were examined for the presence of oral lesions attributable to HIV/AIDS. These lesions were diagnosed clinically, according to the criteria established by the European Community Clearinghouse (ECC) on oral problems related to HIV infection. RESULTS Two hundred and sixty-nine seropositive women were examined with a range of 17-60 years (mean of 32.4 years < 8.09). The age group of 21 30 years was the worst affected (n = 125, 46.5%). Of these patients, 109 (40.5%) were married, 67 (24.9%) were single while 47 (17.5%) had multiple sexual partners. One hundred and eighteen (43.9%) had at least an oral lesion associated with HIV/AIDS. The most common was oral candidiasis, which was present in 98 (36.4%) patients. Pseudomembraneous candidiasis (n = 66, 24.5%) and angular cheilitis (n = 23, 8.6%) were the commonest variants seen. The former was the only lesion significantly associated with the clinical stage of the infection (p = 0.002) while necrotizing gingivitis, linear gingival erythema and angular cheilitis were associated with the age of the patients (p < 0.05). CONCLUSION Oral manifestations are common features of HIV infection among Nigerian women. Oral candidiasis (OC) was the most notable oral lesion associated with HIV/AIDS. It may be a useful clinical indicator of early immune dysfunction mediated by HIV.
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Affiliation(s)
- O O Taiwo
- Regional Centre for Oral Health Research and Training, Initiatives (RCORTI) for Africa, Jos. PMB 2067 Jos Plateau State
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Okeke EN, Agaba EI, Gwamzhi L, Achinge GI, Angbazo D, Malu AO. Prevalence of irritable bowel syndrome in a Nigerian student population. Afr J Med Med Sci 2005; 34:33-6. [PMID: 15971551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Irritable bowel syndrome (IBS) is a widely recognized disorder accounting for up to 50% of referrals to gastroenterologists in the Western world. Existing literature had suggested that its prevalence is low among native Africans. The objective [corrected] is to document the prevalence of IBS in this environment. A cross-sectional study of clinical students at the Jos University Medical School and the School of Medical Laboratory Technology in Jos University were cohorted. Questionnaires based on the Rome II criteria were administered to 330 students (221 males and 109 females). Irritable bowel syndrome was present in 86 (26.1%) of the subjects, being present in 58 (26.4%) of the males and 28 (25.7%) of the females respectively (OR 0.97, 95% CI 0.57-1.63, p = 0.89). The mean age of subjects with IBS was 26.3 +/- 4.0 years and that of subjects without IBS was 26.5 +/- 3.8 years, p = 0.6. The majority (54.8%) of the subjects did not consider their symptoms as illness and therefore did not seek any form of care. More males sought medical care compared to females (19.6% vs. 3.6% respectively, p = 0.02). Depressive symptoms were present in 21 (24.4%) of subjects with IBS compared to 36 (14.8%) of those without (p = 0.06). Irritable bowel syndrome is a common disorder in the student population of a medical school in Northern Nigeria.
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Affiliation(s)
- E N Okeke
- Department of Medicine, University of Jos, Jos, Plateau State, Nigeria.
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Okeke EN, Agaba EI, Achinge GI, Malu AO. Upper gastrointestinal endoscopic findings in patients with HIV/AIDS at the Jos University Teaching Hospital, Nigeria. Niger J Med 2003; 12:202-5. [PMID: 14768194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Upper gastrointestinal tract involvement in HIV/AIDS is common. No data exist on the pattern of upper gastrointestinal endoscopic findings in HIV/AIDS patients in Nigeria. OBJECTIVE To describe the pattern of upper gastrointestinal endoscopic findings in HIV/AIDS patients. DESIGN A hospital based retrospective case-control study involving 52 HIV/AIDS patients and 52 age and sex matched controls. SETTING Medicine Department of the Jos University Teaching Hospital, Nigeria. METHODS Medical records of patients with HIV/AIDS and an age and gender matched control who underwent upper gastrointestinal endoscopy over an eight-year period were reviewed. RESULTS Oesophageal candidiasis was the commonest finding in 18 (34.6%) of subjects with HIV/AIDS followed by normal upper gastrointestinal tract in 17 (32.1%). Normal upper gastrointestinal tract was found in 57.6% of HIV seronegative subjects while oesophageal candidiasis occurred in one (1.9%) of these patients. Duodenal ulcer and gastritis occurred with equal frequencies in HIV/AIDS patients (7.5%) and controls. CONCLUSION Oesophageal candidiasis was the commonest upper gastrointestinal endoscopic finding in patients with HIV/AIDS.
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Affiliation(s)
- E N Okeke
- Department of Medicine, Faculty of Medical Sciences, University of Jos, Nigeria
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Okeke EN, Malu AO, Obafunwa JO, Nwana EJC. Aetiological significance of alcohol in liver cirrhosis on the Jos Plateau. West Afr J Med 2002; 21:12-4. [PMID: 12081334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Fifty-one patients with histologically diagnosed cirrhosis were studied prospectively over one year period. There were forty-one males and ten females. The majority of patients (75.59%) took alcohol in significant quantity and it was thought to be the most likely cause of the cirrhosis in them. Eighty percent of them had micronodular cirrhosis and 51.3% of them drank only "burukutu" a local alcoholic brew brewed mostly in iron pots and contains two other hepatotoxic agents--aflatoxin and iron. Eight (5.7%) of the patients and five (9.8%) of controls were positive for hepatitis B surface antigen (HBs.Ag). It is likely that alcohol is very important cause of cirrhosis of the liver seen in Jos.
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Affiliation(s)
- E N Okeke
- Department of Medicine, Jos University Teaching Hospital, Nigeria
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Rocha AM, Rocha GA, de Magalhães Queiroz DM, Ani AE, Okeke EN, Bello CS, Malu AO. Anti-CagA antibodies in Helicobacter pylori-positive patients and blood donors from Nigeria. Trop Doct 2001; 31:147-9. [PMID: 11444335 DOI: 10.1177/004947550103100310] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The prevalence of antibodies to CagA protein was evaluated in 174 Helicobacter pylori-positive. subjects: 110 patients submitted to upper gastrointestinal endoscopy and 64 male blood donors. The patients were from different regions of Nigeria: Jos, North, Benue,West and East and the blood donors were from Jos. Sera were assayed for anti-CagA antibodies using Helicobacter p120, CagA ELISA (Viva Diagnostika, Hürth, Germany). Anti-CagA antibodies were detected in 104 (94.5%) patients and in 61 (95.3%) blood donors (P=1.0). Patients from the Benue region presented a lower frequency of anti-CagA antibodies than patients from the other regions (P=0.0004). When the subjects were stratified by age, a significant increase in IgG concentration was observed among the men (P=0.03) but not among the women (P=0.57) or among the blood donors (P=0.83). In conclusion, similarly toAsian countries, CagA-positive H. pylori infection is highly frequent in Nigeria.
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Affiliation(s)
- A M Rocha
- Laboratory of Research in Bacteriology, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Tanyigna KB, Ayeni JA, Okeke EN, Onah JA, Bello CS. Antibody levels to Salmonella typhi and paratyphi in Nigerians. East Afr Med J 1999; 76:623-5. [PMID: 10734521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
OBJECTIVE To determine the antibody titre levels to typhoid/paratyphoid fever organisms among apparently healthy volunteers. DESIGN Cross sectional study. SETTING General community and University Teaching Hospital. PARTICIPANTS Volunteer sample of 323 apparently healthy individuals with body temperatures < or = 37.8 degrees C. MAIN OUTCOME MEASURES Questionnaire administration to classify volunteers into three socio-economic status (SES). RESULTS There were 35.29% of the apparently healthy population in Jos community with antibodies to typhoid/paratyphoid fever organisms. The presence of these antibodies were neither sex nor SES related. Normal antibody titres were up to 1:40 and 1:80 for O and H Salmonella antigens respectively. Contrary to the general belief, typhoid/paratyphoid fevers have not affected virtually everybody in Nigeria. The difference between those without previous history and those with previous history was significant (p < 0.05) with those in the former category having a higher percentage. CONCLUSION For a single sero-diagnosis to have any diagnostic value in Jos community and its environs, only a four-fold rise to what has been found to be normal should be significant. This means that only titres of 1:160 and 1:320 and above for O and H antigens should be considered significant.
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Affiliation(s)
- K B Tanyigna
- Department of Medical Microbiology, Faculty of Medical Sciences, University of Jos, Nigeria
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Okeke EN, Juryit Z, Ikeh EI. Open clinical trial of roxithromycin in patients of Plateau Hospitals, Jos in upper and lower respiratory tract infections. West Afr J Med 1995; 14:238-41. [PMID: 8634230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
An open clinical study to assess the efficacy and tolerance of Roxithromycin 150 mg twice daily was carried out amongst Nigerian patients with upper and lower respiratory tract infections at Plateau Hospital Jos. Twenty-two patients aged between 13 and 86 years comprising of twelve women, seven men and three children completed the study. 18 (81.8%) had bronchopulmonary infections, 3 (13.6%) had tonsillitis and 1 (4.6%) had otitis media. Pathogens isolated included streptococcus Pneumonia (22.7%), Streptococcus pyogenes (13.6%), Bramhella Catarrhalis (9.1%), Haemophilus influenzae (9.1%), Staphylococcus Aureus (4.6%), Klebsiella species (4.6%), Pseudomonas Aeruginosa (4.6%). There was 88.2% bacteriological cure and patients responded fast, with no major adverse reactions. Roxithromycin is therefore concluded to be an effective well tolerated drug for treatment of respiratory tract infections in Nigerians.
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Affiliation(s)
- E N Okeke
- Department of Medicine, Plateau Hospital, Jos
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Abstract
Two hundred and forty-three Nigerian patients referred for endoscopy at the Jos University Teaching Hospital in Nigeria were studied. Their overall mean age was 37.7 years (SD 12.7), among those with ulcers it was 38.4 years. The male:female ratio was equal in general, but among those with ulcers it was 2:1. Duodenal and gastric ulcers were found in 42(17.3%) and 12(4.9%) patients respectively, ratio of 3.5:1. There were 3 patients each with oesophageal and gastric carcinoma. Our findings do not support the belief that the savannah region of West Africa is an area of low prevalence of peptic ulcer disease. In the light of the importance of Helicobacter pylori infection in the pathogenesis of gastroduodenal diseases and the apparent discrepancy between its prevalence and that of associated diseases in the developing countries, there is a need to reappraise our traditional beliefs about the epidemiology of these diseases, using similar methods to those used in developed countries.
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Affiliation(s)
- A O Malu
- Department of Medicine, Jos University Teaching Hospital, Nigeria
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Okeahialam BN, Okeke EN. Chloroquine-resistant malaria in Jos, Nigeria. J Trop Med Hyg 1989; 92:365-6. [PMID: 2681816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A 16-year-old Nigerian boy who had lived all his life in a malaria endemic region presented with continuing fever after what would ordinarily be accepted as adequate treatment for malaria. He went on to develop cerebral malaria, recovering only after administration of quinine.
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Affiliation(s)
- B N Okeahialam
- Department of Medicine and Radiology, Jos University Teaching Hospital, Plateau State, Nigeria
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Nawathe DR, Banerjee I, Okeke EN, Tiyagnet JN. Production and use of avianised rabies vaccine in Nigeria. Int J Zoonoses 1981; 8:1-4. [PMID: 7333781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Okeke EN. A survey of rinderpest-like diseases in northern Nigeria: preliminary serological evidence for the occurrence of bovine virus diarrhoea. Bull Anim Health Prod Afr 1976; 24:5-8. [PMID: 215250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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