Fatalities from perinatal asphyxia remain high in developing countries, and continually assessing its risk factors will help improve outcomes in these settings. We explored how some identified risk factors predict mortality in asphyxiated newborns, to assist clinicians in prioritizing interventions. This was a 4-year prospective study conducted at the Enugu State University Teaching Hospital, Enugu, Nigeria. All newborns who met the study criteria that were admitted to this facility in this period were enrolled and monitored. Data collected were analysed with SPSS Version 18. A total of 161 newborns with perinatal asphyxia were enrolled into the study with an in-hospital incidence rate of 12.81 per 1000 birth and a case fatality rate of 18%. Overall, the APGAR scores were severe in 10%, moderate in 22%, mild to normal in 68%, whereas the SARNAT stages were III in 24%, II in 52%, and I in 25%. In terms of mortality, 66.7%, 22.2%, and 11.1% mortalities were, respectively, observed with SARNAT scores III, II, and I (P = .003), whereas the findings with APGAR were 31.2% (severe), 25.0% (moderate), 25.0% (mild), and 18.8% (normal) (P = .030). Fatality outcome was more correlated with SARNAT (R = .280; P = .000) than APGAR (R = −.247; P = .0125). The SARNAT score significantly differentiated between the degrees of asphyxia in newborns based on gestational age at delivery (P = .010), place of delivery (P = .032), and mode of delivery (P = .042). Finally, it was noted that newborns that were female (P = .007), or born outside the hospital (P = .010), or with oxygen saturations <60% (P = .001), or with heart rate <120 (P = .000), and those with respiratory rate <30 (P = .003), all have significantly higher likelihood of deaths from asphyxia. Therefore, predictors of neonatal mortality from perinatal asphyxia in our centre include being female and being born outside the hospital, as well as low oxygen saturations, heart rates, and respiratory rates at presentation.

Purpose To determine the prevalence of active convulsive epilepsy and treatment gap in two Urban slums in Enugu South East Nigeria. Methods A 3 phase cross-sectional descriptive study was done to survey individuals ≥15 years in 2 slums in Enugu, South East Nigeria. Results The prevalence of epilepsy was 6.0 (95% CI: 5.9–6.0) per 1000 (men 4.4/1000, 95% CI: 2.3–6.4, women 7.8/1000, 95% CI: 4.9–10.4), p = 0.06. The peak age of active convulsive epilepsy was 40–44 years (11.2 per 1000) with two smaller peaks at 25–29 and ≥50 years. The age and sex adjusted prevalence using WHO standard population and 2006 Nigerian census population were 5.9 per 1000 (95% CI: 4.0–7.9) and 5.4 per 1000 (95% CI: 3.4–7.4). Conclusion The prevalence of epilepsy is high in urban slums in Enugu. Nationwide studies should be done to find out the true prevalence in the country.

In sub-Saharan Africa (SSA), rapid urbanization and changing lifestyle have modified the profile and pattern of various medical disorders. Apart from high prevalence rates, recent trends with regard to hypertension in Africa include: low levels of awareness, treatment and control. Although a large number of studies provide data about hypertension in SSA, few studies focused on special populations such as urban slum dwellers. The WHO STEP-wise approach to surveillance of noncommunicable diseases was used to access the prevalence of hypertension among adults in one of the urban slums in Enugu. Out of the 811 individuals aged 20 years and above surveyed, 774 (95.4%) cases were analyzed. About 4.7% and 2.7% reported a past history of diabetes and stroke, respectively, whereas 15% had a positive family history of hypertension. The mean (95% confidence interval (CI)) body mass index (BMI) was 23.7 (23.2-24.2) kg m(-2) among males and 26.6 (25.7-26.7) kg m(-2) among females (P<0.0001). The prevalence of hypertension was 52.5% (95% CI: 48.9-56.0) and 55.4% (95% CI: 49.5-61.3) in males and 50.8% (95% CI: 46.4-55.1) in females (P=0.23). It increased with age peaking at 45-54 years in females and ⩾55 years in males. About 40.1% were aware of their hypertension and 28.8% of those aware had normal blood pressure. In regression analysis, systolic (R(2)=0.192) and diastolic (R(2)=0.129) blood pressures increased with age and BMI. The prevalence of high blood pressure among adults in Enugu slums is very high and a cause for concern, and calls for urgent attention.

Background: Despite the rising prevalence of diabetes in Nigeria and sub-Saharan Africa, few studies have assessed the prevalence of prediabetes and diabetes in people with low socioeconomic status or urban slums. Methods: Using the WHO STEP-wise approach to surveillance of noncommunicable diseases, we estimated the prevalence of diabetes and prediabetes among adults 20 years and older living in two urban slums in Enugu south east Nigeria. Diabetes was defined as previous history of diabetes, use of hypoglycemic agents and fasting blood glucose within the diabetes range on two occasions during the survey period. Study duration was 5 months. Results: Out of the 811 individuals invited to the clinic, 605 (74.6%) participants had their fasting blood glucose measured based on the study protocol. The prevalence of diabetes and prediabetes in the population was 11.7% (95% CI; 9.2-14.3) and 7.6% (95% CI; 5.0-9.7) respectively. About 54.9% were newly detected and 28.1% of them had normal control. The prevalence of diabetes peaked at 55-64 years. The odds ratio for diabetes was significantly higher in participants ≥ 45 years (1.033, 95% CI; 1.208-3.420), participants with hypertension (0.442, 95% CI; 0.257-0.762) and stroke (1.638, 95% CI; 0.459-5.848). Conclusion: There is a relatively high prevalence of diabetes among adults in two urban slums in Enugu. Public health educational measures promoting prevention and early detection of diabetes should be encouraged. Efforts should be made to educate the populace on the need for early detection and treatment.

Background:Rapid urbanization and changing lifestyle have modified the profile and pattern of various medical disorders in many Nigerian communities. Surveys of medical admissions into various Nigerian health institutions show an increasing burden of non-communicable diseases in our communities.Aim:To determine the profile and pattern of medical cases admitted and their outcome in a new tertiary medical institution in South East Nigeria.Materials and Methods:A review of medical admissions into the Enugu State University of Science and Technology Teaching Hospital (ESUTTH), Enugu, Nigeria over 5 years between January 1, 2006 and December 30, 2010 was undertaken. Morbidity and mortality data were obtained from ward registers and subsequently medical record registers. Classifications of medical disorders were grouped using ICD 10 coding system.Results:A total of 3,865 case records were analyzed. Males were 2,312/3,865 (59.6%) and females 1,660/3,865 (40.2%). The age range was 14-105 years with a mean age of 54.3 (18.1) years. The 4 commonest causes of medical ward admissions were neurological disorders-850/3,865 (22%), endocrine disorders-735/3,865 (19.1%), cardiovascular disorders-718/3,865 (18.5%) and infectious diseases-604/3,865 (15.6%). The diseases encountered most were diabetes mellitus-735/3,865 (19.1%), hypertension/congestive cardiac failure-703/3,865 (18.2%), strokes-614/3,865 (15.9%) and human immunodeficiency virus (HIV)/AIDS-503 (13.1%). The overall mortality was 766/3,865 (19.8%) men-467/2,312 (20.2%); women-299/2,312 (19.3%). Strokes accounted for most of the deaths-171/766 (22.3%) followed by HIV/AIDS 127/766 (16.6%). Hypertension/cardiac failure and diabetes each accounted for 116/766 (15.1%) of all deaths. Case fatality rates for strokes and HIV/AIDS were the highest (171/614 (27.9%) and 127/503 (25.2%) respectively). Mortality rate was highest in the above 70 years age group.Conclusion:Non-communicable disorders are the commonest causes of medical ward admission in this tertiary institution. Efforts aimed at primary prevention will help to reduce the burden of these disorders in the community.