RESUMO
BACKGROUND: This was a study on national TB data. OBJECTIVE: To assess improvement in TB case notification and treatment coverage through improved data use for action in Nigeria. DESIGN: We analysed pre- and post-intervention secondary TB programme data comprising data on increased supervisory visits, incentives for health workers, DOTS expansion, outreaches and geo-code monitoring. Trend analysis was performed using Cochran-Armitage χ2 test for linear trends. RESULTS: Case-finding increased from 104,904 cases in 2017 to 138,591 in 2020. There was an increase of 2.0% from 2017 to 2018, 13.0% in 2018 to 2019 and 15.0% in 2019 to 2020 (P < 0.001). Facility DOTS coverage increased from 7,389 facilities in 2017 to 17,699 in 2020. There was an increase of 30.0% in 2018, 31.0% in 2019 and 40.0% in 2020 (P < 0.001). The number of reporting facilities increased from 5,854 in 2017 to 12,775 in 2020. Compared with 2017, there were an increase of 20.0% in 2018, 38.0% in 2019 and 32.0% in 2020 (P < 0.001). Treatment coverage rate increased from 24% in 2018 to 27% in 2019 and 30% in 2020. CONCLUSION: TB service expansion, improved monitoring and the use of data for decision making are key in increasing TB treatment coverage.
CONTEXTE: Il s'agit d'une étude sur les données nationales relatives à la TB. OBJECTIF: Évaluer l'amélioration de la notification des cas de TB et de la couverture du traitement grâce à une meilleure utilisation des données pour l'action au Nigéria. MÉTHODE: Nous avons analysé les données du programme secondaire de lutte contre la TB avant et après l'intervention, y compris les données sur l'augmentation des visites de supervision, les mesures incitatives pour les travailleurs de la santé, l'expansion du système DOTS, les activités de proximité et la surveillance des codes géographiques. L'analyse des tendances a été réalisée à l'aide du test du χ2 de Cochran-Armitage pour les tendances linéaires. RÉSULTATS: La recherche de cas est passée de 104 904 cas en 2017 à 138 591 en 2020. On observe une augmentation de 2,0% de 2017 à 2018, de 13,0% de 2018 à 2019 et de 15,0% de 2019 à 2020 (P < 0,001). La couverture DOTS des établissements est passée de 7 389 établissements en 2017 à 17 699 en 2020. On observe une augmentation de 30,0% en 2018, 31,0% en 2019 et 40,0% en 2020 (P < 0,001). Le nombre d'installations déclarantes est passé de 5 854 en 2017 à 12 775 en 2020. Par rapport à 2017, il y a eu une augmentation de 20,0% en 2018, 38,0% en 2019 et 32,0% en 2020 (P < 0,001). Le taux de couverture du traitement est passé de 24% en 2018 à 27% en 2019 et 30% en 2020. CONCLUSION: L'expansion des services de lutte contre la TB, l'amélioration de la surveillance et l'utilisation des données pour la prise de décision sont essentielles pour augmenter la couverture du traitement de la TB.
RESUMO
BACKGROUND: Microalbuminuria (MA) has been associated with increased risk of adverse cardiovascular events in nondiabetic hypertensive patients. This may be partly due to increased serum lipid abnormalities in these patients. The objective was to evaluate the association between MA and serum lipid abnormalities in nondiabetic adult Nigerians with hypertension. MATERIALS AND METHODS: A prospective study which recruited 96 consecutive newly diagnosed adult Nigerian hypertensive met the study criteria. These patients were compared with the same number of age- and sex-matched healthy normotensive individuals. RESULTS: 52 (54.2%) and 44 (45.8%) of patients were males and females, respectively. Mean +/- SD ages were 51.2 +/- 10.1 and 48.2 +/- 8.8 years for male and female patients, respectively. Microalbuminuria was more than five times more prevalent in the patients than in the controls. The means +/- SD serum total cholesterol (5.0 +/- 0.56 vs. 4.05 +/- 0.50 mmol/L, P = 0.04) and low-density lipoprotein cholesterol (3.99 +/- 0.49 vs. 2.84 +/- 0.58 mmol/L, P = 0.001) were significantly higher, while the mean +/- SD for high-density lipoprotein cholesterol was (0.91 +/- 0.16 vs. 1.04 +/- 0.13 mmol/L, P = 0.03) significantly lower in microalbuminuric patients than in non-microalbuminuric patients. CONCLUSION: This study has shown that adult nondiabetic Nigerians with MA are significantly more likely to have dyslipidemia than patients without MA. Hence, this subset of hypertensive patients constitutes a high risk group. Screening for MA, and early recognition and prompt treatment of serum lipid abnormalities in these patients may reduce the risk of adverse cardiovascular events.
