IntroductionHepatitis B virus infection is a major global health problem of public health importance. In a bid to control the infection, the Nigerian government in 2004 introduced hepatitis B vaccine into the National Program on Immunization. There are no studies on the prevalence of hepatitis B in adolescent prior to 2004. The study was aimed at determining the seroprevalence and predictors of viral Hepatitis B in Nigerian children aged 11-19 years.MethodsA cross sectional analytical study was conducted in July 2014. Multi-staged sampling technique was used to select 749 children from six secondary schools in Calabar, Cross River State, Nigeria. Ethical clearance was obtained from the Cross River State Medical Ethical Committee. A validated structured interviewer administered questionnaire was used to obtain information from participants following parental consent. Blood samples were obtained for qualitative detection of HBsAg using rapid chromatographic immunoassays with test kits from ABON (China) having sensitivity, specificity and accuracy of >99%, 97% and 98.5% respectively. Data was analyzed using SPSS version 20.2.ResultsNine of the749 students screened were positive for HBsAg giving an overall prevalence of 1.2%. The sex specific prevalence was 0.8% for males and 1.8% for females. After multivariate analysis, age was the predictor of hepatitis B infection (OR 3.92; 95% CI 1.22-12.63; p-value 0.02).ConclusionThe prevalence of HBV infection was low. Despite the low prevalence, the introduction of the vaccine is justifiable in view of the public health importance of the infection.

Background:Leptin is a hormone produced directly from adipocytes and has been associated with type 2 diabetes mellitus (T2DM) which is characterized by insulin resistance (IR). Due to the increasing prevalence of obesity in sub-Saharan Africa, serum leptin can be explored as a predictive risk factor for T2DM. Therefore, the aim of this study was to determine the relationship between serum leptin and IR among obese women.Methods:This was a cross-sectional study of obese, adult Nigerian females. Participants with body mass index (BMI) ≥30 kg/m2 and nondiabetic were recruited as subjects. Fasting serum leptin, insulin, and plasma glucose were determined. IR was calculated using the formula: Homeostatic model assessment-IR (HOMA-IR) = (glucose × insulin)/22.5. Statistical analyses were performed using SPSS and P < 0.05 was considered to be significant.Results:Eighty obese females with mean ± standard deviation BMI 39.1 ± 7.2 kg/m2 and serum leptin level 48.4 ± 24.4 ng/ml participated in study. Prevalence of hyperleptinemia was 92.5% (confidence interval: 87.3–97.7%). The relationship between leptin and HOMA-IR among the subjects was: BMI 30–34.9 kg/m2: n = 27, r = 0.18, P = 0.42; BMI 35–39.9 kg/m2: n = 24, r = 0.36, P = 0.11; BMI ≥ 40 kg/m2: n = 29, r = 0.52, P = 0.004*; and after controlling for BMI (n = 29, r = 0.46, P = 0.014*). Multiple linear regression showed that leptin did not predict for IR (P = 0.837).Conclusion:Serum leptin levels were positively correlated with IR, which was significant among the Class III (morbid) obesity class. However, leptin was not a predictive factor for IR in obese Nigerian women.

Introduction: Hepatitis E is a hepatotropic virus transmitted through the fecal-oral route and is prevalent in developing countries where sanitation is still a public health issue. There is no epidemiological data about this virus in Nigerian children. All the existing studies are hospital based, with obvious limitations. This study was conducted to establish the seroprevalence and predictors of viral hepatitis E antibody in children in Akpabuyo Local Government Area of Cross River State, Nigeria. Methodology: This was a community-based, cross-sectional study. A multi-staged sampling technique was used to select ten communities from which 406 children were recruited. The study period was April to June 2012. A structured interviewer-administered questionnaire was used for data collection. Blood samples were screened for anti-HEV IgG antibody using the enzyme-linked immunoassay technique. Multivariate logistic regression was used to identify factors that independently predicted the occurrence of the anti-HEV IgG antibody. A p value of < 0.05 was considered significant. Results: The seroprevalence rate of anti-HEV IgG antibody was 7.7% (95% CI = 5.1-10.3). The study population mainly (94.1%) comprised the lower social class. Levels of social amenities in these communities were generally poor, with virtually no piped water and modern sewage disposal systems. After multivariate analysis, the predictor of infection was the duration of residence in the study communities. Conclusions: HEV infection was prevalent in the study population. Educational campaigns and provision of good sewage disposal and piped water are of high necessity.

ObjectivePopulation data on dysglycemia are scarce in West Africa. This study aimed to determine the pattern of dysglycemia in Calabar city in South East Nigeria.DesignThis was a cross-sectional observational study.Methods1134 adults in Calabar were recruited. A multistage sampling method randomly selected 4 out of 22 wards, and 50 households from each ward. All adults within each household were recruited and an oral glucose tolerance test was performed. Dysglycemia was defined as any form of glucose intolerance, including: impaired fasting glucose (blood glucose level 110–125 mg/dL), impaired glucose tolerance (blood glucose level ≥140 mg/dL 2 h after consuming 75 g of glucose), or diabetes mellitus (DM), as defined by fasting glucose level ≥126 mg/dL, or a blood glucose level ≥200 mg/dL, 2 h after a 75 g glucose load.ResultsMean values of fasting plasma glucose were 95 mg/dL (95% CI 92.1 to 97.5) for men and 96 mg/dL (95% CI 93.2 to 98.6) for women. The overall prevalence of dysglycemia was 24%. The prevalence of impaired fasting glucose was 9%, the prevalence of impaired glucose tolerance 20%, and the prevalence of undiagnosed DM 7%. All values were a few percentage points higher for men than women.ConclusionsThe prevalence of undiagnosed DM among residents of Calabar is similar to studies elsewhere in Nigeria but much higher than the previous national prevalence survey, with close to a quarter of the adults having dysglycemia and 7% having undiagnosed DM. This is a serious public health problem requiring a programme of mass education and case identification and management in all health facilities.Trial registration numberCRS/MH/CR-HREC/020/Vol.8/43

IntroductionCardiovascular risk factors are prevalent in HIV-positive patients which places them at increased risk for cardiovascular disease (CVD). We aimed to determine the risk factors and risk assessment for CVD in HIV-positive patients with and without antiretroviral therapy.MethodsThis was a cross-sectional study of HIV-positive patients attending the Lagos University Teaching Hospital, Nigeria. Anthropometric and blood pressure measurements were performed; fasting lipid profile, plasma glucose, homocysteine and hsCRP were determined, as well as prevalences and risk assessments. Statistical tests were used to compare the groups and p-value <0.05 was considered to be significant.Results283 subjects were recruited for this study (100 HIV-positive treatment-naive, 100 HIV-positive treated and 83 HIV negative controls). Compared to the controls, mean (sd) values were significantly higher among HIV-treated subjects: waist circumference = 88.7 (10.4), p = 0.035; systolic bp= 124.9 (20.7), p = 0.014; glucose= 5.54 (1.7), p = 0.015; triglyceride= 2.0 (1.2), p < 0.001; homocysteine= 10.9 (8.9-16.2), p = 0.0003; while hsCRP= 2.9 (1.4-11.6), p = 0.002 and HDL-C = 0.9 (0.4), p = < 0.0001 were higher among the HIV-naïve subjects. Likewise, higher prevalences of the risk factors were noted among the HIV-treated subjects except low HDL-C (p < 0.001) and hsCRP (p = 0.03) which were higher in the HIV-naïve group. Risk assessment using ratios showed high risk for CVD especially in the HIV-naïve group. The median range for Framingham risk assessment was 1.0 - 7.5%.ConclusionRisk factors and risk assessment for CVD are increased in HIV-positive patients with and without antiretroviral therapy. Routine evaluation and risk assessment for CVD irrespective of therapy status is necessary to prevent future cardiovascular events.

Background. Hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV are common blood-borne infections unevenly distributed across regions in Nigeria. Few population-based prevalence studies have been done in Nigeria. Objective. To determine the prevalence of HBV, HCV and HIV and risk factors for infection with these viruses in a Nigerian population. Methods. Hepatitis B surface antigen, anti-HCV and HIV were assayed in 1 498 healthy adult participants. A structured questionnaire was used to assess risk factors for viral acquisition. Bivariate analysis was used to compare differences in sociodemographic characteristics. Significant risk factors were identified by stepwise logistic regression. A p-value <0.05 was considered significant. Results. The prevalences of HBV, HCV and HIV were 8.8%, 10.0% and 12.9%, respectively, with urban/rural disparity. HBV/HCV positivity was higher among males than females. The reverse was true for HIV. Age was significantly associated with being HBV-, HCV-or HIVpositive. Communal use of a toothbrush was significantly associated with HBV positivity in the final model (odds ratio 2.46, 95% confidence interval 1.45 -4.18). Conclusions. The prevalence of HBV, HCV and HIV infection is high in Nigeria, with urban/rural disparity. HCV may be more of a public health concern than HBV in some communities. Population-based studies are required to provide vital data to inform optimal national control strategies.

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IntroductionHepatitis A infection is prevalent in developing countries where sanitation is still a public health issue. In Nigeria, there is no epidemiological data on children for this infection. A community based study was carried out to establish the seroprevalence and predictors of this infection in children.MethodsA community based cross sectional study was carried out in Akpabuyo local Government Area of Cross River State in southern Nigeria. Multi-staged sampling technique was used to recruit 406 children aged 1-18 years. Blood samples were analysed for anti-HAV total antibody (IgM and IgG) using a commercial Enzyme-Linked Immunoassay Assay(ELISA). A multivariate logistic regression was used to identify factors that independently predicted the occurrence of anti-HAV total antibody. p value of < 0.05 was considered significant.ResultsTwo hundred and twenty four subjects tested positive for anti-HAV total antibody giving a prevalence rate of 55.2%. The median age for those positive was 9 years and for those without evidence of HAV infection was 4 years. One hundred and one (45.1%) males and 123 (54.9%) females were positive. The study population was mainly of the low social class with 94.1%. After multivariate analysis, predictors of HAV infection were age and social class.ConclusionHAV infection was prevalent in the study population. Educational campaign is imperative and vaccine provision is advocated to further curb the spread of this infection.