The average patient's/household's pre-diagnostic costs for TB care were catastrophic. More properly designed studies are needed among different populations throughout Africa.

No abstract

To evaluate the possible role of inadequate food intake in the pathogenesis of the growth retardation of patients with sickle cell anemia, we determined the daily intake of calories and macronutrients and measured several anthropometric indices in 20 patients with sickle cell anemia aged 17-35 years and in 15 of their normal siblings of similar age. Compared to the control groups, the male patients, but not the females, had a significantly lower mean weight, body mass index, midarm circumference, and triceps and subscapular skinfold thicknesses. Also, while the male patients consumed significantly less total calories, proteins, carbohydrates, and fats per day than their control group, no difference was noted between the daily intake of calories or macronutrients in the female patients and their control group. However, when the intake of calories and macronutrients was corrected for body weight, there was no statistically significant difference between the intake of nutrients in the male patients and their control subjects or between the female patients and their control group. These results suggest a sex-related difference in the somatic growth of adolescent and adult patients with sickle cell anemia and also suggest that, although an inadequate food intake may be partly responsible for the impaired somatic growth in sickle cell anemia, other factors are also probably important.

Diabetes mellitus (DM) has increasingly become a leading cause of renal morbidity and mortality in many parts of the world. [1][2][3] The results of several studies suggest that the incidence and prevalence of nephropathy in type 2 diabetes mellitus (type 2 DM) differ between ethnic groups, with Mexican-Americans, Pima Indians, people of African descent, and Asians being particularly at risk. [4][5][6][7] The limited data available on the prevalence of nephropathy in Middle East patients with DM suggest that their risk may also be high. 8,9 Information about nephropathy among Bahraini diabetic patients is scarce, despite the fact that Zubra and Al Garf 10 recently reported that type 2 DM affected over 25% of adult patients attending primary health care centers in the country, and a further 14.7% had impaired glucose tolerance. In view of these facts, we investigated the prevalence of microalbuminuria, as well as the factors associated with it, in Bahraini patients with type 2 DM seen at the diabetic unit of the Bahrain Defence Force (BDF) Hospital. Patients and MethodsAll patients with type 2 DM followed at the diabetic clinic of the BDF Hospital, Bahrain, were eligible for the study and were invited to participate. Those with end-stage renal disease, fever, hematuria, leukocyturia, or heart failure were excluded. Participants provided information about age, nationality, and smoking history. Each patient also underwent a physical examination, which included direct ophthalmoscopy after pupillary dilatation to check for the presence of diabetic retinopathy. Blood pressure was obtained in a sitting position, and the body mass index (BMI) (kg/m 2 ) was calculated from height and weight measurements. Venous blood was collected after an overnight fast for the determination of the level of plasma glucose, as well as the concentrations of serum urea, creatinine, triglycerides, total cholesterol and high-density lipoprotein (HDL) cholesterol. The blood level of hemoglobin A 1c (HbA 1c ) was determined by an immunoturbidimetric assay. Each patient submitted a 24-hour urine sample for the estimation of albumin and total protein excretion, and creatinine clearance. The concentration of albumin in urine was determined quantitatively by immunoturbidimetry, while urinary protein was measured by the biuret method after acid precipitation. Those patients whose urine albumin excretion was 30 mg per day or greater submitted one additional 24-hour urine sample for albumin estimation. The glomerular filtration rate (GFR) was determined by a radionuclide renal scan, using Tc-99m diethylene triamine pentacetic acid (DTPA) 11 in 70 patients, randomly selected from the group, in order to validate the results of the creatinine clearance. All patients with micro-or macroalbuminuria had a renal ultrasound study.Diabetes mellitus was diagnosed according to the criteria recommended by the National Diabetes Data Group. 12Patients were regarded as non-insulin dependent if hyperglycemia was controlled with diet alone, or diet combined with or...

Two thousand two hundred and four schoolgirls from four secondary schools in Enugu, the capital of Anambra State in south-eastern Nigeria, were interviewed and provided information regarding their age, menstrual status and the presence or absence of some common chronic disorders. Sickle cell disease was identified and confirmed by haemoglobin electrophoresis in 1.36% of the students. Average age at menarche, determined by probit analysis, was significantly delayed among subjects with sickle cell disease when compared with normal students (14.5 +/- 1.13 years vs. 13.3 +/- 1.09 years; P less than 0.005). Comparison of the average menarcheal age of the normal subjects in this study with previous reports of studies from southern Nigeria confirms a continuing decline of the average age at menarche at a rate of about four months per decade.