Victor Maduabuchi Oguoma

Erratum: Prevalence of cardiovascular disease risk factors among a Nigerian adult population: Relationship with income level and accessibility to CVD risks screening (BMC Public Health (2015) 15:891 DOI 10.1186/s12889-015-1709-2)

Main body text Unfortunately, the original version of this article [1] contained an error. The gender subgroup category of table 2 is displayed incorrectly. The category labelled ‘Female’ should be Male and the other labelled ‘Male’ should be Female. The results subsection of the Abstract also contains a mistake as a result of the mislabel. The first sentence “The 422 participants (149 males and 273 females) had mean age (± standard deviation) of 38.3 ± 20.5 and 42.9 ± 20.7 years, respectively” should read “The 422 participants (273 females and 149 males) had mean age (± standard deviation) of 38.3 ± 20.5 and 42.9 ± 20.7 years, respectively”. This error has been corrected in the original article. The ‘Baseline Characteristics of Participants’ subsection in the results contains an error. Reading from line 4, the sentence “The mean age amongst participant was 42.9 ± 20.7 and 38.3 ± 20.5 for females and males, respectively” should be corrected to “The mean age amongst participant was 42.9 ± 20.7 and 38.3 ± 20.5 for males and females, respectively”. We regret these errors which has now been corrected.

Cardiovascular Risk Assessment in Prediabetes and Undiagnosed Diabetes Mellitus Study: International Collaboration Research Overview

The study aims to develop a screening protocol for the risk of future cardiovascular disease and diabetes mellitus in people with prediabetes and undiagnosed diabetes; and to establish a framework for early identification and intervention of prediabetes including strategies for holistic management and monitoring of progression. The first phase is to identify prediabetes and undiagnosed diabetes in volunteers who are ≥18-years-old for 5 years. Point-of-care testing and questionnaire will be used to screen for prediabetes and cardiovascular disease. We anticipate screening more than 2000 individuals of both genders by the end of first phase. The second and third phases which shall run for 5-10 years will be longitudinal study involving participants identified in the first phase as having prediabetes without dyslipidaemia, or clinically established cardiovascular disease. The second phase shall focus on preventive management of risk of progress to diabetes with explicit diagnosis of cardiovascular disease. Oxidative stress measurements will be performed cum evaluation of the use of antioxidants, exercise, and nutrition. The third phase will include probing the development of diabetes and cardiovascular disease. Binomial logistic regression would be performed to generate and propose a model chart for the assessment of cardiovascular disease risk in prediabetes.

Onchocerciasis in Anambra State, Southeast Nigeria: clinical and psychological aspects and sustainability of community directed treatment with ivermectin (CDTI).

Background A cross-sectional study was performed to determine the psychological impact of onchocerciasis, and assess sustainability of the decade-old community directed treatment with ivermectin (CDTI) in Ayamelum Local Council, Anambra State, Southeast Nigeria. Methods Skin manifestations assessed using the rapid assessment method (RAM) in 894 subjects from 13 communities selected by multi-stage sampling were classified based on the anatomical sites affected. Focus group discussions and in-depth interviews were used to obtain information on the psychological impacts and sustainability of the CDTI programme. Qualitative data were summarised while quantitative data generated were analysed using charts and tables. Results Anatomical distribution showed a preponderance of onchodermatitis on the limbs (the most exposed parts of the body) and buttocks (an area considered ‘private’), thus revealing some reasons for the psychological impacts of the skin disease and the psychosocial inclination of the victims. Itching (40%) and onchocercal skin manifestations (OSDs) (34.3%) were identified as the most troublesome signs and symptoms, while the most worrisome consequence of onchocerciasis was social seclusion (or stigmatisation) (34.3%). Focus group responses revealed the persistence of psychological impacts on the victims, affecting almost all facets of their lives. The CDTI programme has performed creditably well when assessed using the sustainability indicators, yet there are still challenges in the areas of coverage, monitoring, resources, and participation. A ‘quick-win’ was identified whereby the CDTI chain could be utilised to deliver other health interventions. Conclusion It is recommended that onchocerciasis control programmes should include aspects that would address its psychosocial impacts and threats to the sustainability of the CDTI programme.

Cardiovascular Disease Risk Prevention: Preliminary Survey of Baseline Knowledge, Attitude and Practices of a Nigerian Rural Community

Background: Knowledge and attitude are significant factors impinging on whether individuals seek healthcare service. This flows on to impact public health knowledge of prevalence of diseases, and in turn, the practice of preventive medicine. As part of the international research collaboration agenda for Prediabetes and Cardiovascular Complications Study, a preliminary survey of one of the Ndokwa communities of Nigeria has been carried out. Aim: This study was to understand the baseline knowledge, attitudes and practices of a rural community in regards to cardiovascular diseases, and behavior toward risk management. Materials and Methods: Seventy-four volunteer participants were recruited, after public lectures, through secondary school and churches in the community. The survey was done using questionnaire. The knowledge component comprised questions about educational and personal health opinion. The attitude and practice components comprised questions about exercises and visiting healthcare facilities. Occupational backgrounds were also asked. Results: It is observed that majority of the community dwellers have (1) completed at least secondary education, (2) never attended a health check-up; and (3) do not engage in physical activity in the context of exercise. Twenty of the participants indicated not being in good health, of which only 35% have attended medical check-up for their ailment. Many of those who are yet to seek healthcare service cite affordability as their reason. With specific regards to diabetes and cardiovascular risk, over 71% of the survey participants are yet to do any blood sugar and/or lipid profile tests. Conclusion: This preliminary survey indicates that although the majority of respondents have secondary education and therefore are relatively literate, there is a gap between their knowledge of ill-health versus attitude and practice toward prevention; especially cardiovascular and diabetes diseases.

Association between metabolic syndrome and 10-year risk of developing cardiovascular disease in a Nigerian population

BACKGROUND Prevalence of metabolic syndrome (MetS) and consequential cardiovascular disease (CVD) events are on the increase in Nigeria. The study aimed to identify the prevalence of 10-year CVD risk in a Nigerian population and assess its relationship with different indices of MetS. METHOD A cross-sectional study was carried out on apparently healthy persons aged 18 years of age or older. Ten-year risk was calculated using the ATPIII/Framingham criteria. Subjects with risk score <10% were considered as having low risk, 10-20% moderate risk and >20% at high risk of developing CVD in 10 years. MetS was defined based on the Joint Scientific Statement on Harmonizing the MetS. RESULT Of the 211 subjects, mean age was 51.3±17.3 years. Average risk of developing CVD in the next 10 years was 3.7±5.3%. Prevalence of low, moderate and high risk of developing CVD among study participants was 86.3% (95% CI 82.0-91.3%), 11.8% (95% CI 6.9-16.1%) and 1.9% (95% CI 0.0-3.8%), respectively. Prevalence of MetS was 26.7% (95% CI 21.0-33.3%). There was poor agreement between MetS and the CVD risk scores (kappa=0.209, p=0.001) CONCLUSIONS: The results showed that complementary use of MetS and CVD risk score is imperative, as there is indication of risk in individuals without MetS. Also a large proportion of the study population requires lifestyle intervention. These findings provide the evidence necessary to tailor public health interventions in this population, especially towards younger age groups.

Association of physical activity with metabolic syndrome in a predominantly rural Nigerian population

AIMS Physical activity is an essential determinant of health. However, there is dearth of evidence regarding prevalence of physical activity in developing countries, especially its association with metabolic syndrome risk factors. This study assessed the association of physical activity with metabolic syndrome in a Nigerian population. MATERIALS AND METHODS A cross-sectional study was carried out on apparently healthy persons who are ≥ 18 years old. The World Health Organisation (WHO) Global Physical Activity Questionnaire (GPAQ) was used to collect five domains of physical activity. Participants were classified as physically active or inactive based on meeting the cut-off value of 600 MET-min/week. Metabolic syndrome was diagnosed using the Joint Scientific Statement on Harmonizing the Metabolic Syndrome criteria. RESULTS Overall prevalence of physically active individuals was 50.1% (CI: 45.6-54.7%). Physical inactivity is significantly more in females (p<0.01) and among participants >40 years old (p<0.0001). Whereas individuals with metabolic syndrome appeared more likely to be physically active (OR=1.48, CI: 0.71-3.09); physical inactivity showed to exist more among participants who were living in urban area (OR=6.61, CI: 3.40-12.85, p<0.001). Participants with prediabetes (OR=1.69, CI: 0.62-4.61) and diabetes (OR=1.91, CI: 0.65-5.63) were more likely to be physically inactive as compared to other metabolic syndrome risk factors. CONCLUSION The high prevalence of physical inactivity in this study population is a clear indication that concerted efforts to improve physical activity may be required. However, it seems that metabolic syndrome is not improved by being physically active. This suggests that interventions directed at physical activity alone may not produce optimal efficacy in this study population.

Diet and lifestyle habits: Association with cardiovascular disease indices in a Nigerian sub-population

BACKGROUND There is inadequate evidence regarding the pattern of unhealthy lifestyle behaviours in Nigeria hence the aim of this study was to assess the pattern of lifestyle-related habits that predispose to risk of cardiovascular disease (CVD) indices in a Nigerian population. METHODS A population-based cross-sectional study was carried out on 422 apparently healthy males and females ≥18 years old. The World Health Organisation (WHO) STEPwise questionnaire was used to collect information on tobacco use or smoking habits, alcohol consumption and dietary habits. Logistic regression analysis was employed. RESULTS 22.8% and 30.2% of participants indicated that someone smoked in their home and/or in closed areas at workplace, respectively, in the past 30 days. 225/422 admitted to taking alcohol including 72% within the past 12 months. 52.8% of the participants consumed <5 servings of fruits and/or vegetables each day. Results further showed that participants with <5 servings of fruits and/or vegetables (OR: 1.06, CI: 1.01-1.13, p = 0.028) and high level of alcohol consumption (OR: 1.85, CI: 1.18-2.88, p = 0.007) were more likely to have hypertension. CONCLUSIONS The relatively high prevalence of alcohol consumption and apparent unhealthy diet are of huge concern given the increasing prevalence of CVD indices in the population.