Clinical and Epidemiological Characteristics of Hospitalized COVID-19 Patients in an Isolation Centre in South-West Nigeria.

INTRODUCTION: The clinical presentation of coronavirus disease 2019 (COVID-19) can vary widely, and while the primary infection involves the respiratory system, other organs can also be affected. This study presents the clinical and epidemiological characteristics of hospitalized COVID-19 patients in a tertiary hospital in Ado Ekiti, South-West Nigeria. MATERIALS AND METHODS: This is a retrospective study involving COVID-19 patients admitted to the isolation ward between August 2020 and January 2021. The data used for this study was obtained from the patient's medical record, which includes demographic characteristics, clinical presentation, baseline co-morbidities, and laboratory investigations. RESULTS: The average age of the patients was 60.3 years, and more than two-thirds were male. The most common symptoms were fever, shortness of breath, cough, and tiredness. Comorbidities identified among the patients included diabetes mellitus, heart disease, obesity, and chronic kidney disease. The most common radiological findings were bilateral homogeneous patchy opacities and peripheral fluffy infiltrates. The overall mortality rate was 21.9%, with 13 deaths in patients with severe disease. Age and duration of admission were found to be significant predictors of death. CONCLUSION: The results of this study provide valuable insights into the clinical presentation of COVID-19 in Nigeria and may guide future management strategies for similar infections.

Uncovering the Burden of Diabetes in Ekiti State, Nigeria: Insights From a Statewide, Household-Based, Cross-Sectional Study.

INTRODUCTION: Diabetes mellitus (DM) is an important global public health challenge, and the burden of the disease is huge, particularly in low- and middle-income countries (LMICs), where the majority of people with this condition reside. Undiagnosed DM is more prevalent in LMICs. The aim of this study is to determine the prevalence and associated factors for DM in Ekiti State. MATERIALS AND METHODS: A cross-sectional, household-based survey using a four-stage multistage sampling design and the World Health Organization (WHO)-STEPS survey manual was conducted from July to September 2020 as a part of the Ekiti State coronavirus disease 2019 (COVID-19) survey. Of the 5,145 sampled households, 4,726 individuals gave consent to participate in the survey. Out of these, 3043 had fasting plasma glucose results available and were included in the analysis. RESULTS: There were 2257 (74.2%) women and 786 (25.8%) men. The prevalence of DM was 6.5% (6.5% in males and 6.6% in females, P = 0.946). Diabetes was found to be more prevalent among those with a secondary school education or higher (10.9%); employed in the formal sector (13.4%); separated, divorced, or widowed (8.5%); with raised blood pressure (9.3%); and who were aged 30-59 years (all P < 0.05). Multivariable logistic regression showed that age, education, occupation, and hypertension were all positively and significantly associated with an increased risk of DM. CONCLUSION: The prevalence of DM in Ekiti State is high, and its predictors include advancing age, hypertension, education, and occupation. This calls for scaling up public health interventions for controlling DM, targeting the identified risk factors among the people of Ekiti.

Triglyceride-Glucose Index and Related Parameters Predicted Metabolic Syndrome in Nigerians.

Background: Triglyceride-glucose (TyG) index, a product of triglyceride and fasting plasma glucose, is a novel tool that can identify people with metabolic syndrome (MS). It is unknown if TyG index can identify MS among Nigerians. Methods: Cross-sectional health screening conducted between August and December 2018, among staff and students of Ekiti State University/Ekiti State University Teaching Hospital, Nigeria, Ado-Ekiti. The analysis included 473 participants, aged ≥18 years. Anthropometric indices and blood pressure were measured by standard protocol. Fasting lipid profile and blood glucose were determined. TyG index and product of TyG and anthropometric indices were calculated, and MS defined according to the harmonized criteria. The diagnostic ability of TyG index and related parameters to identify people with MS was determined with the area under curve (AUC) of receiver operating characteristic curves. Stepwise logistic regression analyses were used to generate odd ratios (ORs) for prediction of MS. Results: The mean age of the participants was 39.2 (11.4) years and there were 173 (36.6%) men. In all participants, TyG-waist to height ratio (TyG-WHtR) shows the largest AUC for MS detection (0.863, 95% confidence interval, CI: 0.828-0.892) followed by TyG-waist circumference (TyG-WC) (0.858, 95% CI: 0.823-0.888), TyG-body mass index (TyG-BMI) (0.838, 95% CI: 0.802-0.870), TyG index (0.796, 95% CI: 0.757-0.831), WHtR (0.791, 95% CI: 0.752-0.827), and TyG-waist-to-hip ratio (TyG-WHpR) (0.771, 95% CI: 0.730-0.808) in that order. Gender analysis revealed that TyG-WC and TyG-WHtR have largest AUC in both genders. Before and after adjustment, TyG-WHtR (OR: 6.86, 95% CI: 3.94-11.93) and TyG index (OR: 5.91, 95% CI: 3.01-11.59) presented the highest OR in all participants, respectively. Conclusions: TyG index is effective in identifying MS in this cross-sectional study, and the product of TyG index and anthropometric indices improved identification and prediction of MS.

Diabetic neuropathy is associated with increased pain perception, low serum beta-endorphin and increase insulin resistance among Nigerian cohorts in Ekiti State.

INTRODUCTION: There has been an increase in the global prevalence of diabetic polyneuropathy and research evidence suggests that insulin resistance plays an important role in its development and prognosis. However, there seem to be a dearth of information in understanding the likely interplay between beta endorphin, insulin resistance and pain perception especially in the setting of painful diabetic neuropathy. METHOD: This study recruited 120 volunteers divided into four groups (30 per group): group 1 healthy volunteer (control); group 2 DM type 2 without neuropathy (DM group); group 3 DM type 2 with painful neuropathy (DPN group); group 4 DM type 2 without painful neuropathy (DN). All subjects were evaluated for pain threshold and neuropathy using an ischemia-induced pain model and biothesiometer respectively. Their beta-endorphin, glycated hemoglobin, fasting plasma insulin, and HOMA values were determined and means compared using ANOVA. RESULT: Serum beta-endorphin is significantly reduced in DN and DPN (∗p < 0.001) compared with the control and DM group. Also, DPN and DN patients have significantly increased insulin resistance compared to those without neuropathy (∗p < 0.001; ∗p < 0.0001 respectively). There is a significant positive correlation between the pain threshold and beta-endorphin in all the groups except DN group. The correlation between beta-endorphin and insulin resistance was negative and significant in control and DM groups only. Suggestive that the fact that insulin resistance plays an important role in diabetes polyneuropathy, does not alone explain the chronic pain perception noticed in the DPN patients. CONCLUSION: The present study demonstrates that diabetic neuropathy patients have a poor endogenous opioid peptide system which is associated with increased pain perception and high insulin resistance. However, insulin resistance alone does not explain the chronic pain perception noticed in the DPN patients. Thus, further study is required.

Performance of waist circumference and proposed cutoff levels for defining overweight and obesity in Nigerians.

BACKGROUND: Waist circumference (WC) is a simple tool for measuring central obesity in routine clinic settings. Gender- and ethnic-specific optimal cutoff points for WC are encouraged for populations lacking such data. OBJECTIVES: To derive WC cutoff values, predictive of overweight and obesity in Nigerians and to evaluate the performance of currently recommended values. SUBJECTS AND METHODS: Apparently, healthy urban dwellers from six cities spread across Nigeria were selected for this cross-sectional study. Biophysical profiles such as blood pressure and anthropometric indices were measured according to the World Health Organization's STEPs instrument protocol. Receiver operating characteristics curve analysis was used to determine the optimal cutoff levels using the decision rule of maximum (sensitivity + specificity). The level of significance was set at P< 0.05. RESULTS: A total of 6089 subjects (3234 males and 2855 females) were recruited for the study. WC demonstrated a high area under the curve in both genders. Selected cutoff points ranged from 83 to 96 cm with high sensitivities and specificities. CONCLUSIONS: The currently recommended gender-specific WC cutoff values proved inappropriate in this study group, but WC remains a reliable tool for measuring obesity.

Metabolic Syndrome and Framingham Risk Score: Observation from Screening of Low-Income Semi-Urban African Women.

Background: The heightened cardiovascular risk associated with metabolic syndrome (MetS) has been documented by several researchers. The Framingham risk score (FRS) provides a simple and efficient method for identifying individuals at cardiovascular risk. The objective was to describe the prevalence of MetS and its association with FRS in predicting cardiovascular disease among a cohort of semi-urban women; Method: Clinical and laboratory parameters were evaluated among 189 healthy women. The International Diabetes Federation definition was used to diagnose metabolic syndrome. FRS was calculated for each participant; Result: About two thirds of the participant make less than $US 90 per month. The mean systolic blood pressure was 131.80 ± 30. Eighty (42.3%) participants were overweight with a mean waist circumference of 91.64 ± 11.19 cm. MetS was present in 46 (24.3%). Individuals with MetS were more likely to have increased FRS, p = 0.012. One hundred and eighty seven (98.9%) were in the low risk category according to FRS. There was a significant difference in the mean FRS between participants with and without MetS (13.52 versus 10.29 p = 0.025); Conclusion: Prevalence of MetS in this study was comparable to the global rate, despite a low economic status. Individuals with MetS were more likely to have cardiovascular disease than persons without MetS, thus emphasizing the need for risk stratification and prompt management.