Ismail A. Suleiman

Prevalence and control of hypertension in a Niger Delta semi urban community, Nigeria

Background Hypertension is a public health problem worldwide, but the prevalence in Amassoma, Southern Ijaw Local Government Area is not known. Objective To investigate the prevalence of hypertension in the locality and the extent of control in diagnosed cases. Methods It is a prospective study involving interviewing. Four hundred adults aged 20 years and above selected through stratified random sampling across the various compounds called “AMA”; a unit of settlement comprising extended families of common ancestors. A self-developed, validated and pretested interviewer-administered questionnaire on demographics, predisposing factors, and medication history was used. In addition, measurement of respondents’ blood pressure, weight and height was carried out. The Body Mass Index calculated and the data were appropriately analysed. Results The response rate of questionnaire distribution was 100.0% being interviewer administered alongside weight, height and blood pressure measurement. Majority of respondents were female. Almost half of respondents (46.5%) had their BMI above normal, 15.3% (61) of which falls within the obese region (>30.0kg/m2). The mean (SD) systolic blood pressure among males was 133.3 (3.2) mmHg and that of females was 127.4 (3.0) while the mean (SD) diastolic blood pressures were 86.2 (1.7) and 83.9 (2.4) for males and females respectively. Crude prevalence rate of hypertension in the community was 15.0% (60) out of which 13.8 % (55) were previously diagnosed. The hypertension was that of Stage I in 11.5% (46) and Stage II in 3.5% (14). Hypertension prevalence was slightly higher in males (18.8%) than that of the females (12.5%) (p= 0.0889), Relative Risk (RR)=1.500 [95%CI 0.9422:2.388]. The prevalence rate among 40 years and above was 41.6% (42/101) who also constituted 70.0% (42/60) of participants with hypertension in the survey and 10.5% (42/400) of the total. Of the previously diagnosed cases of hypertension, only 31% (17/55) were taking their drugs during the survey and only 12.7% (07/55) had regular adherence to medication and adequate BP control was achieved in 7.3% (04/55). Majority of the patients on drugs (21.8%) (12/55) were either taking methydopa as monotherapy or in combination with amiloride and hydrochlorothiazide. Other drugs being taken by patients include lisinopril, propranolol, amlodipine, atenolol, nifedipine and low dose aspirin. Conclusions The prevalence of hypertension in the semi urban community is 15.0% with a pre-hypertension in another 23.5%. There was poor control of blood pressure among previously hypertensive patients.

Adherence to antiretroviral therapy and its determinants among persons living with HIV/AIDS in Bayelsa state, Nigeria

Background: A high level of adherence is required to achieve the desired outcomes of antiretroviral therapy. There is paucity of information about adherence to combined antiretroviral therapy in Bayelsa State of southern Nigeria. Objectives: The objectives of the study were to determine the level of adherence to combined antiretroviral therapy among the patients, evaluate the improvement in their immune status and identify reasons for sub-optimal adherence to therapy. Methods: The cross-sectional study involved administration of an adapted and pretested questionnaire to 601 consented patients attending the two tertiary health institutions in Bayesla State, Nigeria: The Federal Medical Centre, Yenagoa and the Niger-Delta University Teaching Hospital Okolobiri. The tool was divided into various sections such as socio-demographic data, HIV knowledge and adherence to combined antiretroviral therapy. Information on the patient’s CD4+ T cells count was retrieved from their medical records. Adherence was assessed by asking patients to recall their intake of prescribed doses in the last fourteen days and subjects who had 95-100% of the prescribed antiretroviral drugs were considered adherent. Results: Three hundred and forty eight (57.9%) of the subjects were females and 253 (42.1%) were males. The majority of them, 557 (92.7%) have good knowledge of HIV and combined anti-retroviral therapy with a score of 70.0% and above. A larger proportion of the respondents, 441 (73.4%), had ≥95% adherence. Some of the most important reasons giving for missing doses include, “simply forgot” 147 (24.5%), and “wanted to avoid the side-effects of drugs” 33(5.5%). There were remarkable improvements in the immune status of the subjects with an increment in the proportion of the subjects with CD4+ T cells count of greater than 350 cells/mm3 from 33 (5.5%) at therapy initiation to 338 (56.3%) at study period (p<0.0001). Conclusion: The adherence level of 73.4% was low which calls for intervention and improvement. The combined antiretroviral therapy has significantly improved the immune status of the majority of patients which must be sustained. “Simply forgot” was the most important reason for missing doses.

Cost of illness among diabetes mellitus patients in Niger Delta, Nigeria

There is paucity of information on cost implications of chronic diseases, such as diabetes mellitus, in developing countries, which is needed for well‐informed policies and decisions. The objectives of the study were to evaluate cost of illness among diabetes mellitus patients and determine its probable national cost implications.

Evaluation of the cost of therapy for the treatment of sexually transmitted infections in a Nigerian teaching hospital.

Objective  To determine the cost of therapy to patients of sexually transmitted infections in a Nigerian teaching hospital.

Quality of life of healthy subjects and patients with arthritis and diabetes mellitus in Bayelsa State, Niger Delta region

Purpose: There is paucity of information about quality of life (QOL) studies among patients with arthritis and diabetes mellitus in developing countries. The objective of this study was to evaluate quality of life of patients with arthritis (AR) and diabetes mellitus (DM). Methods: A total of 507 subjects comprising 364 healthy adult volunteers and 143 hospitals patients with arthritis and diabetes mellitus were enrolled into the study. Data were collected using Ferrans and Powers QOL index (QLI). The generic version and disease specific versions were administered to healthy subjects and hospital patients respectively and the data analyzed. Results: The highest mean overall QOL scores of the healthy subjects (364; 71.79%) which ranged from 24.43(SD=4.08) to 26.62 (SD=2.15) (95% CI 24.94-27.27) is the second most desirable category of QOL rating relative to the reference standard score of zero to 30 for the worst and best case scenarios respectively. This was distantly followed by patients with diabetes mellitus alone (slightly satisfied) with mean OQOL score of 18.92 (SD=2.59; 95% CI 16.03-19.24). Subjects with AR had lower OQOL than diabetic subjects with mean OQOL scores of 15.98 (SD=2.75; 95% CI 13.15-16.77). The least mean OQOL score (moderately dissatisfied) was recorded for patients with AR co-existing with other chronic illnesses with a mean OQOL scores of 8.92 (SD=3.97; 95%CI 7.36 - 13.4). There was statistically significant difference between the OQOL of healthy subjects and patients with arthritis and diabetes mellitus ( p <0.0001). A strong association also exists between OQOL and age, marital status, employment and gender ( p <0.05). Conclusions: Arthritis and diabetes mellitus severely impaired patient QOL. Arthritis has more pronounced effects on QOL either alone or as co-morbid chronic illness. Concerted efforts at stemming the prevalence of these conditions, supportive roles for the elderly and married women as well as cost effective management of these conditions among others must be put in place. Keywords: Arthritis, diabetes, Quality of life, Niger Delta, Nigeria