Greg Erhabor

Obstructive sleep apnea among adults in Nigeria.

INTRODUCTION Obstructive sleep apnea syndrome (OSAS) is a common medical condition with significant adverse medical and public health consequences, but OSAS remains undiagnosed in many individuals. The Berlin questionnaire is a validated instrument that is used to identify individuals who are at risk for OSAS. OBJECTIVES To determine the prevalence of high risk of OSAS in an adult population in Nigeria. DESIGN A cross-sectional survey was done of 370 young adults and adults living in Abuja, Nigeria, using the Berlin questionnaire. This instrument includes questions about snoring; witnessed apneas, self-reported hypertension, and daytime sleepiness. Data were collected on sociodemographic characteristics. Excessive daytime sleepiness was determined using Epworth Sleepiness scale. Body mass index (BMI) and blood pressure were calculated and measured, respectively. RESULTS Of the 370 respondents, 218 (59%) were females. The overall prevalence of snoring was 31%. Overall, 19% of participants (22% of men and 16% of women) met the Berlin questionnaire criteria indicating a high risk of OSAS. The highest prevalence of risk of OSAS occurred in ages 50 to 59 years for male. Respondents with a high risk for OSAS were more likely to be obese (BMI >30 kg/m2), have a higher mean ESS score, and a chronic medical condition than those who were at lower risk. CONCLUSIONS OSAS may be more common a medical problem than ever imagined among Nigerians.

Respiratory Symptoms and Lung Function Patterns in Workers Exposed to Wood Smoke and Cooking Oil Fumes (Mai Suya) in Nigeria

Background: ‘Mai suya’ is a common job in the most northern Nigeria in which there is significant exposures to wood smoke and oil fumes. The respiratory impact of these dual exposures on workers engaged in this work has not been previously documented, hence this study was carried out. Aim: The aim is to study the prevalence, patterns and respiratory function assessment among this group. Subject and Methods: This is a case controlled study involving mai suya and workers who are not exposed to wood smoke and oil fumes in an occupational setting. All consenting mai suya and matched controls were recruited. Both groups underwent an interviewer administered questionnaire followed by on spot spirometric test measuring forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow rate (PEFR). Results are presented using descriptive statistics. Chi square was used to test for association between respiratory symptoms and the job categories. Students t-test was used to compare values of continuous variables. Odd ratios were determined for the risk of respiratory symptoms and exposure to wood smoke and oil fumes. Results: Both groups are similar in their demographic characters except in their smoking status, so current smokers were excluded from further analysis. The test group had significantly increased occurrence of chest tightness: 59% (19/32), nasal congestion: 37% (12/32), cough: 32% (10/32), and wheeze: 12% (4/32) compared with the control group, odds ratio (OR) 3.1, 95% confidence interval CI (0.1-5.8), P value 0.04, OR 1.2,95% CI (1.04-1.8), P value = 0.02, OR 0.9 95% CI (0.9-1.4), P value = 0.3, and OR 1.2,95% CI (1-1.3), P value = 0.04, respectively. Occurrences of some respiratory symptoms were associated with duration on the job, while a positive family history of asthma is not associated with increased occurrence of symptoms. The mean (SD) FEV1 and FVC were significantly lower among the test group compared with the control group; 2.5L/s (0.55) versus 3.02L/s (0.51), P value = 0.007 and 2.7L (0.7) versus 3.16L (0.51), P value = 0.04. Conclusion: Mai suya’ have increased risk of respiratory symptoms and altered pulmonary functions. There is a need for protective equipment and periodic evaluation.

Proteomic profiling of Eccrine sweat reveals its potential as a diagnostic biofluid for active tuberculosis

Excessive sweating is a common symptom of the disease and an unexplored biofluid for TB diagnosis; we conducted a proof‐of‐concept study to identify potential diagnostic biomarkers of active TB in eccrine sweat.

Determinants of health related quality of life in a sample of patients with chronic obstructive pulmonary disease in Nigeria using the St. George’s respiratory questionnaire

BACKGROUND Chronic Obstructive Pulmonary Disease (COPD) is a multi-systemic and progressive disease. However the determinants of its impact on health related quality of life are not well-studied or understood in Nigeria. OBJECTIVES To assess the determinants of health related quality of life in COPD. METHODS Patients with stable COPD were recruited consecutively from the outpatient clinics of a university hospital. Health Related Quality of Life (HRQL) was assessed using the St. Georges Respiratory Questionnaire (SGRQ) and the Forced Expiratory Volume in one second (FEV1), Forced Vital Capacity (FVC) were measured by a vitalograph spirometer. RESULTS Fifty patients were recruited for this study (male = 60%). The mean (SD) age was 69 (9) years. The overall mean (SD) SGRQ scores was 45.9 (26.5), 50.6 (29.2), 29.7 (19.9), 38.8 (22.0) for the symptom, activity, impact and total scores respectively. After adjusting for age, sex and smoking, self-reported breathlessness independently predicted on average 25.2, 36.8, 13.65 and 22.9 points increase in SGRQ symptom, activity, impact and total scores respectively. Self-reported weight loss predicted 12.2 points increase in the impact subscale. CONCLUSIONS Self-reported breathlessness and weight loss are independent predictors of low HRQL score in COPD.

Interferon-gamma treatment kinetics among patients with active pulmonary tuberculosis

Introduction: Interferon-γ (IFN-γ) is essential for defence against Mycobacterium tuberculosis; however, levels in patients with active tuberculosis (TB) and changes during treatment have not been documented in our tuberculosis patients in Nigeria, hence this study has been carried out. Objective: To determine variations, treatment kinetics, and predictive value of IFN-γ levels during treatment of active tuberculosis. Design: Patients with pulmonary tuberculosis were recruited and subsequently followed up for 3 months during treatment with anti-TB. Peripheral blood was collected for IFN-γ assays, C-reactive protein and others followed by a Mantoux test. IFN-γ levels produced by stimulation with TB antigens were determined by ELISA and repeated measurement of IFN-γ were done at 1 and 3 months of anti-TB therapy. Chi Associations and correlations between IFN-γ were determined. Regression analysis was done to determine association between serial IFN-γ and treatment outcome. Results: We recruited 47 patients with active tuberculosis with a mean age of 34.8 ± 3.6 years and M:F ratio of 1.12:1. Six (11%) were HIV positive. The mean level of IFN-γ induced by TB antigens was 629 ± 114.1 pg/ml, higher for HIV-negative PTB patients compared with HIV-positive PTB patients, 609.78 ± 723.9 pg/ml and 87.88 ± 130.0 pg/ml, respectively, P-value = 0.000. The mean level of IFN-γ induced by TB antigen increased significantly from 629 ± 114.1 pg/ml to 1023.46 + 222.8 pg/ml, P-value = 0.03 and reduced to 272.3 ± 87.7 pg/ml by the third month on anti-TB drugs, P-value = 0.001. Negative correlation was observed between the mean of baseline and chest X-ray involvement, P = 0.03. There was no significant correlation between sputum smear grade with baseline and follow-up IFN-γ levels. Three-month IFN-γ level among cured patients were higher than those with treatment failure, regression analysis showed that it does not predict outcome. Conclusion: IFN-γ may be useful in early detection and monitoring response; however, large scale studies are needed.