Epidemiology of low back pain: frequency, risk factors, and patterns in South-South Nigeria.

Introduction: Low back pain (LBP) is a prevalent musculoskeletal condition that poses significant public health challenges. However, its epidemiology in Sub-Saharan Africa, especially in rural settings, remains largely unexplored. This study aimed to determine the epidemiology of LBP in a Nigerian Teaching Hospital. Material and methods: This was a retrospective review of the records of all LBP cases seen at the rheumatology clinic from 2018 to 2022 in a Teaching Hospital in South-South Nigeria. The sociodemographic and clinical data, including disability scores, was extracted from the patients' medical records. The data was analyzed using IBM SPSS version 25, and the level of significance was set at p < 0.05. Results: Among 1,580 patients, 319 (20.2%) reported LBP. The mean age was 59.51 ±10.21, and the peak age incidence was 51-60 years. Low back pain was more prevalent in females (61.4%). Work-related factors (47.3%) such as heavy lifting (26.3%), prolonged sitting (19.4%), and poor posture (27.9%) were the prominent risk factors. Sedentary behavior (11.5%) and obesity (16.9%) contributed. Common clinical manifestations included difficulty standing or bending (73%), walking difficulties (67.7%), sleep disturbances (51.4%), and radicular pain (45.8%). Common etiologies were spondylosis (66.5%), spondylolisthesis (22.3%), disc prolapse (19.4%), spinal canal stenosis (15.4%), muscle spasm (12.2%), and tuberculous spondylitis (9.7%). Acute and chronic LBP constituted 12.2% and 79.9% of cases, respectively. In terms of disability, 33.5% had minimal, 44.5% had moderate, 15.4% had severe, and 6.6% had crippling disabilities. Conclusions: Mechanical causes were the most implicated in LBP. Work-related factors and lifestyle choices contribute to the occurrence of LBP. Adjusting posture and lifestyle modification reduces LBP risk. Understanding its epidemiology is crucial for optimizing care and implementing preventive strategies.

Clinical and laboratory profile of systemic lupus erythematosus patients at a rural tertiary centre in South-South Nigeria: experience from a new rheumatology clinic.

OBJECTIVES: Systemic lupus erythematosus (SLE) is an autoimmune disorder with a poorly understood aetiology. It predominantly affects females and has a variety of clinical manifestations. In Nigeria, there are limited data on the prevalence and burden of the disease. This study aimed to determine the clinical and laboratory profiles of SLE patients seen in a new rheumatology clinic in South-South Nigeria. MATERIAL AND METHODS: This was a retrospective cross-sectional study conducted over five years (January 2016 to December 2020). The case files of patients that satisfied the diagnosis of SLE were reviewed. The diagnosis was based on the 1997 update of the American College of Rheumatology revised criteria for the classification of SLE. The sociodemographic, clinical, and immunological data were extracted from case records. Data analysis was carried out using IBM SPSS statistics® 2012 version 21.0. RESULTS: Fifty-two patients were diagnosed with SLE, giving a frequency of 4.7%. Forty-seven (90.4%) of the study participants were females, with a female-to-male ratio of 9.4 : 1. The mean age of the study group was 28.42 years. The mean duration of disease before diagnosis was 4.04 months with a range of 1-15 months. The patients had various organ system manifestations, with polyarthritis being the commonest (86.5%). Others included mucocutaneous (78.8%), haematological (69.2%), serositis (40.4%), renal (38.5%), and neurological (25%) manifestations. Antinuclear antibody (ANA) assay and anti-double-stranded DNA were positive in 100% and 69.2% of patients, respectively. All patients were placed on steroids, and 96.2% had hydroxychloroquine. None of the patients were on biologic disease-modifying antirheumatic drugs. CONCLUSIONS: This study's results are consistent with data from other African countries. To fully understand the burden and epidemiology of SLE in Nigeria, a larger prospective study is needed.

Fibromyalgia in HIV-positive patients in Nigeria: A cross-sectional prospective study.

BACKGROUND: Fibromyalgia is a chronic pain syndrome of unknown etiology characterized by chronic widespread musculoskeletal pain and tenderness. It affects the quality of life of patients and has been associated with the human immunodeficiency virus (HIV). The study aimed to determine the prevalence of fibromyalgia in HIV-positive patients and assess the effect of fibromyalgia on their functional status. METHODOLOGY: This was a cross-sectional study comprising 160 treatment-naive HIV-positive patients and 160 age- and sex-matched HIV-negative controls. The diagnosis of fibromyalgia was based on the 2011 modification of the 2010 American College of Rheumatology diagnostic criteria by assessing the widespread pain index and symptom severity score. The severity of fibromyalgia was assessed with the revised fibromyalgia impact questionnaire. RESULTS: The prevalence of fibromyalgia in HIV-positive individuals was found to be 10.6%, which was significantly higher compared with controls (3.1%; P = .008). There was no significant association between fibromyalgia and age, gender, or occupation. There was a significant relationship between CD4 count levels (P < .001), WHO clinical stage (P < .001), and fibromyalgia. A statistically significant higher score on the Revised FM Impact Questionnaire was found in HIV-positive individuals with fibromyalgia (P < .001). CONCLUSION: The study found that HIV-positive patients had a significantly higher incidence of fibromyalgia than controls and this was related to active indices of HIV disease. Fibromyalgia had a greater clinical impact on HIV patients than in controls. As a result, fibromyalgia should be identified and treated in people living with HIV.

Migraine: prevalence and associated disability among Nigerian undergraduates.

BACKGROUND: Studies on migraine in Nigeria are scanty while the disability associated with the disease has not been determined. We aimed at determining the lifetime prevalence of migraine and its associated disability among the students of a Nigerian university. METHOD: Using a multi-stage sampling method, undergraduates of Ambrose Alli University, Nigeria were screened with the International Headache Society (IHS) criteria. Those who satisfied the criteria for migraine were then assessed with the Migraine Disability Assessment questionnaire to ascertain the level of disability resulting from migraine in the three months preceding the study. Information was also obtained on the use of preventive and abortive medications. RESULTS: Out of the 1513 respondents screened, 145 satisfied the IHS criteria for the diagnosis of migraine giving an overall lifetime prevalence of 9.6% (females 10.3%, males 8.9%, p > 0.05). Migraine associated disability was little or none in 53.1% (males 55.2%, females 51.3%, p > 0.05), mild in 10.3% (males 11.9%, females 9.0%, p > 0.05), moderate in 20.7% (males 20.9%, females 20.5%, p > 0.05) and severe in 15.9% (males 11.9%, females 19.2%, p > 0.05). In spite of the fact that 53 (36.6%) of the migraineurs had moderate-severe disability, only 19/53 (35.8%) reported being on preventive treatment while none had ever used a triptan. CONCLUSION: Prevalence of migraine among our respondents falls within the range reported from similar studies among university students outside Africa. In spite of the high disability associated with the disease, use of effective preventive and abortive therapies is very poor.