IntroductionThere has been no nationwide health (diabetes) survey in Nigeria since 1992, when a diabetes mellitus (DM) prevalence of 2.2% was reported. We aimed to determine the prevalence of and risk factors for DM in Nigeria by performing a systematic review and meta-analysis.MethodsWe searched Medline, EMBASE, PubMed, PapersFirst, the Cochrane Library, Scopus, Bioline, African Journals Online, Institute of Scientific Information, and Google Scholar from the year 1990 to 2017. Using MeSH headings, the terms “diabetes mellitus,” “risk factors,” “prevalence,” and “Nigeria” as well as variations thereof were searched for. The last search was performed on 26 November 2017. We only included studies that utilized the random plasma glucose test, the fasting plasma glucose test, the oral glucose tolerance test (OGTT), or HbA1c to diagnose DM. A total of 23 studies (n = 14,650 persons) were evaluated. A random effects model was used to estimate the pooled prevalence of DM. We estimated the overall pooled prevalence of DM and subgroup-specific DM prevalences while accounting for inter-study and intra-study variability/heterogeneity.ResultsThe overall pooled prevalence of DM was 5.77% (95% CI 4.3–7.1). The pooled prevalences of DM in the six geopolitical zones of Nigeria were 3.0% (95% CI 1.7–4.3) in the north-west, 5.9% (95% CI 2.4–9.4) in the north-east, 3.8% (95% CI 2.9–4.7) in the north-central zone, 5.5% (95% CI 4.0–7.1) in the south-west, 4.6% (95% CI 3.4–5.9) in the south-east, and 9.8% (95% CI 7.2–12.4) in the south-south zone. Risk factors for the pooled prevalence of DM were a family history of DM (4.6%; 95% CI 3.5–5.6); urban dwelling (6.0%; 95% CI 4.3–7.8); unhealthy dietary habits (8.0%; 95% CI 5.4–10.5); cigarette smoking (4.4%; 95% CI 1.3–10.2); older age (6.6%; 95% CI 4.5–8.7); physical inactivity (4.8%; 95% CI 3.2–6.4); and obesity (5.3%; 95% CI 3.8–6.9).ConclusionThere has been an increase in the prevalence of DM in Nigeria. All regions of the country have been affected, with the highest prevalence seen in the south-south geopolitical zone. Urban dwelling, physical inactivity, advanced age, and unhealthy diet are important risk factors for DM among Nigerians. A national diabetes care and prevention policy is highly recommended.

Background: Previous studies that evaluated the prevalence, awareness and treatment of hypertension in Nigeria were either localized to some specific regions of the country or nonstandardized thereby making evaluation of trend in hypertension care difficult. Methods: We used the World Health Organization (WHO) STEPwise approach to chronic disease risk factor surveillance to evaluate in a nationally representative sample of 4192 adult Nigerians selected from a rural and an urban community in one state in each of the six geo-political zones of the country. Results: The overall age-standardized prevalence of hypertension was 38.1% and this varied across the geo-political zones as follows: North-Central, 20.9%; NorthEast , 27.5%; NorthWest , 26.8%; SouthEast , 52.8%; South-South, 44.6%; and SouthWest , 42.1%. Prevalence rate did not differ significantly (p > 0.05) according to place of residence; 39.2% versus 37.5 %; urban vs rural. Prevalence of hypertension increased from 6.8% among subjects less than 30 years to 63.0% among those aged 70 years and above. Awareness was better (62.2% vs. 56.6%; P = 0.0272); treatment rate significantly higher (40.9 % vs. 30.8%; P < 0.0001) and control similar (14 vs. 10.8%) among urban compared to rural residents. Women were more aware of (63.3% vs. 52.8%; P < 0.0001); had similar (P > 0.05) treatment (36.7 vs. 34.3%) and control (33.9% vs. 35.5%) rates of hypertension compared to men. Conclusion: Our results suggest a large burden of hypertension in Nigeria and a closing up of the rural-urban gap previously reported. This calls for a change in public health policies anchored on a primary health care system to address the emerging disease burden occasioned by hypertension.

Assessment of level of salt intake in a population is the first step toward planning strategies aimed at salt reduction. As a surrogate of salt intake, we measured a single 24-hour urine sodium (uNa) of free-living 2503 adults in a nationally representative sample of Nigerians drawn from 12 rural and urban communities; and evaluated the community-level association of uNa with blood pressure (BP). Overall, the median (interquartile range (IQR)) of uNa was 99 (105) mmol, ranging from 23.8 (32.4) in rural north-central to 172.8 (131.0) mmol in urban northwestern region. Daily uNa was significantly higher (p < .001) in men compared to women (107.1 vs 93.9 mmol); and urban compared to rural dwellers (114.9 vs 86.0mmol). About one-half of participants excreted uNa in excess of recommended daily maximum value (86mmol). In a model adjusted for age, sex, body mass index (BMI), level of education, place of residence, and use of antihypertensive medication; being a man (odds ratio, OR 1.69, 95% confidence Interval CI, 1.21-2.37, p = .002) and being < 60 years of age (OR 1.74, 95% CI 1.23-2.45, p = .002), were associated with excreting higher than recommended uNa. | 2267 ODILI et aL.

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