Prevalence and Predictors of Metabolic Syndrome among Adults in North-Central, Nigeria.

BACKGROUND: Metabolic syndrome contributes to the burden of non-communicable diseases and is a growing public health problem in both developed and developing countries. We determined the prevalence and predictors of metabolic syndrome among adults in Benue State, North-Central, Nigeria to guide targeted interventions. METHODS: We conducted a community-based cross-sectional study in Benue State, North-Central, Nigeria. Multistage sampling technique was used to recruit 823 respondents. We defined metabolic syndrome using the National Cholesterol Education Programme Adult Treatment Panel III guideline and adapted a component of the WHO Stepwise questionnaire for data collection. Prevalence of metabolic syndrome and the associated risk factors were estimated using Chi square test and logistic regression at 5% level of significance. Statistical analysis was done using SPSS version 23.0. RESULTS: The mean age of the respondents was 40.1± 15.7 years. Most of the respondents were literate (86.8%) and married (67.0%). The prevalence of metabolic syndrome was 19.4%. One in every four of the respondents had pre-metabolic syndrome (25.6%) and this was more in females (28.2%) compared to males (22.9%). Thirty-four percent of the respondents had only one whereas 20.7% did not have any of the risk factors for metabolic syndrome. Age [aOR:10.3; 95%CI: 4.8-22.2], sex [aOR:2.4; 95% CI: 1.7-3.5] and education [aOR:2.9; 95%CI: 1.4-6.1] were significantly associated with metabolic syndrome among the respondents. CONCLUSION: The prevalence of metabolic syndrome was high. The associated risk factors were age, gender and educational status. Therefore, interventions should be targeted at young adults to reduce the long-term impact of the disease.

CONTEXTE: Le syndrome métabolique contribue à la fardeau des maladies non transmissibles et est un public croissant problème de santé dans les pays développés comme dans les pays en développement. Nous avons déterminé la prévalence et les prédicteurs du metabolism syndrome chez les adultes dans l'État de Benue, centrenord du Nigéria pour orienter les interventions ciblées. MÉTHODES: Nous avons mené une enquête transversale communautaire étude dans l'État de Benue, centre-nord du Nigéria. Multistage la technique d'échantillonnage a été utilisée pour recruter 823 répondants. Nous avons define syndrome metabolique à l'aide du National Cholesterol Programme d'éducation Groupe de traitement des adultes III lignes directrices eta adapté une composante du questionnaire Par étapes de l'OMS pour collecte de données. Prévalence du syndrome métabolique et des facteurs de risque associés ont été estimés à l'aide du test du chi carré et la régression logistique à un niveau de signification de 5 %. Statistique l'analyse a été effectuée à l'aide de SPSS version 23.0. RÉSULTATS: L'âge moyen des répondants était de 40.1 ± 15,7 ans.La plupart des répondants étaient alphabétisés (86.8 %) et mariés(67.0%). La prévalence du syndrome métabolique était de 19.4%.Un répondant sur quatre avait un prémétabolique (25.6 %) et c'était plus fréquent chez les femmes (28.2 %)comparativement aux hommes (22.9 %). Trente-quatre pour cent des n'en avaient qu'un, alors que 20.7 % n'en avaient aucun les facteurs de risque du syndrome métabolique. Âge [aOR:10.3; IC à 95 %:4.8-22.2], le sexe [aOR:2.4; IC à 95 %: 1.7-3.5] et l'éducation [aOR:2.9;IC à 95 % : 1.4 à 6.1] étaient significativement associés au metabolism chez les répondants. CONCLUSION: La prévalence du syndrome métabolique était haut. Les facteurs de risque associés étaient l'âge, le sexe et le statut scolaire. Par conséquent, les interventions devraient être ciblées chez les jeunes adultes pour réduire l'impact à long terme de la maladie. Mots-clés: Prévalence, facteurs de risque, syndrome métabolique, Nigéria.

Population-based prevalence and associated risk factors of hypertension among adults in Benue State, Nigeria.

BACKGROUND: The increasing prevalence of hypertension in low- and middle-income countries is associated with increased morbidity and mortality. AIM: To determine the prevalence of hypertension and associated risk factors in Benin state, Nigeria. MATERIALS AND METHODS: A population-based cross-sectional study was conducted among 1265 adults selected by multistage sampling technique. The World Health Organization (WHO) STEPwise approach was used to collect data. Data were analyzed using Statistical Package for the Social Sciences (SPSS) software program, version 23.0 (IBM). We estimated prevalence and odds of hypertension at 5% level of significance. RESULTS: The prevalence of hypertension was 35.6%. The odds of hypertension was higher among age 30-39 (aOR: 2.0; 95% CI: 1.3-3.1) compared to age 18-29 years, males (aOR: 1.4; 95% CI: 1.1-2.0) compared to females, overweight (aOR: 2.3; 95%CI: 1.6-3.2), and obesity (aOR: 4.9; 95%CI: 3.2-7.7) compared to normal weight, and high cholesterol (aOR: 1.6; 95% CI: 1.1-2.3) compared to normal cholesterol. CONCLUSION: The prevalence of hypertension was high among young adults in Benue State. The associated risk factors for hypertension were age, sex, overweight, obesity, and high total cholesterol.

Predictors of pediatric HIV disclosure among caregivers of HIV positive children attending special treatment clinic in dalhatu araf specialist hospital, Lafia, Nigeria.

BACKGROUND: HIV-infected children now live longer due to the availability of HIV counseling, testing, and treatment with highly active antiretroviral treatment (HAART). Efforts to help these children to know about the HIV infection and their status are important steps toward long-term disease management. This study was conducted to determine the factors associated with pediatric HIV disclosure among caregivers of children attending Special Treatment Clinic at Dalhatu Araf Specialist Hospital, Lafia. METHODS: This was a descriptive cross-sectional study conducted among 160 caregivers of children attending the Special Treatment Clinic (STC) at DASH, Lafia, selected by systematic random sampling technique. Interviewer administered structured questionnaire was used to collect data, while bivariate and multivariate analyses were done with the Epi Info version 7. RESULTS: Pediatric HIV disclosure rate in this study was 33.8%. The mean age at pediatric HIV disclosure was 9.85 ± 1.86 years. The independent predictors for pediatric HIV disclosure following logistic regression were child's age, 10-14 years (AOR = 4.46; 95%CI 1.47-13.61), child knowledge of caregivers' HIV status (AOR = 51.18; 95%CI 13.40-195.66), and caregivers' age ≥40 years (AOR = 3.58; 95%CI 1.25-11.74). CONCLUSIONS: The pediatric HIV disclosure was low in this study due to the caregivers' and their wards' factors. Health care workers need to intensify health education on the benefit of pediatric HIV disclosure at the STC clinic.

The response to re-emergence of yellow fever in Nigeria, 2017.

Yellow fever (YF) is an acute viral hemorrhagic disease caused by the YF virus (arbovirus) which continues to cause severe morbidity and mortality in Africa. A case of YF was confirmed in Nigeria on the 12th of September 2017, 21 years after the last confirmed case. The patient belongs to a nomadic population with a history of low YF vaccination uptake, in the Ifelodun Local Government Area (LGA) of Kwara State, Nigeria. An active case search in Ifelodun and its five contiguous LGAs led to the listing of 55 additional suspect cases of YF within the period of the outbreak investigation between September 18 to October 6, 2017. The median age of cases was 15 years, and 54.4% were males. Of these, blood samples were collected from 30 cases; nine tested positive in laboratories in Nigeria and six were confirmed positive for YF by the WHO reference laboratory in the region; Institut Pasteur, Dakar. A rapid YF vaccination coverage assessment was carried out, resulting in a coverage of 46% in the LGAs, with 25% of cases able to produce their vaccination cards. All stages of the yellow fever vector, Aedes mosquito were identified in the area, with high larval indices (House and Breteau) observed. In response to the outbreak, YF surveillance was intensified across all States in Nigeria, as well as reactive vaccination and social mobilisation campaigns carried out in the affected LGAs in Kwara State. A state-wide YF preventive campaign was also initiated.

OUTBREAK OF CEREBROSPINAL MENINGITIS IN KEBBI STATE, NIGERIA.

BACKGROUND: Cerebrospinal meningitis (CSM), is a major public health problem still affecting tropical countries particularly in sub-Saharan Africa. Group A and occasionally group C account for large scale epidemics in many countries in the African meningitis belt. The study aimed to describe the pattern of cerebrospinal meningitis outbreak in Kebbi state in 2015. METHOD: Information on cases and deaths was collected throughout the duration of the meningitis outbreak in all affected local government areas of Kebbi state. During this outbreak, we defined a suspected case as any person with sudden onset of fever (>38.5 C rectal or 38.0 C axillary) and one of the following signs: neck stiffness, altered consciousness or other meningeal signs and any toddler with sudden onset of fever (>38.5 C rectal or 38.0 C axillary) and one of the following signs: neck stiffness, or flaccid neck, bulging fontanel, convulsion or other meningeal signs. All the data was entered into SPSS statistical software and analyzed. RESULTS: A total of 1,992 suspected cases of CSM were seen within the 18 weeks that the outbreak lasted. 1127 (57.0%) were males and 865 (43.0%) were females with a case fatality rate of 4.0%. The highest proportion of cases was found among those above 15 years of age (31.0%), 1252 (62.9%) of cases were immunized against neisseria meningitides type A. Two-thirds (16) of the LGAs in the state were affected and Aliero LGA had about half (n=1106; 55.5%) of cases seen. Most (77.3%) of samples analysed were positive for Nm type C. CONCLUSION: Kebbi state experienced an outbreak of cerebro-spinal Meningitis in 2015 which was massive. Effective surveillance system and mass vaccination with polyvalent vaccines containing serogroup C will prevent future occurrence.

Determination of chloramphenicol residues in commercial chicken eggs in the Federal Capital Territory, Abuja, Nigeria.

The use of antibiotics in poultry can result in residues in eggs. The joint FAO/WHO committee recommended banning the use of chloramphenicol (CAP) in food animals due to its public health hazards of aplastic anaemia, leukaemia, allergy, antibacterial resistance and carcinogenicity. This paper determines the prevalence of CAP residues in chicken eggs and assesses the usage and awareness of its ban amongst poultry farmers in the Federal Capital Territory (FCT), Abuja, Nigeria. A cross-sectional survey of registered poultry farmers in FCT was conducted using questionnaires to determine CAP administration in poultry and awareness of its ban. Pooled egg samples were collected from each poultry farm surveyed and from randomly sampled government-owned markets in FCT. Source of eggs by state were identified by the marketer at the time of collection. Samples were analysed using an enzyme-linked immunosorbent assay (ELISA) technique for the presence of CAP, and prevalence was determined. Of 288 total pooled samples collected, 257 (89.2%) were from the markets and 31 (10.8%) were from poultry farms. A total of 20 (7%) pooled egg samples tested CAP-positive; market eggs originated from 15 (41%) states of the country. Of the market eggs, 16 (6.2%) pooled samples tested positive. Of eggs from poultry farms, four (12.9%) tested positive. Mean CAP concentrations in the positive samples ranged from 0.49 to 1.17 µg kg(-1) (parts per billion). CAP use amongst poultry farmers in FCT was 75.5%; awareness of the CAP ban was 26.3%. Though 66% of veterinarians were unaware of a CAP ban, they were more likely to be aware than other poultry farmers (odds ratio (OR) = 1.4). Farm managers who use CAP were more likely to be aware of CAP ban than the farm managers not using CAP (OR = 5.5; p = 0.04). Establishing a drug residue surveillance and control program and enforcement of CAP legislation/regulation is needful to educate and prohibit the widespread CAP use amongst Nigerian poultry farmers.

Working with risk: occupational safety issues among healthcare workers in Kenya.

The objective of this study was to explore knowledge of, attitudes towards and practice of post-exposure prophylaxis (PEP) among healthcare workers (HCWs) in the Thika district, Kenya. We used site and population-based surveys, qualitative interviews and operational research with 650 staff at risk of needlestick injuries (NSIs). Research was conducted over a 5-year period in five phases: (1) a bio-safety assessment; (2) a staff survey: serum drawn for anonymous HIV testing; (3) interventions: biosafety measures, antiretrovirals for PEP and hepatitis B vaccine; (4) a repeat survey to assess uptake and acceptability of interventions; in-depth group and individual interviews were conducted; and (5) health system monitoring outside a research setting. The main outcome measures were bio-safety standards in clinical areas, knowledge, attitudes and practice as regards to PEP, HIV-sero-prevalence in healthcare workers, uptake of interventions, reasons for poor uptake elucidated and sustainability indicators. Results showed that HCWs had the same HIV sero-prevalence as the general population but were at risk from poor bio-safety. The incidence of NSIs was 0.97 per healthcare worker per year. Twenty-one percent had had an HIV test in the last year. After one year there was a significant drop in the number of NSIs (OR: 0.4; CI: 0.3-0.6; p<0.001) and a significant increase in the number of HCWs accessing HIV testing (OR: 1.55; CI: 1.2-2.1; p=0.003). In comparison to uptake of hepatitis B vaccination (88% of those requiring vaccine) the uptake of PEP was low (4% of those who had NSIs). In-depth interviews revealed this was due to HCWs fear of HIV testing and their perception of NSIs as low risk. We concluded that Bio-safety remains the most significant intervention through reducing the number of NSIs. Post-exposure prophylaxis can be made readily available in a Kenyan district. However, where HIV testing remains stigmatised uptake will be limited - particularly in the initial phases of a programme.

Susceptibility of healthcare workers in Kenya to hepatitis B: new strategies for facilitating vaccination uptake.

Hepatitis B virus (HBV) infection is preventable, yet many healthcare workers (HCWs) in resource-poor countries remain at risk. The aims of this study were to evaluate the susceptibility of HCWs in a Kenyan district to HBV infection, and the feasibility of expanding the Extended Programme of Immunization (EPI) for infants to incorporate hepatitis B vaccination of HCWs. HCWs in Thika district, Kenya were invited to complete an interviewer-administered questionnaire about their immunization status and exposure to blood or body fluids. Participants were asked to provide a blood sample to assess natural or vaccine-induced protection against HBV. All non-immune HCWs were offered hepatitis B vaccination. Thirty percent (168/554) of HCWs reported one or more needlestick injuries (NSIs) in the previous year, with an annual incidence of 0.97 NSIs/HCW/year. Only 12.8% (71/554) of HCWs had received vaccination previously and none had been screened for immunity or for hepatitis B surface antigen. In total, 407 staff provided blood samples; 41% were HBV core antibody, 4% expressed hepatitis B surface antibody from previous vaccination, and 55% were unprotected. Two hundred and twenty-two staff were eligible for vaccine delivered through the EPI infrastructure. Self-motivated uptake of a full course of vaccine was 92% in the smaller health centres and 44% in the district hospital. This study demonstrates the importance of hepatitis B vaccination of HCWs in parts of Africa where high exposure rates are combined with low levels of vaccine coverage. High rates of vaccination can be achieved using childhood immunization systems for the distribution of vaccine to HCWs.