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The Prevalence of Stroke Survivors in Urban Slums in Enugu, Nigeria

Open Journal of Preventive Medicine 2019年第6期9卷 51-67页

作者： Oluchi Stella Ekenze Ezeala-Adikaibe Birinus Adikaibe Onodugo Obinna Chime Peter Orjioke Casmir Onodugo Pauline Nkiruka Mbadiwe Nkeiruka Onyekonwu Chinwe Ijoma Nkemdilim Uchenna Okoye Julius Uwabunkeonye Obumneme-Anyim Ijeoma Nnenne Ekochin Fintan ernest okwundu nwazor Emmanuel Uzodimma Iwuozo Department of Medicine University of Nigeria Teaching Hospital Enugu Nigeria Department of Medicine Enugu State University of Science and Technology Teaching Hospital Enugu Nigeria Department of Pediatrics University of Nigeria Teaching Hospital Enugu Nigeria Department of Medicine Federal Medical Center Owerri Nigeria Federal Medical Center Makurdi Nigeria

Background: Stroke is one of the commonest non-communicable diseases and the commonest cause of death in adult neurology wards. Stroke preva-lence in sub Saharan Africa has dramatically increased over the past decades possibly due to changing life styles, poverty, poor health infrastructures which had led to increased risk factors for stroke. Poor nutrition and lack of access to standard medical care, predispose to high rates of stroke morbidity and mor-tality hence possible low prevalence. Little is known about the prevalence of stroke in people with low socio-economic status in Nigeria. Objectives: The main objective of this study was to determine the prevalence of stroke in two urban slums in south east Nigeria. Materials and Methods: This was a cross sectional descriptive study carried out in two slums in Enugu, South East Nige-ria. Participants were screened using a stroke specific questionnaire and further examined by two independent neurologists for evidence of focal neurological deficits. Analysis was done by SPSS version 22. Results: A total of 1440 par-ticipants were surveyed in the study;769 (53.4) females and 671 (46.6%) males. About 22.3% (321) screened positive for various neurological diseases out of which 17 (5.3%) had evidence for stroke giving an overall prevalence of 1.2% (males 9 (1.3%) vs females 8 (1%) p = 0.6). The mean age of stroke sur-vivors was 60.1 years, similar in males and females (p = 0.6). The odds ratio for stroke from 40 years showed progress increment doubling between 60 and 70 years and tripled between 40 and 70 years. Age, lower level of education, positive history of hypertension, sickle cell disease, leg swelling and use of snuff positively are correlated with clinical diagnosis of stroke. Conclusion: The prevalence of stroke in two urban slums in Enugu metropolis was 12/1000. Hypertension, diabetes, use of snuff, and low levels of education were signifi-cant risk factors for stroke. Public health educational measures, promoti

关键词： Stroke Prevalence Nigeria

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Low prevalence of epilepsy and onchocerciasis after more than 20 years of ivermectin treatment in the Imo River Basin in Nigeria

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Infectious Diseases of Poverty 2019年第1期8卷 36-44页

作者： Joseph N.F.Siewe Chinyere N.Ukaga ernest O.nwazor Murphy O.Nwoke Modebelu C.Nwokeji Blessing C.Onuoha Simon O.Nwanjor Joel Okeke Kate Osahor Lilian Chimechefulam Ann I.Ogomaka Augustine A.Amaechi Chika I.Ezenwa Monika N.Ezike Chidimma I.kpeama Ogechi Nwachukwu Austine I.Eriama-Joseph Berthram E.B.Nwoke Robert Colebunders Global Health Institute University of AntwerpCam pus Drie EikenDoornstraat 3312610 WilrijkAntwerpBelgium Imo State University OwerriNigeria Federal Medical Centre OwerriNigeria Madonna University Teaching Hospital EleleNigeria Imo State Ministry of Health OwerriNigeria

Background:High epilepsy prevalence and incidence have been reported in areas with high onchocerciasis *** findings suggest that proper community-directed treatment with ivermectin(CDTI)is potentially able to prevent onchocerciasis-associated epilepsy(OAE).We assessed the epilepsy prevalence and onchocerciasis transmission in two Nigerian villages following more than 20 years of ***:A cross-sectional door-to-door survey was performed in two villages in the Imo River Basin reported to be mesoendomic for onchocerciasis(Umuoparaodu and Umuezeala).Individuals were screened for epilepsy using a validated 5-item *** suspected to have epilepsy were examined by a neurologist or a physician with training in epilepsy for *** was investigated via skin snip microscopy and rapid diagnostic tests for Ov16 *** were compared with previous findings from the Imo river ***:A total of 843 individuals from 257 households in the two villages were *** detected four persons with epilepsy(PWE)giving a crude epilepsy prevalence of 0.5%.This finding differs from observations reported 14 years ago which showed an epilepsy prevalence of 2.8%in the neighbouring village of Umulolo(P=0.0001),and 1.2%from 13 villages in the Imo river basin(P=0.07).The seroprevalence of Ov16 antibodies was found to be 0%.Only 4.6%of skin snips were positive compared to 26.8%in previous surveys(P<0.0001).Ivermectin mass distribution coverage in the study sites in 2017 was 79.7%.Conclusions:A low epilepsy and onchocerciasis prevalence was observed following more than 20 years of CDTI in the Imo River *** of Ov16 antibodies indicates minimal transmission of *** results contrast with observations from areas of high onchocerciasis transmission,where epilepsy prevalence and incidence remain *** from this study suggest that sustained efforts could eventually achieve elimination of onch

关键词： Epilepsy Onchocerciasis Nigeria Ivermectin Ov16

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