A Community Survey on Association of Sociodemographic Characteristics with Risk Perception and Awareness about Oral Cancer in Lagos, Nigeria

ABSTRACT Objective: To assess the level of oral cancer awareness and risk factors perception and the relationship between this awareness and the sociodemographic and behavioral characteristics. Material and Methods: This descriptive study was conducted among rural and urban residents in Lagos State, Nigeria. A multi-stage random sampling method was utilized. The sociodemographic and behavioral characteristics of respondents, as well as their knowledge about oral cancer risk factors, were assessed with a validated questionnaire. The bivariate association was done using an independent t-test and one-way ANOVA. Multivariate regression was used to determine the association between predictor variables and oral cancer knowledge scores. The statistical significance level is set at p<0.05. Results: 590 participants between 18 and 82 years (mean age 34.5 ±13.7) completed the survey. The prevalence of cigarette smoking was 25.7%, of which 16 (1.5%) were heavy smokers (20+ cigarettes per day). The prevalence of alcohol consumption was 66.1%, with 57 (9.7%) being heavy drinkers, consuming drinks for 5-7 days of the week. A high proportion of the respondents (>60%) exhibited gaps in their knowledge of oral cancer. Uneducated participants had lower oral cancer knowledge than those with >12 years of formal education (aOR = 5.347; 95% CI: 4.987-6.240). Participants who were smokers had lower oral cancer knowledge compared with non-smokers (aOR = 3.341; 95% CI: 2.147-4.783); Participants who consumed alcohol had more deficient oral cancer knowledge compared with non-drinkers (aOR = 1.699; 95% CI: 1.087-2.655); While heavy smokers aOR = 4.023; 95% CI: 3.615-4.825) and heavy drinkers aOR = 4.331; 95% CI: 3.158-5.939) had lower oral cancer knowledge compared with those who did not abuse both substances. Conclusion: A high proportion of the respondents exhibited gaps in their knowledge of oral cancer in their responses. Delayed diagnosis of oral cancer can be reduced by increasing the awareness and knowledge of the populace about risk factors and also in the recognition of its signs and symptoms.

Comparison of Dental Caries and Oral Hygiene Status of Children in Suburban with those in Rural Population of Southwestern Nigeria

ABSTRACT Objective: To compare prevalence of dental caries, oral hygiene status and associated risk factors of children in suburban and rural communities in the Southwest region of Nigeria. Material and Methods: Secondary data was extracted from cross-sectional researches conducted in two study locations involving 8 to 12 year olds. Data retrieved included age, gender, family structure, socioeconomic status, oral hygiene and dental caries. Caries assessment was done using WHO Oral Health Survey methods. Oral hygiene data was collected using Simplified Oral Hygiene Index (OHI-S) by Greene and Vermillion. Statistical significance was established at p<0.05. Results: The prevalence of dental caries in Group A and Group B study participants were 13.4% and 22.2% respectively. Children from rural community had significant higher caries prevalence (p=0.00) and poorer oral hygiene (P=0.00) compare with their counterparts in the suburban community. There was a significant association between oral hygiene, age and dental caries in suburban participants (p=0.02) while among the rural participants there was significant association between gender and dental caries (p=0.04). Children with poor oral hygiene have increased odds of having dental caries compared to children with good oral hygiene in the two study communities. Conclusion: Dental caries was more prevalent among the rural dwellers than the sub-urban dwellers. There is a need to make oral health care services/products available, accessible and affordable for the rural community.

Relationship Between Socio-Demographic Profile, Parity and Dental Caries Among a Group of Nursing Mothers in South East, Nigeria

ABSTRACT Objective: To determine the prevalence and risk indicators of caries among nursing mothers in a tertiary hospital. Material and Methods: This was a cross-sectional study of 408 nursing mothers aged 15 to 52 years who brought their children for immunization in a tertiary hospital in Enugu, Nigeria. Data on socio-demographic profile, parity, dental visits were collected. The presence of dental caries was recorded using the World Health Organization criteria. Results: The prevalence of dental caries was 11.0%, and the mean DMFT was 0.18. There was a statistically significant association between level of education (p<0.001), past dental visit (p<0.001) and the occurrence of dental caries. Caries was more prevalent in the mandibular teeth than the maxillary teeth. The left mandibular first and second permanent molars had the highest occurrence of dental caries. Missing (M) component of the DMFT index was highest and the care index was low. The significant predictors of caries among nursing mothers were fair oral hygiene and having below tertiary education. Conclusion: The prevalence of caries and the care index were both low in this study population. The significant predictors of dental caries were a tertiary level of education and poor oral hygiene. Incorporating oral health education during postnatal care can help reduce dental caries' occurrence and complications among nursing mothers in the study population.

Seroprevalence of chikungunya virus infection in five hospitals within Anyigba, Kogi State of Nigeria

ABSTRACT Febrile illnesses in developing countries are often misdiagnosed as malaria or typhoid fever. Although arboviral infections have similar clinical symptoms, they are usually not screened because of limited resources and the fact that there are several viruses in this group. Chikungunya virus (CHIKV) has been isolated in parts of Nigeria, but there is no documented evidence of the infection in Kogi State. This study determined seroprevalence of active and past CHIKV infection among febrile patients who tested negative for malaria and typhoid fever. Sera from 243 febrile patients were screened for CHIKV IgG and IgM using an immunochromatographic test kit. Clinical and socio-demographic variables were collected using a structured questionnaire. Recent CHIKV infection was observed in 5.8% of the study participants while 25.1% had IgG antibodies demonstrating previous infection. Significant associations were observed between seropositivity and age of participants (p < 0.001), sex (p = 0.044), marital status (p = 0.002), and occupation (p < 0.001). Clinical symptoms such as fever, joint pain, and headache were significantly associated with seropositivity. This study identified recent CHIKV infection in Anyigba. Therefore, there is need for routine screening of febrile patients and molecular characterization to determine the nature of circulating strains.

Body dysmorphic disorder in patients attending a dermatology clinic in Nigeria: sociodemographic and clinical correlates

Abstract: Background: Body dysmorphic disorder is a relatively common psychiatric disorder in the context of dermatology and cosmetic and plastic surgery but is underdiagnosed and underreported in Africa. Objective: To evaluate the prevalence of body dysmorphic disorder and symptoms of anxiety/depression and determine their sociodemographic and clinical correlates. Methods: A systematic random sampling design was made to recruit 114 patients with skin diseases. Sociodemographic and clinical data were obtained. The Body Dysmorphic Disorder Modification of the Yale-Brown Obsessive-Compulsive Scale, Hospital Anxiety and Depression Scale was administered, and data were analyzed using SPSS 20. Results: Mean age of participants was 37.70±17.47 years, and 67/114 (58.8%) were females. Prevalence of body dysmorphic disorder was 41/114 (36.0%), and prevalence of anxiety/depression symptoms was 35/114 (30.7%). Prevalence of body dysmorphic disorder in patients with anxiety/depression symptoms was 15/41 (36.6%), and patients with facial disorders expressed the highest burden of anxiety/depression symptoms, in 15/35 (42.9%). Factors associated with significantly higher mean body dysmorphic disorder include age<50years (p=0.039), and anxiety/depression (p<0.001), education below high school was associated with higher mean anxiety/depression score (P= 0.031). In a binary logistic regression model, presence of anxiety/depression symptoms was predictive of body dysmorphic disorder (OR=10.0, CI: 4.1-28.2, p<0.001). Study limitations: the study is uncontrolled, conducted in a single source of care, thus limiting generalization to nonrelated settings. Conclusion: Prevalence of body dysmorphic disorder is high among dermatology patients and most prevalent in facial disorders. Facial diseases are associated with the highest burden of anxiety/depression symptoms. This is a clarion call for dermatologists to routinely assess for body dysmorphic disorder and appropriately refer affected patients to mental health care.

Prevalence of Chronic Kidney Disease in newly diagnosed patients with Human immunodeficiency virus in Ilorin, Nigeria / A prevalência de doença renal crônica em pacientes recentemente diagnosticados com o vírus da imunodeficiência humana em llorin, Nigéria

Abstract Introduction: Human immunodeficiency virus (HIV) the causative agent of Acquired immunodeficiency syndrome (AIDS) is an important cause of renal diseases in sub-Saharan Africa. There is paucity of studies on the burden of chronic kidney disease (CKD) among patients with HIV/AIDS in the North-Central zone of Nigeria. Methods: This is a cross-sectional study of 227 newly-diagnosed, antiretroviral naïve patients with HIV/AIDS seen at the HIV clinic of the Medical Out-patient Department (MOPD) of University of Ilorin Teaching Hospital (UITH). They were matched with 108 control group. Laboratory investigations were performed for the participants. CKD was defined as estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 and/or albumin creatinine ratio (ACR) > 30 mg/g. Results: There were 100 (44%) males among the patients and 47 (43.5%) among the control group. The mean ages of the patients and controls were 40.3 ± 10.3 years and 41.8 ± 9.5 years respectively. CKD was observed in 108 (47.6%) among the patients and 18 (16.7%) of the controls (p = 0.01). The median CD4 T-cell count was significantly lower in patients with CKD. Ninety-three (41.0%) of the patients had dipstick proteinuria of > 2 +. The median albumin creatinine ratio (ACR) was significantly higher among the HIV-positive patients (272.3 mg/g) compared with the HIV-negative controls (27.22 mg/g) p = 0.01. The CD4 T-cell count correlates positively with eGFR (r = 0.463, p = 0.001) and negatively with ACR (r = -0.806, p = 0.001). Conclusions: CKD is very common among patients with HIV/AIDS in Ilorin. Screening and early intervention for CKD should be part of the protocols in the management of these patients. .

Resumo Introdução: o vírus da imunodeficiência humana (HIV), o agente causador da síndrome da imunodeficiência adquirida (AIDS), é uma importante causa de doenças renais na África subsaariana. Há escassez de estudos sobre o impacto da doença renal crônica (DRC) em pacientes com HIV/AIDS na zona centronorte da Nigéria. Métodos: Este é um estudo transversal com 227 pacientes recém-diagnosticados com HIV/AIDS, não tratados com agentes antirretrovirais, atendidos no ambulatório de HIV do Hospital Universitário da Universidade de Ilorin (UITH). Eles foram pareados com 108 indivíduos do grupo controle. Os pacientes foram submetidos a investigações laboratoriais. A DRC foi definida como taxa estimada de filtração glomerular (eTFG) ≤ 60 ml/min/1,73m2 e/ou a relação entre albumina e creatinina (RAC) ≥ 30 mg/g Resultados: Houve 100 (44%) pacientes do sexo masculino entre os pacientes e 47 (43,5%) entre os indivíduos do grupo controle. As médias de idade dos pacientes e controles foram de 40,3 ± 10,3 anos e 41,8 ± 9,5 anos, respectivamente. A DRC foi observada em 108 indivíduos (47,6%) entre os pacientes e em 18 (16,7%) dos controles (p = 0,01). A contagem mediana de linfócitos T CD4 foi significativamente menor nos pacientes com DRC. Noventa e três (41,0%) dos pacientes tiveram proteinúria ≥ 2 + no exame de dipstick (tiras reagentes). A mediana da relação entre creatinina e albumina (RAC) foi significativamente maior entre os indivíduos HIV-positivos (272,3 mg/g), em comparação com os controles HIV negativos (27,22 mg/g) p = 0,01. A contagem de linfócitos T CD4 correlacionou-se positivamente com a eTFG (r = 0,463, p = 0,001) e negativamente com o RAC (r = -0,806, p = 0,001). Conclusões: DRC é muito comum entre os pacientes com HIV/AIDS em Ilorin. Triagem e intervenção precoce para DRC devem fazer parte dos protocolos de tratamento desses pacientes. .

The burden of HIV infection among women attending antenatal clinic in a semi-urban Nigerian town / Dimensión del problema de la infección por el VIH entre las mujeres que asisten a la clínica prenatal en un pueblo nigeriano semiurbano

BACKGROUND: Stable heterosexual relationships are a major determinant of the HIV epidemic and seroprevalence rate of HIV amongst antenatal women is a reflection of what is happening in the larger society. OBJECTIVES: This study aims to determine the HIV seroprevalence rate and to identify factors responsible for this rate among pregnant women. METHOD: The study was a three-year (July 2008-June 2011) cross-sectional evaluation of cases of HIV in pregnancy. Data were collected with the aid of a closed structured self-administered questionnaire for all the positive women and randomly selected negative cases. The study was carried out at Niger Delta University Teaching Hospital in Bayelsa State, Nigeria. RESULTS: The seroprevalence rate during the study period was 4.9%. Parity, age at first coitus, educational status, marital status and occupation do not seem to increase the risk. However, partner being unemployed, hospital/clinic delivery, the route of last delivery, previous induced abortion and the number of lifetime partners were identified as risk for HIV seropositivity (all p-values < 0.005). CONCLUSION: Sex education on the dangers of sexual promiscuity, availability of barrier methods of contraception, delivery with strict adherence to the principles of universal precaution and routine screening of all pregnant women during the antenatal period will help to decrease the prevalence of HIV in our environment.

ANTECEDENTES: Las relaciones heterosexuales estables son un factor determinante importante de la epidemia de VIH, y la tasa de seroprevalencia de VIH entre las mujeres prenatales es un reflejo de lo que está sucediendo en la sociedad en general. OBJETIVOS: Este estudio persigue determinar la tasa de seroprevalencia de VIH, e identificar los factores responsables de este índice entre las mujeres embarazadas. MÉTODO: Se llevó a cabo un estudio de tres años (julio 2008 – junio 2011) consistente en una evaluación transversal de casos de VIH en el embarazo. Se recogieron datos con la ayuda de un cuestionario autoadministrado estructurado cerrado aplicado a todas las mujeres positivas así como a casos negativos seleccionados al azar. El estudio se hizo sólo en el Hospital Docente Universitario de Niger Delta, en el estado de Bayelsa, Nigeria. RESULTADOS: La tasa de seroprevalencia durante el periodo de estudio fue de 4.9%. La paridad, la edad al primer coito, la escolaridad, el estado civil, y la ocupación, no parecen aumentar el riesgo. Sin embargo, la pareja desempleada, el parto en el hospital o la clínica, el desarrollo del último parto, un aborto previo inducido, y el número de parejas durante toda la vida, fueron identificados como riesgos de seropositividad de VIH (todos los valores de p < 0.005). CONCLUSIÓN: La educación sexual acerca de los peligros de la promiscuidad sexual, la disponibilidad de métodos anticonceptivos, el parto bajo la estricta observancia de los principios de precaución universal, y el tamizaje de rutina de todas las mujeres embarazadas durante el período prenatal, ayudará a disminuir la prevalencia de VIH en nuestro medio ambiente.

Fatores de risco de apneia obstrutiva do sono entre pacientes ambulatoriais nigerianos / Risk factors of obstructive sleep apnea among nigerian outpatients

Apneia obstrutiva do sono (SAOS) é uma condição médica com consequências adversas. OBJETIVOS: Descrever os fatores de risco associados com OSA em adultos atendidos em uma clínica especializada ambulatorial. Forma de estudo: Estudo clínico prospectivo, entre pacientes ambulatoriais adultos em uma clínica especializada. MÉTODO: Os dados foram coletados por meio de questionário incorporando o BQ e os pacientes foram divididos em riscos de baixa e alta da OSA. Os fatores de risco associados com OSA na análise univariada foram submetidas a um modelo multivariado de regressão logística binária. Odds ratio ajustados com intervalo de confiança de 95% foram calculados para as seguintes variáveis independentes. RESULTADOS: Cento e nove e cinco pacientes participaram do estudo (sexo masculino 56,4%; idade 43,5 ± 15,6 anos; não roncadores habituais 81,5%, risco de alta OSA 17,4%, IMC 24,1 ± 4,6 kg/m²; obesos 12,9%). Seis fatores, incluindo o estado civil e a pressão arterial, foram significativamente associados com SAOS usando análise bivariada, no entanto, idade, horas de trabalho, tabagismo e IMC permaneceu preditivo da OSA na análise de regressão logística. CONCLUSÕES: SAOS é comum entre pacientes nigerianos, pode ser sub-reconhecida e está associada a fatores de risco que são passíveis de estratégias preventivas.

Obstructive sleep apnea (OSA) is a medical condition with adverse consequences. OSA is credited to be a sleep disorder that disproportionately affects blacks. The Berlin Questionnaire (BQ) is a screening questionnaire for OSA. OBJECTIVE: To describe the risk factors associated with OSA among adults attending an out-patient specialist clinic. Study design: Prospective, clinical study including adult outpatients attending a specialist clinic. METHOD: Data was collected using a questionnaire incorporating the BQ and patients were divided into low and high risks of OSA. The risk factors associated with OSA in the univariate analyses were subjected to a multivariate binary logistic regression model. Adjusted odds ratios with 95% confidence intervals were calculated for these independent variables. RESULTS: One hundred and ninety five patients participated in the study (Males 56.4%; Age 43.5 ± 15.6 years; Non-habitual snorers 81.5%; High risk OSA 17.4%; BMI 24.1 ± 4.6 kg/m²; Obese 12.9%). Six factors including marital status and blood pressure were significantly associated with OSA using bivariate analysis nevertheless age, hours at work, smoking status and BMI remained predictive of OSA on logistic regression analysis. CONCLUSIONS: OSA is common among Nigerian outpatients, may be under-recognized and is associated with risk factors that are amenable to preventive strategies.

Knowledge and perception of HIV prevention through condom use among midlife and older adults in Calabar, Nigeria / Conocimientos y percepción de la prevención del VIH a través del uso del condón entre adultos de mediana y avanzada edad en Calabar, Nigeria

OBJECTIVES: Older people are at increasing risk of HIV/AIDS and other sexually transmitted diseases. The use of condoms which can protect both partners from sexually transmitted infections (STIs) including HIV during vaginal and anal sex is mostly neglected by them. In fact, postmenopausal women may not see the need for condom use when they are no longer at risk for pregnancy. Even though HIV/AIDS in older patients carry a high mortality, it is many times neglected by even healthcare providers because of the belief that older persons are no longer sexually active. This study aimed to determine the perception and knowledge ofcondom use as a strategy for HIV/AIDS prevention among midlife and older adults in Calabar, Nigeria. METHOD: A cross-sectional study was carried out to identify the perception and knowledge of HIV transmission and condom use among adults over 50 years of age, in the University of Calabar Teaching Hospital, Calabar, Nigeria. A structured questionnaire was used to get the demographic data, sources of information about the disease, knowledge about the use of condom and its efficacy in preventing the disease. RESULTS: A total of 488 participants were interviewed, comprising 263 males (53.9%) and 225 females (46.1%). Most of them (83.8%) were married and the rest (16.2%) were single. The majority of the respondents (368, 75.7%) got their information about HIV/AIDS transmission and prevention from the television. Other sources of information for respondents on HIV/AIDS were awareness campaigns (43.5%), newspapers (38.6%), friends (37.3%) and neighbours (27.1%). Three hundred and four (62.3%) of the respondents said that they had used condoms and believed that condoms could effectively prevent transmission of STIs including HIV compared to the one hundred and eighty-four (31.7%) who opined otherwise. Abstinence was the major mode of prevention of the disease among respondents while unprotected sexual intercourse was identified by the majority of the respondents (87.5%) as a high risk factor. CONCLUSION: There should be more public education on HIV/AIDS to midlife and older adults.

OBJETIVOS: Las personas de edad más avanzada enfrentan un riesgo creciente de VIH/SIDA y otras enfermedades de transmisión sexual. El uso de condones que pueden proteger a las parejas de las infecciones de transmisión sexual (ITS) - incluyendo el VIH - durante el sexo vaginal y anal, es descuidado la mayor parte de las veces. De hecho, las mujeres post-menopáusicas pueden no ver la necesidad del uso del condón cuando no corren ya más riesgo de salir embarazadas. Aunque el VIH/SIDA en los pacientes más viejos conlleva una mortalidad alta, a menudo es descuidado por los proveedores de salud debido a la creencia de que las personas de mayor edad no están ya sexualmente activas. Este estudio se propuso determinar la percepción y los conocimientos del uso del condón como una estrategia para la prevención de VIH/SIDA entre los adultos de mediana y avanzada edad en Calabar. METODOLOGIA: Se llevó a cabo un estudio transversal con el fin de identificar la percepción y los conocimientos de transmisión de VIHy el uso del condón entre los adultos mayores de 50 años de edad, en la Universidad del Hospital Docente de Calabar, en Cross River State. Se aplicó un cuestionario estructurado para obtener los datos demográficos, las fuentes de información sobre la enfermedad, así como el conocimiento sobre el uso del condón y su eficacia para prevenir la enfermedad. RESULTADOS: Un total de 488 participantes fueron entrevistados, de los cuales 263 eran varones (53.9%) y 225 hembras (46.1%). La mayoría de ellos (83.8%) estaban casados y el resto (16.2%) eran solteros. La mayoría de los encuestados (368, 75.7%) recibió la información queposeían sobre la transmisión y prevención del VIH/SIDA, a través de la televisión. Otras fuentes de información para los encuestados sobre el VIH/SIDA fueron las campanas de concientización (43.5%), los periódicos (38.6%), los amigos (37.3%) y los vecinos (27.1%). Trescientos cuatro (62.3%) encuestados dijeron que habían usado condones y creían que los condones podían prevenir de forma efectiva la transmisión de ITS, incluyendo el VIH, en comparación con los ciento ochenta y cuatro (31.7%) que opinaban diferente. La abstinencia fue el modo mayor de prevención de la enfermedad entre los encuestados, mientras que las relaciones sexuales sin protección fueron identificadas como un factor de riesgo alto por la mayoría de los entrevistados (87.5%) CONCLUSIÓN: Debe aumentarse la educación pública sobre el VIH/SIDA para las personas de mediana y avanzada edad.

Respiratory diseases morbidity and mortality among adults attending a tertiary hospital in Nigeria / Morbidade e mortalidade relacionadas a doenças respiratórias em adultos atendidos em um hospital terciário na Nigéria

OBJECTIVE: To determine the morbidity and mortality related to respiratory diseases among adults attending a tertiary-care hospital in Nigeria. METHODS: We carried out a retrospective study of 183 adult patients (> 15 years of age), diagnosed with respiratory diseases between November of 2006 and October of 2008 at the Federal Medical Centre in Ido-Ekiti, Nigeria. RESULTS: Of the 183 patients enrolled in the study, 78 (42.6 percent) were male and 105 (57.4 percent) were female, the male: female ratio being 1:1.4. Respiratory diseases were predominant in the 25-44 year age bracket (37.2 percent) and lower socioeconomic class (81.4 percent). Pulmonary TB was the leading cause of morbidity (in 42.1 percent), followed by asthma (in 17.5 percent) and pneumonia (in 15.3 percent). Lung cancer was uncommon (in only 0.6 percent). Pulmonary TB was the leading cause of hospitalization for respiratory disease (in 32 percent). Pulmonary TB, asthma, pneumonia and pleural pathologies were more common in women, whereas COPD was more common in men. The most common comorbidity was HIV infection (in 11.5 percent). The overall mean length of hospital stay was 14 days. Overall mortality was 8.7 percent; 50 percent of the deaths were attributed to pulmonary TB, 25 percent were attributed to pleural disease, 12.5 percent were attributed to pneumonia, and 6.25 percent were attributed to acute exacerbation of COPD. Mortality was higher in women and in the 25-44 year age bracket. CONCLUSIONS: Pulmonary TB, asthma and pneumonia were the leading causes of respiratory disease-related morbidity. Pulmonary TB was the leading cause of respiratory disease-related mortality among the adult Nigerians evaluated. Therefore, these conditions should be given higher priority in patient care. In addition, antiretroviral therapy should be readily accessible and affordable to HIV-infected individuals.

OBJETIVO: Determinar a morbidade e a mortalidade relacionadas a doenças respiratórias em adultos atendidos em um hospital terciário na Nigéria. MÉTODOS: Estudo retrospectivo com 183 pacientes adultos (> 15 anos) diagnosticados com doenças respiratórias, entre novembro de 2006 e outubro de 2008, no Centro Médico Federal em Ido-Ekiti, Nigéria. RESULTADOS: Dos 183 pacientes estudados, 78 (42,6 por cento) eram do sexo masculino e 105 (57,4 por cento) do sexo feminino (razão entre homens e mulheres: 1:1,4). As doenças respiratórias foram predominantes na faixa etária entre 25 e 44 anos (37,2 por cento) e classe socioeconômica baixa (81,4 por cento). A forma pulmonar da TB foi a principal causa de morbidade (em 42,1 por cento), seguida por asma (em 17,5 por cento) e pneumonia (em 15,3 por cento). O câncer de pulmão foi raro (em somente 0,6 por cento). A TB pulmonar foi a principal causa de hospitalização devido à doença respiratória (em 32 por cento). A forma pulmonar da TB, asma, pneumonia e patologias da pleura foram mais frequentes no sexo feminino, ao passo que a DPOC foi mais frequente no sexo masculino. A comorbidade mais frequente foi a infecção por HIV (em 11,5 por cento). A média do tempo de hospitalização foi de 14 dias. A mortalidade foi 8,7 por cento; 50 por cento das mortes foram atribuídas à TB pulmonar, 25 por cento à doença pleural, 12,5 por cento à pneumonia e 6,25 por cento à exacerbação aguda da DPOC. A mortalidade foi maior em mulheres e na faixa etária de 25 a 44 anos. CONCLUSÕES: TB pulmonar, asma e pneumonia foram as principais causas de morbidade relacionada a doenças pulmonares. A forma pulmonar da TB foi a principal causa de mortalidade relacionada a doenças respiratórias na população adulta nigeriana estudada. Portanto, deve-se dar grande prioridade a essas doenças no atendimento desses pacientes. Além disso, a terapia antirretroviral deve ser de fácil acesso e pouco dispendiosa para indivíduos infectados com HIV.

Adverse reactions from community directed treatment with ivermectin (CDTI ) for onchocerciasis and loiasis in Ondo State, Nigeria

Onchocerciasis is an endemic disease in Ondo state, Nigeria. Community directed distribution of ivermectin is currently on-going in some local government areas of the state. Randomly selected persons (2 331 males and 2 469 females) were interviewed using a modified rapid assessment procedure for Loa loa (RAPLOA) to assess community directed treatment with ivermectin. The retrospective study evaluated the coverage, impacts and adverse reactions to the drug treatment. A questionnaire was administered by house-to-house visit in six local government areas, implementing community directed treatment with ivermectin (CDTI) in this bioclimatic zone. A total of 2,398 respondents were reported to have participated in the treatment. The overall ivermectin coverage of 49.96% was recorded (range 0 - 52% in different communities). Adverse reactions from ivermectin administration were experienced in 38% of individuals. Diverse adverse reactions experienced included predominantly itching (18.50%); oedema, especially of the face and the limbs (8.2%); rashes (3.4%) and body weakness (2.4%). Expulsion of intestinal worms occurred in 0.96% of the respondents. The occurrence of adverse reactions in relation to age categories was statistically significant. Neither fatal nor severe adverse reactions were reported by respondents. Significantly, despite experienced adverse reactions, continued participation, acceptability and compliance to ivermectin treatment was expressed by the various communities. This attitude is in consonance with the African Programme for Onchocerciasis Control (APOC) objectives. Rev. Biol. Trop. 56 (4): 1635-1643. Epub 2008 December 12.

La oncocercosis es endémica en el estado Ondo, Nigeria. Se seleccionaron 4 800 personas al azar para evaluar con encuesta retrospectiva la cobertura, efectos y reacciones al tratamiento farmacológico con ivermectina administrado por la misma comunidad. La cobertura global de ivermectina fue 50 % con reacciones adversas en 38 % de los individuos. Estas fueron comezón picazón (18%), edema, especialmente de la cara y las extremidades (8%), erupciones cutáneas (3%) y debilidad (2%); dependieron de la edad y no hubo reacciones más graves. La expulsión de las lombrices intestinales se produjo en 96% de los encuestados. A pesar de las reacciones adversas, hubo continuidad, aceptación y cumplimiento del tratamiento con ivermectina, en consonancia con los objetivos del Programa Africano para el Control de Oncocercosis (APOC).