Background. A community-based study put the prevalence of hypertension in Nigeria at 32.8%. Market workers in Nigeria lead sedentary life style and often depend on salt-laden fast food while at work. Method. An unselected population of market workers were screened for hypertension and its risk factors by a pretested, structured questionnaire, clinical examination, and laboratory investigation. Hypertension was defined as BP ≥ 140 and/or ≥ 90 mmHg or being on drug therapy. Results. Forty-two percent of the screened population were hypertensive. Of this number, 70.6% did not know they were hypertensive before the screening. More males than females (P = .022) were hypertensive. Prevalence of hypertension increased with age from 5.4% in the age group <20 years to 80% in the age group ≥70 years. Conclusion. The prevalence of hypertension in market workers in this study was 42%, and the majority of them were unaware of their disease.
Chronic kidney disease (CKD) is a global problem with increasing prevalence. End-stage renal disease (ESRD) accounts for 8% of all medical admissions and 42% of renal admissions in Nigeria. Screening for CKD facilitates early detection, evaluation, and treatment of CKD. There is a dearth of community-based data on the magnitude of CKD in Nigeria. This was an epidemiological study to define CKD and its risk factors in rural and semiurban communities in Southeast Nigeria. Obesity was defined as body mass index (BMI) 430 kg/m 2 . The metabolic syndrome was evaluated using the National Cholesterol Evaluation Programme Adult Treatment Panel III definition; hypertension was defined as systolic blood pressure (SBP) X140 mm Hg and/or diastolic blood pressure (DBP) X90 mm Hg. Diabetes mellitus (DM) was defined as fasting plasma glucose X7.0 mmol/l or 2-h plasma glucose X11.1 mmol/l. Proteinuria was regarded as significant if 1 þ and above, and hematuria was considered present if positive using urine strips. The glomerular filtration rate (GFR) was estimated using the CKD-EPI formula. A total of 2182 respondents aged 25-64 years were screened; 1941 with mean age of 43.7 ± 13.2 years were analyzed. Of this number, 26.1% had hypertension, 5.9% had DM, 10.4% had the metabolic syndrome, 14.9% were obese and 19% had proteinuria and/or hematuria. The prevalence of CKD was 11.4%. This study documented high prevalence of CKD and its risk factors. Routine screening of patients for risk factors for CKD at each contact with the doctor will help to identify early CKD patients who may benefit from preventive measures.
Background: Continental Africa is facing an epidemic of chronic kidney disease (CKD). APOL1 risk variants have been shown to be strongly associated with an increased risk for non-diabetic kidney disease including HIV nephropathy, primary non-monogenic focal and segmental glomerulosclerosis, and hypertension-attributed nephropathy among African ancestry populations in the USA. The world's highest frequencies of APOL1 risk alleles have been reported in West African nations, overlapping regions with a high incidence of CKD and hypertension. One such region is south-eastern Nigeria, and therefore we sought to quantify the association of APOL1 risk alleles with CKD in this region. Methods: APOL1 risk variants were genotyped in a case-control sample set consisting of non-diabetic, CKD patients (n = 44) and control individuals (n = 43) from Enugu and Abakaliki, Nigeria. Results: We found a high frequency of two APOL1 risk alleles in the general population of Igbo people of south-eastern Nigeria (23.3%). The two APOL1 risk allele frequency in the CKD patient group was 66%. Logistic regression analysis under a recessive inheritance model showed a strong and significant association of APOL1 two-risk alleles with CKD, yielding an odds ratio of 6.4 (unadjusted p = 1.2E-4); following correction for age, gender, HIV and BMI, the odds ratio was 4.8 (adjusted p = 5.1E-03). Conclusion: APOL1 risk variants are common in the Igbo population of south-eastern Nigeria, and are also highly associated with non-diabetic CKD in this area. APOL1 may explain the increased prevalence of CKD in this region.
Human immunodeficiency virus (HIV) infection is a common cause of chronic kidney disease (CKD) in Sub-Saharan Africa. This study aims at identifying the prevalence and predictors of CKD in newly diagnosed HIV patients in Owerri, South East Nigeria. This was a cross-sectional study consisting of 393 newly diagnosed HIV-seropositive subjects and 136 age- and sex-matched seronegative subjects as controls. CKD was defined as 24-hour urine protein (24-HUP) ≥0.3 g and/or glomerular filtration rate (GFR) < 60 ml/min. Subjects were recruited from the HIV clinic and the Medical Outpatient Department of Federal Medical Centre, Owerri. Clinical and anthropometric data were collected. Relevant investigations were performed, including HIV screening and relevant urine and blood investigations. The mean age of the HIV subjects was 38.84 ± 10.65 years. CKD was present in 86 (22.9%) HIV subjects and 11 (8.l %) controls. Low waist circumference (WC), high serum creatinine, high spot urine protein/creatinine ratio (SUPCR), high 24-HUP/creatinine Ratio (24-HUPCR), high 24-HUP/osmolality Ratio (24-HUPOR) predicted CKD in HIV subjects. CKD prevalence is high (22.9%) among newly diagnosed HIV patients in South East Nigeria. The predictors of CKD included WC, serum creatinine, SUPCR, 24-HUPCR, and 24-HUPOR.
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