Emerging risk factors associated with prevalence of hepatitis c virus infection among Nigerians: Findings from blood donors in an academic hospital, Enugu South-Eastern Nigeria.

AIM: In Nigeria, reports on the prevalence of Hepatitis C risk factors have not been clearly elucidated, we investigate the risk factors that influence the prevalence and how the difference in awareness level of risk factors screening across age groups contributes to the disease. METHODS: A total of 8790 aged 18-55 years old, who attended the Department of Haematology and Blood Transfusion Services, University of Nigeria Teaching Hospital, Enugu were screened. Among them, 135 were diagnosed with hepatitis C infection from 1 January 2017 to 1 January 2019. Participants completed a questionnaire related to demographics, risk factors, history of previous medical screening. Age groups, income and education were indicators. Multivariate analyses were used to identify correlates. RESULTS: A total of 135 blood donors (95 males and 40 females) with a mean age of 35.9 ± 10.5 and 36.4 ± 10.7 years respectively were positive for hepatitis C infection, giving overall prevalence (1.5%), injecting drug use (39%), unprotected multiple sex (22.2%), sacrification (14.8%), blood transfusion (11.1%). Multivariate analysis revealed that injecting drug use (P < .0001), unprotected multiple sex (P = .004), sacrification (P = .036) were independent risk factors that influence the prevalence among younger age groups. Blood transfusion was not significant (P = .053) but the mostly accessed. Low income and educational background were significantly more prevalent among the studied group. CONCLUSION: Injecting drug use, multiple sex and sacrification are independent predictors of prevalence of Hepatitis C infection. The early onset of the risk factors among the younger adult clearly underlines the need for early screening and interventions.

Prevalence and Pattern of Thyroid Disorders among Patients Attending University of Nigeria Teaching Hospital, Enugu, Southeastern Nigeria.

INTRODUCTION: Thyroid disorders (TDs) remain the second-most common endocrine disease after diabetes worldwide. Recently, there has been increased interest in the prevalence and pattern of TD based on the fact that it accelerates cardiovascular complications. However, there are limited data on the prevalence and pattern of TDs in the University of Nigeria Teaching Hospital (UNTH) Enugu, Southeast Nigeria. OBJECTIVES: We studied prevalence and pattern of TDs as seen in patients attending UNTH, Enugu, Nigeria. METHODS: This study was conducted in the Outpatient Department of UNTH Enugu from January 2016 to January 2019. Demographic and clinical data collected include age, gender, anthropometrics, clinical features, and associated complications of TDs. The patients were grouped as hyperthyroidism, hypothyroidism, and euthyroid sick syndrome (ESS) according to symptoms, signs, thyroid function test, liver function test, fasting blood sugar, and cholesterol. RESULTS: A total of 260 patients (210 females and 50 males) with a mean age of 49.22 ± 9.79 years reflected overall prevalence rate of 2.4%. The prevalence of hyperthyroidism 150 (58%), hypothyroidism 100 (39%), and (ESS) 10 (3.9%) was 1.4%, 0.9%, and 0.09%, respectively. Hypertension 34.3%, heart failure 26.7%, and atrial fibrillation 20% seen in Grave's disease were the most common cause of hospitalization and death. CONCLUSION: Grave's disease is the most common cause of TDs and occurs more in females than males in this study. We observed that hypertension, heart failure, and atrial fibrillation are promoters of complication in TDs. Health system facilities need to be strengthened in this area to improve the detection and management of TDs.

Cardiovascular disease risk factors in a Nigerian population with impaired fasting blood glucose level and diabetes mellitus.

BACKGROUND: Diabetes is a risk factor for cardiovascular diseases (CVDs) and there are reports of increasing prevalence of prediabetes in Nigeria. This study therefore characterised CVDs risk factors in subjects with impaired fasting glucose (IFG) and diabetes. METHODS: Data from 4 population-based cross-sectional studies on 2447 apparently healthy individuals from 18 - 89 years were analysed. Anthropometric, blood pressure and biochemical parameters were collected and classified. Individuals with IFG (prediabetes) and diabetes were merged each for positive cases of dyslipidaemia, high blood pressure (HBP) or obesity. Optimal Discriminant and Hierarchical Optimal Classification Tree Analysis (HO-CTA) were employed. RESULTS: Overall prevalence of IFG and diabetes were 5.8% (CI: 4.9 - 6.7%) and 3.1% (CI: 2.4 - 3.8%), respectively. IFG co-morbidity with dyslipidaemia (5.0%; CI: 4.1 - 5.8%) was the highest followed by overweight/obese (3.1%; CI: 2.5 - 3.8%) and HBP (1.8%; CI: 1.3 - 2.4%). The predicted age of IFG or diabetes and their co-morbidity with other CVD risk factors were between 40 - 45 years. Elevated blood level of total cholesterol was the most predictive co-morbid risk factor among IFG and diabetes subjects. Hypertriglyceridaemia was an important risk factor among IFG-normocholesterolaemic-overweight/obese individuals. CONCLUSION: The higher prevalence of co-morbidity of CVD risk factors with IFG than in diabetes plus the similar age of co-morbidity between IFG and diabetes highlights the need for risk assessment models for prediabetes and education of individuals at risk about factors that mitigate development of diabetes and CVDs.

Maximum accuracy obesity indices for screening metabolic syndrome in Nigeria: A consolidated analysis of four cross-sectional studies.

BACKGROUND: In sub-Saharan Africa, there is no precise use of metabolic syndrome (MetS) definitions and risk factors screening indices in many clinical and public health services. Methods proposed and used in Western populations are adopted without validation within the local settings. The aim of the study is to assess obesity indices and cut-off values that maximise screening of MetS and risk factors in the Nigerian population. METHOD: A consolidated analysis of 2809 samples from four population-based cross-sectional study of apparently healthy persons≥18 years was carried out. Optimal waist circumference (WC) and waist-to-height ratio (WHtR) cut points for diagnosing MetS and risk factors were determined using Optimal Data Analysis (ODA) model. The stability of the predictions of the models was also assessed. RESULTS: Overall mean values of BMI, WC and WHtR were 24.8±6.0kgm(-2), 84.0±11.3cm and 0.52±0.1 respectively. Optimal WC cut-off for discriminating MetS and diabetes was 83cm in females and 85cm in males, and 82cm in females and 89cm in males, respectively. WC was stable in discriminating diabetes than did WHtR and BMI, while WHtR showed better stability in predicting MetS than WC and BMI. CONCLUSION: The study shows that the optimal WC that maximises classification accuracy of MetS differs from that currently used for sub-Saharan ethnicity. The proposed global WHtR of 0.50 may misclassify MetS, diabetes and hypertension. Finally, the WC is a better predictor of diabetes, while WHtR is a better predictor of MetS in this sample population.