Health-related quality of life in asthma measured by the World Health Organization brief questionnaire (WHO-BREF) and the effect of concomitant allergic rhinitis-A population-based study.

BACKGROUND AND OBJECTIVE: The impact of allergic rhinitis (AR), a common comorbidity in asthma, on global quality of life (QoL) using generic QoL questionnaires has not been extensively evaluated. METHODS: This was a cross-sectional population-based study among adults ≥18 years old. Generic QoL was measured using the World Health Organization (WHO) questionnaire (WHOQOL-BREF), and asthma control was assessed using the Asthma Control Test. Participants were categorized into four groups: Group 1 (No asthma, no AR), Group 2 (Asthma only), Group 3 (AR only) and Group 4 (Concomitant asthma and AR). The student t-test or the ANOVA was used for comparison between groups and based on the level of asthma control. Linear regression was used to assess the association between the level of asthma control and QoL scores, adjusted for age and sex. A p-value of less than 0.05 was considered significant for all associations. RESULTS: There were 9115 participants; 906 (9.9%) had asthma, and 1998 (21.9%) had AR. The lowest QoL scores were in the environment domain. Mean QoL scores were significantly lower in asthma compared to 'no asthma' and in AR compared to 'no AR'. Either asthma or rhinitis (Group 2 or 3) had significantly lower scores compared to no disease (Group 1) only in the environment domain, but the concomitant disease (Group 4) had lower scores across all categories and domains. Scores were significantly lower for uncontrolled asthma compared to controlled asthma and for 'concomitant asthma and AR' compared to 'asthma only'. Increasing age and uncontrolled asthma predicted worse health-related quality of life (HRQoL) consistently. CONCLUSION: Although asthma and AR negatively impact HRQoL independently, concomitant asthma and AR are worse. Uncontrolled asthma underpins poor QoL in asthma because QoL is not impaired in controlled disease. This underscores the need for recognition and treatment of AR in asthma and reinforces the benefits of achieving asthma control as a priority in asthma treatment.

The prevalence of asthma and allergic rhinitis in Nigeria: A nationwide survey among children, adolescents and adults.

PURPOSE: Asthma is an important cause of morbidity and mortality worldwide and information on the prevalence of asthma in Nigeria is inconsistent. Nationally representative data, important for health planning is unavailable. We aimed to determine the current prevalence of asthma and allergic rhinitis in Nigeria. MATERIALS AND METHODS: A cross-sectional population survey conducted between June 2017 and March 2018 across five cities representing five geo-political zones in Nigeria. Validated screening questionnaires were used to identify persons with asthma and allergic rhinitis respectively. Asthma was defined as physician diagnosed asthma, clinical asthma and by presence of wheeze in the last 12 months respectively. Socio-demographic information, tobacco smoking, sources of household cooking fuel were also obtained. RESULTS: A total of 20063 participants from 6024 households were screened. The prevalence (95% confidence interval) of physician diagnosed asthma, clinical asthma and wheeze was 2.5% (2.3-2.7%), 6.4% (6.0-6.64%) and 9.0% (8.6-9.4%) respectively. The prevalence of allergic rhinitis was 22.8% (22.2-23.4%). The prevalence of asthma and rhinitis increased with age (prevalence of clinical asthma: 3.1% (2.8-3.4%), 9.8% (9.1-10.5) and 10.7% (9.4%-12.0) among 6-17 years, 18-45 years and >45 years respectively). Prevalence also varied across different cities with the highest prevalence of clinical asthma occurring in Lagos (8.0%) and the lowest in Ilorin (1.1%). The frequency of allergic rhinitis among persons with clinical asthma was 74.7%. Presence of allergic rhinitis, family history of asthma, current smoking and being overweight were independent determinants of current asthma among adults. CONCLUSION: The prevalence of asthma and allergic rhinitis in Nigeria is high with variabilities across regions and age groups. The number of persons with clinical asthma in Nigeria (approximately 13 million) is likely to rank among the highest in Africa. This warrants prioritization by stakeholders and policy makers to actively implement risk reduction measures and increase investment in capacity building for the diagnosis and treatment of asthma and allergic rhinitis.

Asthma management and control in Nigeria: the asthma insight and reality Nigeria (AIRNIG) study.

Background: The state of asthma management and asthma control at the population level in Nigeria is unknown. We aimed to determine the level of asthma control and asthma management practices in Nigeria. Methods: A cross-sectional population-based study of 405 participants with current asthma (physician-diagnosed with use of asthma medication or asthma symptoms in the preceding 12 months). We determined the level of asthma control, self-perception of asthma control, health-care use, missed work/school, and medication use. Results: Asthma was controlled in 6.2% of the participants. Night-time awakening and limitation in activity in the preceding 4 weeks were reported by 77.5% and 78.3%, respectively, 56.3% and 14.1% missed work/school and had emergency room visits, respectively, and 11.6% and 38.8% used inhaled corticosteroid and short-acting beta-2 agonist, respectively, in the preceding year. About a third (34.3%) had spirometry ever performed and 46.7% had training on inhaler technique. Nearly 90% with uncontrolled asthma had self-perception of asthma control between somewhat and completely controlled. Conclusion: The level of asthma control in Nigeria is poor with a high burden of asthma symptoms and limitation in activities. This calls for a broad-based approach for the improvement in asthma care that encompasses education and access to medications.

Respiratory Health Status of Workers in a Bottling Factory in Benin City, Nigeria.

Introduction: There is a paucity of data on the respiratory health status of workers in bottling factories in Benin City, Nigeria. Such data will help to drive future studies and influence policy development on occupational health and safety in the country. This study assesses the respiratory symptoms and spirometric indices of exposed workers and controls. Methods: Respiratory symptoms and spirometric parameters of 18 workers on routine mandatory annual lung screening were assessed using the modified MRC (Medical Research Council) questionnaire and spirometer respectively, according to the European Respiratory Society and American Thoracic Society (ERS/ATS) guidelines. Results: The mean age of workers was 35.1 ± 6.7 years. Workers and controls were similar in age, sex, BMI (Body Mass Index) and health status (p > 0.05). Respiratory symptoms were significantly higher among workers compared to controls. Overall, the result was statistically significant in the variables of wheeze in a smoky or dusty environment, presence of at least one respiratory symptom, better symptoms at weekends and better symptoms during holidays (p < 0.05). In particular, 6 (33.3%) exposed workers had wheeze in a smoky or dusty environment, 9 (50.0%) exposed workers reported at least one respiratory symptom compared with 2 (11.1%) controls, 5 (27.8%) had better symptoms at weekends, and 7 (38.9%) had better symptoms at holidays (p < 0.05). Generally, the reported frequency of respiratory symptoms among exposed workers were: cough (22.2%), sputum production (5.6%), breathlessness (11.1%) and wheeze (44.4%). Similarly, workers had significantly lower spirometric indices than controls, particularly in forced expiratory volume in 1 s (FEV1), FEV1/forced vital capacity (FVC) ratio and forced expiratory flow between 25% and 75% of FVC (FEF 25⁻75%) measurements. Conclusions: This study provides evidence of adverse respiratory health effects among bottling factory workers which requires further investigation.

Screening for diabetes mellitus among tuberculosis patients in Southern Nigeria: a multi-centre implementation study under programme settings.

Implementation studies are recommended to assess the feasibility and effectiveness of programmes. In Nigeria, little is known about the burden of diabetes mellitus (DM) among tuberculosis (TB) patients. The objective of this study was to determine screening efficacy, prevalence of DM and determinants of DM among TB patients. We report on a multi-centre implementation study carried-out in 13 health facilities in six States of Southern Nigeria. All newly diagnosed TB patients registered from March to October 2015 were screened for DM using current World Health Organisation guidelines. Overall, 2094 TB patients were evaluated, 196 (9.4%) were found to have DM. The prevalence of newly diagnosed DM was 5.5% (115/2094). DM prevalence varied according to age group; occurring in 2.2% of patients aged ≤ 25 years and 16.9% in patients aged (56-65) years. The additional yield of DM was 59% while the number needed to screen to detect a new case of DM was 18. Factors associated with DM were; age >40 years (aOR2.8, CI 2.1-3.9), rural residence (aOR2.3, 1.6-3.2), private health facility care (aOR2.0, 1.4-2.7), and having an occupation that engages in vigorous activity (aOR0.6, 0.4-0.9). The burden of DM among TB patients is high. Prioritization of DM screening for TB patients is indicated.

Differences in rates of obstructive lung disease between Africans and African Americans.

OBJECTIVE: The prevalence of obstructive lung disease is rising in the United States, particularly among those of African descent. Rates of ventilatory impairment and reported respiratory symptoms were examined in a cross-sectional study of urban Nigerian civil servants who are in transition to a westernized lifestyle. DESIGN: 410 civil servants (235 men, 175 women) aged 30-69 years in Benin City, Nigeria (West Africa) were recruited for a cross-sectional study on respiratory health and compared to 3,397 African Americans enrolled in NHANES III between 1988 and 1994. METHODS: Forced vital capacity (FVC), expiratory flow rate in 1 sec (FEV1), FEV1/FVC ratio, and peak expiratory flow rate (PEFR) were measured by spirometry. Demographic characteristics and respiratory symptoms were ascertained by questionnaire. RESULTS: Nigerians had lower age and height adjusted FVC and FEV1 than African Americans in both genders, independent of smoking and respiratory disease. However, relative lung function was better among Nigerians. Fewer Nigerians had an age-adjusted FEV1/FVC ratio below 0.70 than African Americans (10.54 vs 14.10/100 men, 6.29 vs 8.67/100 women). Overall, Nigerians had a lower age-adjusted prevalence of any self-reported respiratory symptoms than African Americans (3.65 vs 22.90/100 men, 4.57 vs 35.38/100 women). Similarly, Nigerians had a lower age-adjusted prevalence of current smoking than African Americans (10.82 vs 46.50/100 in men and 0 vs 30.93/100 in women). CONCLUSIONS: Urban Nigerians who have limited exposure to cigarette smoke and who work in a non-industrial setting have a low prevalence of obstructive lung disease.

Anthropometry and menarcheal status of adolescent nigerian urban senior secondary school girls.

BACKGROUND: Age at menarche is a significant indicator of growth and sexual maturation in girls. During adolescence, anthropometry provides a tool for monitoring and evaluating the hormone-mediated changes in growth and reproductive maturation. OBJECTIVES: We aimed to examine the anthropometric status of pre- and post-menarcheal Nigerian adolescent girls attending senior secondary schools. MATERIALS AND METHODS: In this school-based cross-sectional survey, a pre-tested structured self-administered questionnaire was set for obtaining the socio-demographic data (age at menarche, number of siblings, occupation and educational attainment of their parents, etc.), while the anthropometric status data was obtained by direct measurement of weight and height. The body mass index (BMI) and the ponderal index (PI) of each participant were computed from their respective weight and height values. The study was designed to include all the students in the two schools that were randomly selected. The anthropometric indices of pre- and post-menarcheal girls were compared. RESULTS: Out of a total population of 2,166 students, 2,159 (99.7%) participated but 9 questionnaires were incompletely filled and were rejected, leaving 2,150 (510 were pre-menarcheal and 1,640 were post- menarcheal) for further analysis. The mean menarcheal age was 13.44 ± 1.32 years (95% Confidence Interval (CI) = 13.38-13.5). Girls from families with high socio-economic status (SES) attained menarche 8.0 and 9.0 months earlier than their counterparts from families with middle and low SES respectively. Girls from small-size families had a significantly lower menarcheal age than their counterparts from large-size families. A comparison of the anthropometric indices of pre- and post-menarcheal girls showed: weight, 41.1 ± 6.3 kg (95% CI = 40.6-41.6) vs 47.6 ± 7.2 kg (95% CI = 47.3-47.9), P < 0.001; height, 146.2± 5.5 cm (95% CI = 145.7-146.7) vs 153.6 ± 9.9 cm (95% CI = 153.1-154.1), P < 0.001; BMI, 16.4 ± 1.9 (95% CI = 16.2-16.6) vs 18.8 ± 1.6 (95% CI = 18.7-18.9), P < 0.001; and PI, 45.1 ± 1.7 (95% CI = 45.0-45.2) vs 44.6 ± 1.4 (95% CI = 44.5-44.7), P < 0.01. CONCLUSIONS: Post-menarcheal girls were significantly taller and heavier with a higher BMI than their pre-menarcheal counterparts, but the pre-menarcheal girls possessed a better linear body as reflected by the PI.