Bone Mineral Density and Vitamin D Status in Nigerians: The Impact of HIV.

BACKGROUND: Both HIV infection and antiretroviral therapy (ART) may be associated with metabolic complications including bone loss. To further inform guidance on screening and treatment of bone disease, we evaluated the impact of HIV and ART on vitamin D (VD) levels and bone mineral density (BMD) among HIV-infected and uninfected Nigerians. METHODS: We carried out a cross-sectional study of HIV-infected participants and uninfected matched controls, who were recruited from a large clinical site in Jos, Nigeria. Calcaneal ultrasonography was used to assess BMD. VD levels were determined using electrochemiluminescence binding assay, with vitamin D deficiency (VDD) defined as <25 ng/ml. RESULTS: There were 241 participants (61 ART-experienced, 60 ART-naïve, and 120 HIV-uninfected), and the mean age was 39±10 years; 66% were female. VDD was present in 70.5% (95% CI:64.3­76.2%) of all participants; occurring in 70.0% of ART-experienced, 73.0% of ART-naïve and 69.0% of HIV-uninfected controls (p = 0.84). Overall, the prevalence of low BMD was 21.1% (95% CI: 16.1­26.8%); being present in 24.5% of ART-experienced, 26.6% of ART-naïve and 16.6% of HIV-uninfected controls (p = 0.22). Only female sex (OR 6.82; 95% CI:1.93­24.0, p <0.001) was significantly associated with low BMD in the HIV group. No HIV-specific factor including ART use and type was associated with low BMD. CONCLUSION: VDD and low BMD are both prevalent among HIV-infected and uninfected individuals in Nigeria. HIV, ART use, and VDD were not associated with low BMD.

CONTEXTE: L'infection par le VIH et la thérapie antirétrovirale (ART) peuvent être associées à des complications métaboliques, y compris la perte osseuse. Afin d'éclairer davantage les conseils sur le dépistage et le traitement des maladies osseuses, nous avons évalué l'impact du VIH et de la thérapie antirétrovirale sur les niveaux de vitamine D (VD) et la densité minérale osseuse (DMO) chez les Nigérians infectés et non infectés par le VIH. MÉTHODES: Nous avons mené une étude transversale auprès de participants infectés par le VIH et de témoins appariés non infectés, recrutés dans un grand centre clinique de Jos, au Nigeria. L'échographie calcanéenne a été utilisée pour évaluer la DMO. Les taux de vitamine D ont été déterminés à l'aide d'un test de liaison par électrochimiluminescence, la carence en vitamine D étant définie comme <25 ng/ml. RÉSULTATS: Il y avait 241 participants (61 ayant déjà reçu un traitement antirétroviral, 60 n'ayant jamais reçu de traitement antirétroviral et 120 non infectés par le VIH), et l'âge moyen était de 39±10 ans ; 66% étaient des femmes. La DMV était présente chez 70,5 % (IC 95 % : 64,3-76,2 %) de tous les participants ; elle était présente chez 70,0 % des personnes ayant déjà reçu un traitement antirétroviral, 73,0 % des personnes n'ayant jamais reçu de traitement antirétroviral et 69,0 % des témoins non infectés par le VIH (p = 0,84). Globalement, la prévalence d'une faible DMO était de 21,1 % (IC à 95 % : 16,1-26,8 %) ; elle était présente chez 24,5 % des personnes ayant déjà reçu un traitement antirétroviral, 26,6 % des personnes n'ayant jamais reçu de traitement antirétroviral et 16,6 % des témoins non infectés par le VIH (p = 0,22). Seul le sexe féminin (OR 6,82 ; 95% CI:1,93-24,0, p <0,001) était significativement associé à une faible DMO dans le groupe VIH. Aucun facteur spécifique au VIH, y compris l'utilisation et le type d'ART, n'a été associé à une faible DMO. CONCLUSION: La DMV et la faible DMO sont prévalentes chez les personnes infectées ou non par le VIH au Nigéria. Le VIH, l'utilisation d'un traitement antirétroviral et la DMV ne sont pas associés à une faible DMO. Mots-clés: Densité minérale osseuse, VIH, Ostéopénie, T-score, Vitamine D.

Undiagnosed depression among adults with diabetes mellitus in Jos.

BACKGROUND: Diabetes mellitus (DM) and depression are common chronic disease states of public health importance with huge burden and the potential to impact many aspects of life. They are said to be related though this relationship is not fully understood. The presence of depression among patients with DM is associated with poor glycemic control, complications, and poor self-care. METHOD: This was a descriptive cross-sectional study conducted at the Diabetes Clinic of the Jos University Teaching Hospital. Three hundred and ten (310) patients with diabetes mellitus were recruited consecutively. The depression module of the Mini International Neuropsychiatric Interview (M.I.N.I.) version 5.0 was used to ascertain depression among these patients. Other demographic data were obtained using a questionnaire. Blood pressure, weight, and height were also measured and the body mass index (BMI) calculated. RESULTS: One hundred and eighty four (59.35%) of the study population were females and the mean age (SD) of the study population was 54 ± 12 years. The mean age (SD) of the females was 53 ± 11 years and that of the males was 54 ± 12 years with no significant statistical difference (P = 0.35). Two hundred and forty nine (80.32%) of the study population were urban dwellers with 140 (45.16%) earning less than N500, 000 (794 USD) yearly. Current major depression was found in 35 (11.3%) patients, among whom 7 (2.3%) had recurrent depression. The presence of DM complications (OR: 3.50, 95% CI 1.16-10.61) and a positive family history of depression (OR: 4.03, 95% CI 1.32-12.29) were found to be correlates of current major depression. CONCLUSION: The prevalence of current major depression among patients with diabetes mellitus in this study is high. We recommend that all patients with DM should be screened for depression and treated appropriately to reduce its consequences.

Heavy metals in fish species from lotic freshwater ecosystem at Afikpo, Nigeria.

A study was conducted between March 2006 and February 2007 to assess the concentration of Fe, Zn, Cu, Mn, Pb, and Cr in the gills and muscles of six fish species (Chrysichthys nigrodigitatus, Clarias anguillaris, Tillapia zillii, Mormyrus rume rume, Mormyrus macrophthalmus and Mormyrus tapirus) from lotic freshwater ecosystem at Afikpo South- East Nigeria using Atomic Absorption Spectrophotometer. In all the fish species studied the concentration of metals in the gills was significantly higher than that of the muscles (p<0.05). While the highest concentration (mg l(-1)) of Fe (702.20 +/- 0.04), Zn (34.40 +/- 0.02), Cu (2.10 +/- 0.01), Mn (4.91 +/- 0.08) Pb (0.50 +/- 0.02) and Cr (1.12 +/- 0.07) were recorded in the gills of C. nigrodigitatus, that in the muscles were recorded in T. zillii (443.20 +/- 0.08, 23.30 +/- 0.06, 1.33 +/- 0.06, 3.09 +/- 0.02, 0.31 +/- 0.01 and 0.66 +/- 0.04 for Fe, Zn, Cu, Mn, Pb and Cr respectively). The lowest concentration of all the heavy metals in the gills was recorded in M. tapirus (309.00 +/- 0.07, 16.45 +/- 0.03, 0.92 +/- 0.04, 2.15 +/- 0.04, 0.21 +/- 0.01 and 0.50 +/- 0.06 mg l(-1)for Fe, Zn, Cu Mn, Pb and Cr respectively) while the lowest in the muscles was recorded in C. anguillaris [Fe (186.00 +/- 0.07), Zn (14.20 +/- 0.08), Cu (0.56 +/- 0.03), Mn (1.30 +/- 0.02), Pb (0.10 +/- 0.01) and Cr (0.28 +/- 0.04)]. The order of heavy metals concentrations in both the gills and muscles was Fe>Zn>Mn>Cu>Cr>Pb. While the concentration of Zn, Cu and Pb both in the muscles and gills of all the six fish species studied were within the WHO and FEPA prescribed limits, that of Fe(except in the muscles), Mn and Cr were above the prescribed limits thus indicating contamination of the fish species by these metals. Fe has the highest bio-concentration factor (BCF) in both tissues while the least was Cu. Periodic monitoring of these metals in both fishes and river to ensure safety is advocated.

Endo-parasitic helminthes of four mormyrid species (Osteichthyes: Mormyridae) from a West African flood river system.

Mormyrus rume rume, Hyperopisus bebe bebe, Campylomormyrus tamandua and Gnathonemus petersii sampled from the Anambra river with a fleet of gill nets, traps and hook and line were examined for endo-parasitic helminthes from October 2005 to September 2006. Recovered helminthes were Rhadinorhynchus horridus from the intestine of H. bebe bebe and G. petersii; Procamallanus laeviconchus from the stomach of M. rume rume and C. tamandua; Spinitectus mormyri from the stomach of M. rume rume; Contracaecum sp. from the coelom of H. bebe bebe, G. petersii and C. tamandua, whereas an unidentified cestode infected the intestine of all the mormyrids. G. petersii constitutes a new host record for R. horridus; M. rume rume for S. mormyri and M. rume rume and C. tamandua for P. laeviconchus. In cases of mixed infection the parasites occupied their preferred habitats. The overall prevalence of the endo-parasites in the fish hosts was 41.9%, which is within the range (< 50%) typical of southern Nigerian freshwater lotic habitats. Prevalence, mean intensity and mean abundance of R. horridus in its host fishes were higher in the dry (October/November-March) than the rainy season (April-September/October); in the nematodes (P. laeviconchus, S. mormyri and Contracaecum) the reverse was the case, whereas no definite pattern was exhibited by the unidentified cestode. P. laeviconchus appeared reddish from engorgement of blood but no damage was evident at the point of attachment. Local inflammation where R. horridus was attached to the mucosa of the intestine was not considered severe. R. horridus and P. laeviconchus are probably the most important parasites of the mormyrids in terms of fishery management in the Anambra river system.