Baba Maiyaki Musa

Prevalence of hepatitis B virus infection in Nigeria, 2000-2013: A systematic review and meta-analysis

Vaccination against the hepatitis B virus (HBV) in the West African nation of Nigeria is lower than many Sub-Saharan African countries. In Nigeria, HBV is reported to be the most common cause of liver disease. However, the extent of HBV exposure among Nigerians at average risk is unknown. Our aim, therefore, was to accurately estimate the HBV prevalence for the country and the prevalence for specific subgroups. We used electronic databases to select systematic reviews and meta-analyses from 2000 to 2013. Forty-six studies were included (n = 34,376 persons). We used a random effects meta-analysis of cross-sectional and longitudinal studies to generate our estimates. The pooled prevalence of HBV in Nigeria was 13.6% (95% confidence interval [CI]: 11.5, 15.7%). The pooled prevalence (% [95% CI]) among subgroups was: 14.0% (11.7, 16.3) for blood donors; 14.1% (9.6, 18.6) for pregnant women attending antenatal clinics; 11.5% (6.0, 17.0) for children; 14.0% (11.6, 16.5) among adults; and 16.0% (11.1, 20.9) for studies evaluating adults and children. HBV prevalence in Nigeria varied by screening method [% (95% CI)]: 12.3% (10.1, 14.4) by using enzyme-linked immunosorbent assay; 17.5% (12.4, 22.7) by immunochromatography; and 13.6% (11.5, 15.7) by HBV DNA polymerase chain reaction. HBV infection is hyperendemic in Nigeria and may be the highest in Sub-Sahara Africa. Our results suggest that large numbers of pregnant women and children were exposed to HBV from 2000 to 2013. Increased efforts to prevent new HBV infections are urgently needed in Nigeria.

Xanthoma disseminatum in a black African woman

Purpose  To report a partial steroid response of xanthoma disseminatum in a black African woman. Design  Case report and literature review. Methods  Histopathologic study of cutaneous tumour and clinical follow-up. Results  A 32-year-old black African woman with mucocutaneous xanthomatosis and dysphonia, which partially responded to treatment with steroids. Conclusions  Xanthoma dissseminatum is a rare condition for which there is no medical treatment. We reported the condition in a black African woman whose skin and CNS symptoms regressed remarkably within 22 weeks of steroid therapy.Purpose  To report a partial steroid response of xanthoma disseminatum in a black African woman.

Overweight and Obesity among Adolescents in Kano, Nigeria

Background: Childhood and adolescent obesity is a global public health concern because of associated increased risk of cardiovascular diseases later in life. Although there are several studies on childhood obesity in Nigeria, few have assessed it in adolescents. Objectives: This study intends to assess the prevalence of overweight and obesity in adolescents in urban northern Nigeria. Method: A cross sectional school based survey was conducted to determine the prevalence of overweight and obesity. Stratified sampling was used to select 718 students. Their weight and height were measured and used to compute the Body Mass Index (BMI). Overweight and obesity were defined using the International Obesity Task Force (IOTF). Results: The prevalence of obesity and overweight were 0.84% and 1.98% respectively; with advancing age as a risk factor for both overweight and obesity. Multivariate logistic regression showed that the risk of overweight was almost two times higher with advancing age adjusted odds ratio of {1.79} with a p-value of { 0.03} and C.I. { 1.05 - 3.09}, adjusted for gender and school type. Conclusion: The data suggest the prevalence of overweight and obesity are low, and that advancing age is a risk factor for obesity.

Incidence of tuberculosis and immunological profile of TB/HIV co-infected patients in Nigeria.

Background: We obtained estimates of the incidence of tuberculosis (TB) among patients receiving HIV Treatment. We also modeled the relationship between incident TB and change in CD4 count over the follow-up period. Methods: We analyzed the incidence of TB over 10 years from initiation of HIV treatment among 345 HIV treatment-naοve persons, who were enrolled in a cohort in Kano, Nigeria. We used Generalized Estimating Equation [GEE] to identify determinants of TB incidence and model the relationship between the occurrences of TB with change in CD4 count over the follow-up period. We created Kaplan-Meier curves stratified by anti-retroviral therapy (ART) treatment failure status to examine the effect of first line ART treatment failure on occurrence of TB. Result: During the 10-year period, 47(13.62%) had TB [incidence was 7.43 per (1,000) person year)]. It is associated with decreasing age (OR = 0.98), female gender (OR = 0.83), being on first line ART other than AZT (OR = 0.87), poor adherence (OR = 1.25), change in ART regimen (OR = 2.3) and ART treatment failure (OR = 1.51). Odds of TB occurrence was also associated with CD4 increment at 10 years (OR = 0.99). Those with TB/HIV co-infection tend to have statistically significant shorter time to failing first line ART regimen compared to those with HIV infection alone. Conclusion: There was high incidence of TB in the studied HIV cohort with a deleterious effect on the outcome of ART treatment. There is need for early TB screening and re-screening among all HIV patients.

Higher prevalence of wheezing and lower FEV1 and FVC percent predicted in adults with sickle cell anaemia: A cross-sectional study

Respiratory symptoms including wheezing are common in adults with sickle cell anaemia (SCA), even in the absence of asthma. However, the prevalence of spirometry changes and respiratory symptoms in adults with SCA is unknown.

Cost-optimization in the treatment of multidrug resistant tuberculosis in Nigeria

To compare the cost of facility‐based MDR TB care (F) to home‐based care (H) from the perspective of the Nigerian national health system.

Prevalence and burden of human immunodeficiency virus and hepatitis B virus co-infection in Nigeria: a systematic review and meta-analysis.

Background: Studies on HIV/HBV co-infection in Nigeria yielded prevalence ranging between 10% and 70%, giving the widest variation in prevalence of HIV/HBV co-infection from studies emanating from any country all over the world. However, estimation of clinical and public health impacts of HIV/HBV co-infection requires a robust and reliable epidemiological data for an appropriate estimation of the logistical, economic, and humanitarian impact of the two viruses in Nigeria. Objective: The aim of this review was to estimate the prevalence and burden of HBV infections in HIV-infected patients in Nigeria. Methods: Estimates were derived from a random effects meta-analysis of observational studies reporting the prevalence of HBV/HIV in Nigeria. The derived estimate for the prevalence of HBV/HIV co-infection was applied to the total HIV-infected populations in Nigeria to give an estimated burden of HBV/HIV co-infection in Nigeria. Result: Thirty three studies with quality data from seventeen states in Nigeria, up to December 16, 2013, were included. I-squared heterogeneity was 98%. Random effect model (REM) estimate of prevalence among HIV-infected patients from the 33 studies was 15% (95% CI 13-17). The prevalence of HIV/HB co-infection among attendees of HIV clinics was 17% [95% CI 13-20], among pregnant HIV-infected patients were 10% [95% CI 6-15], 12% [95% CI 6-17] among HIV-infected children and among newly discovered HIV-infected voluntary blood donor (VBD) patients 10% [95% CI 6-15]. Meta- regression showed no significant associations between the mean age of the patients, the proportion of female patients, year of the study and prevalence of co-infection. The burden of HBV/HIV co-infection in Nigeria, based on the estimate, was 984 000 C.I. [852 800-1115 200]. Conclusion: In Nigeria, the estimated prevalence of HBV/HIV infection is 15% resulting in a substantial burden for the country.

Initiation of antiretroviral therapy based on the 2015 WHO guidelines.

Objective:In 2015, the WHO recommended initiation of antiretroviral therapy (ART) in all HIV-positive patients regardless of CD4+ cell count. We evaluated the cost-effectiveness of immediate versus deferred ART initiation among patients with CD4+ cell counts exceeding 500cells/&mgr;l in four resource-limited countries (South Africa, Nigeria, Uganda, and India). Design:A 5-year Markov model with annual cycles, including patients at CD4+ cell counts more than 500 cells/&mgr;l initiating ART or deferring therapy until historic ART initiation criteria of CD4+ cell counts more than 350 cells/&mgr;l were met. Methods:The incidence of opportunistic infections, malignancies, cardiovascular disease, unscheduled hospitalizations, and death, were informed by the START trial results. Risk of HIV transmission was obtained from a systematic review. Disability weights were based on published literature. Cost inputs were inflated to 2014 US dollars and based on local sources. Results were expressed in cost per disability-adjusted life years averted and measured against WHO cost-effectiveness thresholds. Results:Immediate initiation of ART is associated with a cost per disability-adjusted life years averted of −

Mobilising the alumni of a Master of Public Health degree to build research and development capacity in low- and middle-income settings: The Peoples-uni

317 [95% confidence interval (CI): −

The impact of rural residence and HIV infection on poor tuberculosis treatment outcomes in a large urban hospital: a retrospective cohort analysis

796–