2019. Effect of carbapenem resistance on outcomes of bloodstream infection caused by Enterobacteriaceae in lowincome and middle-income countries (PANORAMA): a multinational prospective cohort study. Lancet Infectious Diseases 19 (6) , pp.

IntroductionWorldwide, hypertension and diabetes mellitus (DM) are major causes of morbidity and mortality. This study assesses the prevalence and correlates of hypertension and DM in an urban community in northwestern Nigeria.MethodsThis was a cross-sectional descriptive study. Adults aged 18 years and above, who attended a medical outreach program were interviewed and screened for hypertension and DM. Anthropometry, blood glucose and blood pressure were measured with standard instruments and methodology. Primary outcomes were hypertension and DM. Data were analyzed using STATA version 14 and presented as mean ± standard deviation and frequencies. Chi-square and Pearson's correlation co-efficient were used to identify the correlates of hypertension and DM, at 5% level of significance.ResultsThe mean age of participants was 51.0 ± 14.0 years and 87.8% were females. Prevalence of hypertension and DM were 55.9% and 23.3% respectively. Age greater than 40 years and female gender were associated with risk of hypertension and DM respectively, p < 0.05. There was a weak correlation between systolic hypertension and age (r = 0.18, p = 0.02), diastolic hypertension and body mass index (r = 0.16, p = 0.03) and blood sugar and waist circumference (r = 0.19, p = 0.02).ConclusionThe high prevalence of hypertension and DM among the study population highlights the need for the development and implementation of a community-based public health interventions aimed at reducing their risk factors.

Introduction Dyslipidemia confers excess atherosclerotic cardiovascular risk in type 2 diabetes mellitus (DM) patients, and this requires prompt identification and management to reduce morbidity and mortality. This study assessed the prevalence and pattern of dyslipidemia in type 2 DM patients in Zaria, Northwestern Nigeria. Methods This was a cross-sectional study of newly diagnosed type 2 DM patients at Ahmadu Bello University Teaching Hospital (ABUTH), Zaria. Demographic, clinical and laboratory data were extracted from the case notes of eligible patients and analyzed using STATA version 14. Continuous variables were presented as mean ± standard deviation (SD), or median and interquartile range (IQR) while categorical variables were as frequencies and percentages. Student t and chi-square tests were used to test for association at p < 0.05. Results A total of 322 subjects (161 male, 161 female) with a mean age of 53.5 ± 10.8 years partook in the study. The prevalence of dyslipidemia was 69.3%. Mixed dyslipidemia of high triglyceride (TG) and high low-density lipoprotein cholesterol (LDL-C) was present in 41.0%; high TG and low high-density lipoprotein cholesterol (HDL-C) in 2.8%; and high LDL and low HDL in 2.5%. Atherogenic dyslipidemia, isolated hypercholesterolemia and isolated low HDL-cholesterol were present in 3.4%, 2.5% and 23.6% respectively. Dyslipidemia status was not associated with age, sex, duration of DM or hypertension, obesity, and mean fasting blood sugar (FBS) and 2-hour postprandial glucose. Conclusion The prevalence of dyslipidemia is high in the newly diagnosed type 2 DM patients and therefore, initial management should incorporate measures to control dyslipidemia.

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Immune Reconstitution Inflammatory Syndromes (IRIS) are exaggerated pathological inflammatory reactions occurring after initiation of highly active antiretroviral therapy (HAART) due to exuberant immune responses to occult or apparent opportunistic infections or cancers. In view of paucity of studies from Nigeria, we report 3 cases of IRIS presenting as disseminated infections in HIV-1 infected patients initiating HAART. The first case was a previously healthy female who developed disseminated tuberculosis after 4 weeks of regular HAART. Her HAART regimen was continued and she improved after commencement of anti-tuberculosis drugs, with evidence of progressive increase in CD4 cell count. The second case was a HAART-experienced female who stopped her drugs for 4months. Two months after recommencement of her previous HAART regimen, she developed features of disseminated herpes zoster infection, despite evidence of decrease in viral load by 95%. HAART was continued and she recovered completely after receiving valaciclovir tablets and antibiotics. The third patient was a female student who was commenced HAART on account of chronic cough and weight loss. Three months after regular HAART, she developed features of disseminated Kaposi's sarcoma involving the skin, oropharynx and lungs, despite evidence of 42% increase in CD4 cell count. Unfortunately, she rapidly deteriorated and died during the course of management. Clinicians should be alert to the possibility of IRIS in HIV-infected patients initiated or re-initiated on HAART. There is need for future prospective studies determining risk factors for IRIS in HIV-infected patients from Nigeria.