BackgroundCongestive cardiac failure (CCF) has emerged as a major public health problem worldwide and imposes an escalating burden on the health care system.ObjectiveTo determine the causes and mortality rate of CCF in the University of Port Harcourt Teaching Hospital (UPTH), south Nigeria, over a five-year period from January 2001 to December 2005.MethodsA retrospective study of CCF cases were identified from the admission and discharge register of the medical wards of UPTH and the case notes were retrieved from the medical records department and analyzed.ResultsThere were 423 patients: 242 males and 181 females. Their ages ranged from 18 to 100 years with a mean of 54.4 ± 17.3. The commonest causes of CCF were hypertension (56.3%) and cardiomyopathy (12.3%). Chronic renal failure, rheumatic heart disease, and ischemic heart disease accounted for 7.8%, 4.3%, and 0.2% of CCF, respectively. Peripartum heart disease was rare despite being commonly reported in northern Nigerian females. Eighteen patients died from various complications with a mortality rate of 4.3%.ConclusionThe burden of CCF in the Niger Delta is mainly attributed to hypertension. Efforts should be geared towards hypertension awareness, detection, treatment, and prevention in the region.

The case records of 202 consecutive adult Nigerian in-patients with stroke at the University of Port Harcourt Teaching Hospital (UPTH) were retrospectively reviewed. The mean age at presentation was 62.62 +/- 14.2 years. The male to female ratio was 1:1.2. The commonest risk factors were hypertension, diabetes mellitus, hypercholesterolaemia, older age and a previous history of stroke. Clinically, 67.3% had cerebral infarction (CI), while 27.7% had intracerebral haemorrhage (ICH). The peak age of events for both sub-types was the 7th decade. The case fatality was 55.4% for ICH and 23.5% for CI. Thus, stroke is associated with high mortality at the UPTH. Improved emergency care of stroke patients is needed while the setting up of dedicated stroke centres is advocated. A community-based study is necessary to provide more insight into the problem and also highlight the basis for appropriate intervention and policy.

Objectives: The prevalence of HIV dementia in West Africa is poorly defined. Hence we sought to determine the frequency of HIV-associated dementia in advanced HIV-1 infection and assess the contributory role of HIV-2 co-infection and other risk factors in a Nigerian population.  Subjects and Methods: A total of 130 HIV seropositive patients with CD4+ T lymphocytes count <200 cells/µl were compared with 130 age- and sex-matched healthy controls. Detailed clinical evaluation and cognitive assessment for dementia using the International HIV Dementia Scale (IHDS) were carried out on all participants.  Results: The life-time prevalence of dementia in HIV- positive patients was 66.2%. The HIV-positive patients had lower scores in all cognitive domains of the IHDS (p<0.05). Reduced mean score of Karnofsky performance scale, reduced body mass index, reduced total lymphocyte count and CD4+ T-lymphocyte cell count increased risk of dementia but HIV-2 co-infection was not associated with development of dementia.  Conclusion: There is a high burden of dementia among Nigerian adults with HIV/AIDS. This underscores the need for regular cognitive assessment for early detection and institution of appropriate intervention.