Primary Hypertension with Target Organ Damage among Apparently Healthy Secondary School Students in Osogbo, South-Western Nigeria.

INTRODUCTION: In recent times, there has been an increase in the frequency of hypertension among young people which is contributing globally to the increase in cardiovascular morbidity and mortality in adults. OBJECTIVE: The aim of this study was therefore to determine the prevalence of primary hypertension and its risk factors among apparently healthy secondary school students in Osogbo, southwestern Nigeria. METHODS: A school-based cross-sectional study of a total of 404 secondary school students in Osogbo city. Following informed parental consents of all the students involved in the study, blood pressure (BP) measurements were taken at 2 different visits by auscultation after a negative urine dip stick test result (thus excluding haematuria or proteinuria) in every subject before each BP was measured. RESULTS: The overall prevalence of hypertension and prehypertension in this study was 3.5% (n = 14) and 6.2% (n = 25), respectively. Obesity, consumption of extra - uncooked salt, high parental education and attendance of privately-owned secondary schools were identified risk factors associated with elevated BP. Seven (29%) of 24 subjects with hypertension had features of left ventricular hypertrophy (an evidence of target organ damage) on echocardiography and electrocardiography. All subjects with elevated BP had normal renal scan. CONCLUSION: Hypertension with features of target organ damage exists among adolescents. No known primary aetiologies were found among the hypertensive adolescents in the study and thus they were all deemed to have essential hypertension.

INTRODUCTION: Ces derniers temps, on a constaté une augmentation de la fréquence de l'hypertension chez les jeunes, ce qui contribue globalement à l'augmentation de la morbidité et de la mortalité cardiovasculaires chez les adultes. OBJECTIF: Le but de cette étude était donc de déterminer la prévalence de l'hypertension primaire et de ses facteurs de risque parmi des élèves du secondaire apparemment en bonne santé à Osogbo, sud-ouest du Nigeria. MÉTHODES: Étude transversale en milieu scolaire portant sur un total de 404 élèves du secondaire dans la ville d'Osogbo. Après avoir obtenu le parents informés de tous les élèves participant à l'étude, des mesures de l'étude, la pression artérielle a été mesurée par auscultation lors de 2 visites après un résultat négatif à la bandelette urinaire (excluant ainsi l'hématurie ou la protéinurie) chez chaque sujet avant que la TA ne soit mesurée. RÉSULTATS: La prévalence globale de l'hypertension et de la préhypertension dans cette étude était de 3,5% (n = 14) et de 6,2% (n = 25), respectivement. L'obésité, la consommation de sel extra-cuit, le haut niveau d'éducation des parents et la fréquentation d'écoles secondaires privées ont été identifiés comme des facteurs de risque associés à une tension artérielle élevée. Sept (29%) des 24 sujets hypertendus présentaient des caractéristiques d'hypertrophie du ventriculaire gauche (preuve d'une atteinte des organes cibles) à l'échocardiographie et à l'électrocardiographie. Tous les sujets présentant une PA élevée avaient une scintigraphie rénale normale. CONCLUSION: L'hypertension avec des caractéristiques d'atteinte des organes cibles existe chez les adolescents. Aucune étiologie primaire connue n'a été trouvée chez les adolescents hypertendus de l'étude et donc tous considérés comme souffrant d'hypertension essentielle. Mots clés: Hypertension primaire, dommages aux organes cibles, adolescents sains.

Community Advocacy and Capacity Building of Community Health Workers on Rheumatic Heart Disease in Osun State, Nigeria.

Rheumatic heart disease (RHD) is one of the leading causes of cardiovascular diseases in the world. The study aimed to assess awareness and capacity building on the diagnosis and prevention of RHD among Community Health Workers (CHWs) Nigeria. It was an interventional study, where 300 CHWs from public Primary Health Care (PHC) facilities were selected pre-assessed on the diagnosis and prevention of RHD before their training on RHD. Also, a post-test evaluation was done to reassess the CHWs awareness on RHD. Data were analyzed and RHD knowledge was scored and graded. Results showed, at pre-test evaluation, that 49% of the CHWs had good knowledge, 49.7% had fair knowledge while 4.1% had poor knowledge on the diagnosis and prevention of RHD, while post-test evaluation revealed that 100% of the CHWs had good knowledge. Awareness of the CHWs about the diagnosis and prevention of RHD was fair in the pre-test and improved after the training with all the CHWs having good knowledge. This showed the training was impactful. Intermittent assessment of the awareness and simultaneous training of the CHWs on RHD may be scaled up into a significant and effective measure in the armamentarium of community prevention of the disease.

La cardiopathie rhumatismale est l'une des principales causes de maladies cardiovasculaires dans le monde. L'étude visait à évaluer la sensibilisation et le renforcement des capacités sur le diagnostic et la prévention de la cardiopathie rhumatismale chez les agents de santé communautaire (ASC). au Nigeria. Il s'agissait d'une étude interventionnelle, dans le cadre de laquelle 300 ASC des établissements publics de soins de santé primaires (PHC) ont été sélectionnés et pré-évalués sur le diagnostic et la prévention des RHD avant leur formation sur les RHD.. De plus, une évaluation post-test a été réalisée pour réévaluer la connaissance des ASC sur la RHD. Les données ont été analysées et les connaissances sur la RHD ont été notées et évaluées. Les résultats ont montré, lors de l'évaluation du pré-test, que 49% des ASC avaient une bonne connaissance, 49,7 % une connaissance moyenne et 4,1 % une mauvaise connaissance du diagnostic et de la prévention de RHD, tandis que l'évaluation du post-test a révélé que 100% des ASC avaient de bonnes connaissances. La connaissance des ASC sur le diagnostic et la prévention de la RHD était moyenne dans le pré-test et s'est améliorée après la formation, tous les ASC ayant de bonnes connaissances. Cela montre que la formation a eu un impact. L' évaluation intermittente de la sensibilisation et la formation simultanée des ASC sur la RHD peut devenir une mesure significative et efficace dans l'arsenal de prévention communautaire de la maladie. Mots-clés: Cardiopathie rhumatismale, Agents de santé communautaire, service de santé, prévention.

Aortic Valve Regurgitation following Transthoracic Open Surgical Ligation of Patent Ductus Arteriosus.

BACKGROUND: Transthoracic open surgical ligation (TTOSL) of patent ductus arteriosus (PDA) remains the most readily available and affordable treatment option in resource-poor countries such as Nigeria. OBJECTIVES: To determine the incidence and outcome of aortic valve regurgitation (AR) following TTOSL of PDA. METHODS: Retrospective audit of consecutive patients who underwent TTOSL of PDA over a 4½-year period (January 2015 to June 2019) at the OAUTHC, Ile-Ife, Nigeria. Hospital records including echocardiograms (pre-operative, immediate post-operative and follow-up performed a day after TTOSL, at 1, 3 and 12 months) were reviewed for presence and severity of AR. RESULTS: Twenty-six patients (11 males and 15 females) aged 3 months 24 years (Mean = 3.16 years) had TTOS PDA ligation. Only 3 (11.5%) patients had AR pre-operatively; 2 graded moderate AR and 1 graded mild. Twenty (76.9 %) patients had immediate post-operative AR; 4 (20.0%) of which were moderate and the others (80.0%) were mild. Eighteen (69.2%) patients still had AR post-operative day 1; 16 were mild and the rest 2 which were moderate were the same patients that had AR pre-operatively. At 3 months follow-up, 6 of 20 patients (30.0%) had AR; all were mild. Only 2 of 18 (11.1%) followed up for 12 months had AR. They both had had moderate AR pre-operatively which were now graded as mild. There was no mortality. CONCLUSION: Aortic regurgitation is common after TTOSL of PDA. However, in most instances, it is mild and transient.

Latrogenic burns injury complicating neonatal resuscitation.

A case ofiatrogenic thermal injury in a newborn infant during resuscitation for perinatal asphyxia at a secondary health facility is described. The injury, with surface area coverage of about 4%, involved the lower limbs. This report highlights the poor newborn resuscitation skills of traditional medical practice.

Pyogenic meningitis in Ilesa, Nigeria.

This study was conducted in 124 children with meningitis to review the etiology, antimicrobial susceptibility and outcome of disease in a Nigerian tertiary health facility. Of these, 97 (78.27%) were culture positive; in the rest 27(21.8%), diagnosis was based on Gram staining of the CSF. Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Staphylococcus aureus and Escherichia coli were isolated in 33.9%, 33.9%, 5.6%, 2.4%, and 2.4% samples respectively. All the isolates had 100 percent; sensitivity to both ceftriaxone and ciprofloxacin while the sensitivities to penicillin and ampicillin were remarkably low. The mortality was 33/124 (26.6%) while 16/ 91 (17.6%) of the survivors had various neurologic sequelae.

Iatrogenic burns injury complication neonatal resuscitation

A case of iatrogenic thermal injury in a newborn infant during resuscitation for perinatal asphyxia at a secondary health facility is described. The injury; with surface area coverage of about 4; involved the lower limbs. This report highlights the poor newborn resuscitation skills of traditional medical practice