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.

Acne vulgaris is a very common skin disorder affecting human beings. There is a paucity of report on the role of heavy metals-lead (Pb) and cadmium (Cd)-globally, and trace metals-zinc (Zn) and copper (Cd)-particularly in Nigeria in the development/severity of acne vulgaris. This study is aimed to determine the blood levels of some heavy metals-cadmium and lead-and trace metals-zinc and copper-in acne vulgaris sufferers in a Nigerian population. Venous blood samples were collected from a total number of 90 non-obese female subjects consisting of 30 mild, 30 moderate and 30 severe acne vulgaris sufferers for blood Cd, Pb, Cu and Zn determination. They were age-matched with 60 females without acne vulgaris who served as the control subjects. Acne sufferers had significantly higher blood Cd and Pb (P = 0.0143 and P = 0.0001 respectively) and non-significantly different blood levels of Cu and Zn (P = 0.910 and P = 0.2140 respectively) compared to controls. There were significant progressive increases in blood levels of Cd and Pb (P = 0.0330 and P = 0.0001 respectively) and non-significant differences in the mean blood level of Cu and Zn (P = 0.1821 and P = 0.2728 respectively) from mild to moderate and severe acne vulgaris sufferers. Increases in blood Cd and Pb may play critical roles in the pathogenesis/severity of acne vulgaris, while Cu and Zn seem to play less significant roles in the development of this disorder in this environment.

Background: The role of trace metals in Pathogenesis of Pre-eclampsia has received insufficient attention in Nigeria.Materials and Methods: We examined the effect of serum levels of some trace metals; selenium (Se), zinc (Zn), copper (Cu), cobalt (Co), and manganese (Mn) in the development of pre-eclampsia in Nigeria. Blood samples were collected from 59 pre-eclamptic, 150 normal pregnant and 122 non pregnant women. Serum Se, Zn, Cu, Co and Mn were determined by AAS.Results: Result shows significantly lower serum Se, Zn, Cu, Cu: Zn ratio, Co and Mn in pre-eclamptics compared to normal pregnant women (p<0.001). Comparison of normal pregnant women and controls showed non significant difference in the zinc level (P>0.05), significantly lower levels of serum Se, Co, Mn (p<0.00011, p=0.0022, p<0.0001 respectively) and significantly raised copper level (p<0.001) in normal pregnant women compared to controls.  Serum Se, Zn, Co and Mn were significantly lower (p<0.001) while serum copper and Cu: Zn ratio were significantly higher (p<0.001) in pregnant women compared to controls. ANOVA shows significant progressive decreases in serum Se, Zn Co and Mn, from controls to normal pregnant women and pre-eclamptics (p<0.0001).Conclusion: Decreases in serum level of Se, Zn, Cu, Cu: Zn ratio, Co and Mn may play important role in the pathogenesis of pre-eclampsia.Asian Journal of Medical Sciences Vol. 7(3) 2016 78-83

Background: Overweight and obesity present a growing health problem among Africans from all socioeconomic status. In Sub Saharan African, obesity is not only a consequence of overnutrition but possibly from excessive consumption of unbalanced diet dominated by carbohydrates and saturated fats. Characteristics of the distribution of obesity/overweight in Nigeria include its high prevalence along with socioeconomic class and in mid-life. Methods: Using the WHO STEP-wise approach to surveillance of noncommunicable diseases, we conducted a cross-sectional descriptive study of the adult population living in two urban slums in Enugu. The study was carried out in 2013. Statistical analysis was done using SPSS version. Results: A total of 605 (414 women (68.4%) and 191 (31.6%) men were recruited and analysed. The mean body mass index was 25.8 kg/m 2 higher in females (26.7 kg/m 2) than males (24 kg/m 2) p < 0.01. The prevalence of overweight and obesity is 29.4% (178/605) and 19.5% (118/605) respectively. There also a modest prevalence of underweight 4% (24/605) among the population. All classes of obesity were significantly more prevalent in females. Significant positive correlates of BMI were: female sex (r = 0.21, p < 0.001), systolic blood pressure (0.25, p < 0.001), DBP (0.27, p < 0.001), fasting blood glucose (0.19, p < 0,001) and positive history of hypertension (0.23, P < 0.001). Negative correlates were physical activity and use of tobacco (0.2 (<0.001) and −0.16 (<0.001) respectively). Conclusion: The prevalence of obesity is relatively high in two urban slums in Enugu and co-exists with a modest rate of underweight. Public health and community-based approaches should be used to tackle these two-opposing social/health problems.

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Background:Stroke is a growing noncommunicable disease in Africa and accounts for a substantial number of medical and neurological admissions in Nigerian hospitals. The prevalence of some risk factors for stroke such as hypertension and diabetes are high and growing among Africans.Aim:The aim was to investigate the distribution of stroke risk factors and estimate the 10-year probability of stroke among patients attending the out-patient clinics in the two biggest hospitals in Enugu South East Nigeria.Subjects and Methods:Consecutive consenting patients attending out-patient clinics at University of Nigeria Teaching Hospital and Enugu state University of Science and Technology Teaching Hospital all in Enugu were enrolled. Risk factors for stroke were evaluated using a series of laboratory tests, medical history and physical examinations. The 10-year probability of stroke was determined by applying the Framingham stroke risk equation. Statistical analysis was performed with the use of the SPSS 17.0 software package (SPSS Inc., Chicago, IL, USA).Results:A total of 165 patients were evaluated. Of these 94 were male and 71 were female. The most common risk factors were left ventricular hypertrophy 70.3% (116/165) and raised systolic blood pressure 52.7% (87/165). The mean age of patients was 66.1 (8.1) years. The mean 10-year probability of stroke was 18.1 (14.6) (19.7 [14.9] in men and 14.5 [14.6] women) and was higher in older age groups.Conclusion:The 10-year probability of stroke in Nigerians attending medical outpatient Clinic in SE Nigeria may be high. Aggressive interventions are needed to reduce risk factors and the probability of stroke risks especially in men in SE Nigeria.