There are a misconception and low level of awareness and knowledge of CKD, including those with risk factors, in the community. Efforts should be made to create awareness and educate people on CKD and prevention of its risk factors.

Background and Objectives:The increasing frequency of cardiovascular disease (CVD) rests on the presence of major cardiovascular risk factors including dyslipidemia. This dyslipidemia is also a target for the prevention and treatment of many cardiovascular diseases. Hence, identification of individuals at risk of CVD is needed for early identification and prevention. The study was carried out to evaluate dyslipidemia using the lipid ratios and indices instead of just the conventional lipid profile.Methodology:It was a cross-sectional study with 699 participants recruited from semi-urban communities in Nigeria. Anthropometric indices, blood pressure, and fasting lipid profiles were determined. Abnormalities in lipid indices and lipid ratios with atherogenic index were also determined. SPSS software version 17.0 were used for analysis, P < 0.05 was considered statistically significant.Results:There were 699 participants with a mean age of 64.45 ± 15.53 years. Elevated total cholesterol, high low-density lipoprotein-cholesterol, elevated triglyceride, and low high-density lipoprotein were seen in 5.3%, 19.3%, 4.4%, and 76.3% of the participants, respectively. The Castelli's risk index-I (CRI-I) predicted the highest prevalence of predisposition to cardiovascular risk (47.8%) with females being at significantly higher risk (55.2% vs. 29.3%, P < 0.001). Atherogenic coefficient, CRI-II, CHOLIndex, atherogenic index of plasma (AIP) predicted a cardiovascular risk prevalence of 22.5%, 15.9%, 11.2%, and 11.0%, respectively, with no significant difference in between the sexes.Conclusions:Serum lipid ratios and AIP may be used in addition to lipid parameters in clinical practice to assess cardiovascular risks even when lipid profiles are apparently normal. AIP was more gender specific amidst the lipid ratios.

No abstract

IntroductionDespite the global increase in awareness of prostatic diseases resulting from widespread availability of screening tools, there is no evidence that the knowledge, attitudes and screening practices of Nigerian men have improved regarding prostatic diseases.MethodsA descriptive cross-sectional study amongst 305 community-dwelling men. Respondents were selected using multi-staged sampling techniques. Knowledge, attitudes and screening practices were determined based on responses to a semi-structured KAP questionnaire. Data were analyzed using SPSS version 18. Pearson's chi-square and Fisher's exact test (two-tail) with level of significance set at 0.05 were used to determine the level of statistical significance. Pearson's correlation coefficient was used to establish correlation between variables.ResultsMean age of respondents was 63.4±11.8 years. Slightly less than half, 145(47.5%) were aware of prostate cancer (PCa) while only 99(32.5%) and 91(29.8%) were aware of BPH and prostatitis respectively. About a quarter (25.1%) had heard of PSA. The main sources of information were radio and television. Overall, 143(46.9%) respondents had good knowledge while 162(53.1%) had poor knowledge. Sexually transmitted disease was the commonest misconception as the cause of prostatic diseases. Overall, 44.3% had good attitudes. Only 31(10.2%) respondents had ever carried out screening for PCa. Only educational and occupational status had significant associations with level of knowledge and attitudes of participants. The only factor that influenced screening practices was educational status.ConclusionThere is a poor level of knowledge, attitudes and screening practices regarding prostatic diseases in Nigeria. We recommend a widespread public health education to improve knowledge, attitudes and screening practices for prostatic diseases.

High prevalence of cardiovascular risk factors call for an urgent need for more public health attention and reinforcement of primary preventive strategies to curb its menace.

SummaryBackgroundIn addition to poor socio-economic indices and a high prevalence of infectious diseases, there have been various reports of a rising prevalence of cardiovascular diseases, with associated morbidity and mortality in developing countries. These factors co-exist, resulting in a synergy, with serious complications, difficult-to-treat conditions and fatal outcomes. Hence this study was conducted to determine the clustering of cardiovascular disease risk factors and its pattern in semi-urban communities in south-western Nigeria.MethodsThis was a cross sectional study over seven months in 11 semi-urban communities in south-western Nigeria.ResultsThe total number of participants was 1 285 but only 1 083, with 785 (65%) females, completed the data. Participants were 18 years and older, and 51.2% were over 60 years. The mean age was 55.12 ± 19.85 years. There were 2.6% current cigarette smokers, 22% drank alcohol and 12.2% added salt at the table, while 2% had been told by their doctors they had diabetes, and 23.6% had hypertension. The atherogenic index of plasma was at a high-risk level of 11.1%. Elevated total cholesterol and low-density lipoprotein cholesterol, and low high-density lipoprotein cholesterol levels were seen in 5.7, 3.7 and 65.1%, respectively. Prevalence of hypertension was 44.9%, diabetes was 5.2%, obesity with body mass index (BMI) > 30 kg/m2 was 5.7%, and abdominal circumference was 25.7%. Prevalence of clusters of two, three, and four or more risk factors was 23.1, 15.5 and 8.4%, respectively. Increasing age 2.94 (95% CI: 1.30–6.67), BMI 1.18 (95% CI: 1.02–1.37), fasting plasma glucose level 1.03 (95% CI: 1.00– 1.05), albuminuria 1.03 (95% CI: 1.00–1.05), systolic blood pressure 1.07 (95% CI: 1.04–1.10), diastolic blood pressure 1.06 (95% CI: 1.00–1.11) and female gender 2.94 (95% CI: 1.30–6.67) showed increased odds of clustering of two or more cardiovascular risk factors.ConclusionClustering of cardiovascular risk factors is prevalent in these communities. Patterns of clustering vary. This calls for aggressive and targeted public health interventions to prevent or reduce the burden of cardiovascular disease, as the consequences could be detrimental to the country.

BackgroundNephrologists are faced with enormous challenges in the management of patients with end-stage renal disease, especially in sub-Saharan Africa, where hemodialysis is the most common modality of renal replacement therapy in the region. Therefore, we reviewed our 3 years of experience with hemodialysis services in a tertiary hospital located in a rural community of South West Nigeria. This was with a view to presenting the profile of hemodialysis patients and the challenges they face in sustaining hemodialysis.MethodsWe reviewed the case records and hemodialysis registers for 176 patients over the 3 years from November 2010 to December 2013. The data were analyzed using Statistical Package for the Social Sciences version 20 software.ResultsOf the 176 patients, 119 (66.9%) were males. The mean age of the patients was 44.87±17.21 years. Most were semiskilled or unskilled (111; 63.5%) and 29 (16.5%) were students. Twenty-six (14.8%) had acute kidney injury in the failure stage. Chronic glomerulonephritis, hypertensive nephropathy, and diabetic nephropathy accounted for 45.3%, 23.3%, and 12.1%, respectively, of patients with end-stage renal disease. Only 6.8% of patients could afford hemodialysis beyond 3 months.ConclusionSustainability of maintenance hemodialysis is poor in our environment. Efforts should be intensified to improve other modalities of renal replacement therapy, in particular kidney transplantation, which is cost-effective in the long-term. Also, preventive measures such as education for affected patients and the general population would assist in reducing the prevalence and progression to end-stage renal disease.

Background: There exists a synergy between chronic kidney disease (CKD) and cardiovascular risk factors (CVRFs) with increased morbidity and poor outcomes. Objectives: Data relating to this clustering in black homogenous populations is scanty. We aim to investigate this relationship in Nigerian communities. Patients and Methods: It was a cross-sectional observation study from semi-urban communities in South-West Nigeria. We used modified World Health Organization (WHO) questionnaire on chronic diseases (WHO STEPS) to gather information on socio-demographic data, biophysical and clinical characteristics. Biochemical analysis of plasma samples was done. Results: We analyzed data of 1084 with mean age of 56.3 ± 19.9 years (33.4% female). Prevalence of stage 3 CKD was 14.2% (3a and 3b were 10.3% and 3% respectively). Prevalence of hypertension (systolic and diastolic blood pressure) and low high-density lipoprotein cholesterol (HDL-C) increased as clustering of cardiovascular (CV) risk factors (CVFRs) increased both in CKD and proteinuria (P < 0.05). CKD prevalence increases with number of risk factors. There was an inverse relationship between increasing risk factors and mean estimated glomerular filtration rate (eGFR) (P < 0.05). Clustering at least 2 CVRFs in the population with CKD compared to those without CKD was significantly higher (76.6% vs. 65.1%, OR: 1.8, 95% CI: 1.2-2.6, P = 0.005). Similarly, in a univariate analysis, albuminuria had an increased odds of clustering (69.7% vs. 59.6%, OR: 1.9, 95% CI 0.6-6.2, P = 0.409). Using multivariate logistic analysis, there is significantly increased odds of clustering when eGFR is <45 mL/min/1.73 m2 (OR: 2.66, 95% CI: 1.12-6.32) and microalbuminuria 1.74 (95% CI: 1.10-2.75). Conclusions: Reduced kidney function and proteinuria significantly clustered with CVRFs. This data suggests that individuals with CV clusters should be screened for CKD or vice versa and they should be considered for prompt management of their CVRFs.