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Current trends in the epidemiology and management of enteric fever in Africa: A literature review

Asian Pacific Journal of Tropical Medicine 2020年第5期13卷 204-213页

作者： Oluwaseyitan A.Adesegun Oluwafunmilola O.Adeyemi osaze ehioghae David F.Rabor Tolulope O.Binuyo Bisola A.Alafin Onyedikachi B.Nnagha Akolade O.Idowu Ayokunle Osonuga Department of Internal Medicine Babcock University Teaching HospitalIlishan-RemoOgun StateNigeria College of Medicine University of IbadanIbadanOyo StateNigeria Benjamin S.Carson(Snr.)School of Medicine Babcock UniversityIlishan-RemoOgun StateNigeria Oyo State Ministry of Health IbadanOyo StateNigeria Arubah Family Medical Centre LekkiLagos StateNigeria College of Medicine Imo State UniversityOwerriImo StateNigeria Medway Maritime Hospital KentUnited Kingdom

Enteric fever remains a tropical disease of public health significance in Africa, due to its high endemicity and transmission rates, more in sub-Saharan Africa with 7.2 million cases of typhoid fever annually and incidence rate of 762 per 100000 person-years when compared with Northern Africa with a reported incidence rate of 557 per 100000 person-years and lower. Recent studies show that almost all regions of sub-Saharan Africa are tending towards high incidence rates, especially Central and Western Africa. Though clinically indistinguishable from paratyphoid fever, typhoid fever causes more morbidity and mortality than paratyphoid fever, with a greater threat to children. Risk factors include consumption of contaminated water, patronizing food vendors and a history of contact with a case or a chronic carrier, amongst others. Environmental factors such as the rainy season, open sewers, contaminated water bodies and areas of low elevation have been implicated. Diagnosis in Africa is challenging due to resource constraints, as many centres still depend on clinical diagnosis and serodiagnosis using Widal test, in an era where more sensitive and specific tests exist. The polymerase chain reaction is one of the most sensitive diagnostic methods, while culture (particularly bone marrow) is considered to be one of the most specific. Quinolones (ciprofloxacin) and third-generation cephalosporins, amongst others, remain potent in the management of enteric fever, with resistance to quinolones gradually on the rise. Poor diagnostics, poor antibiotic stewardship and lack of drug (antibiotic) regulation are contributors to the problem of antibiotic resistance in Africa. Prevention of typhoid fever through;vaccination, especially in children is still under investigation, with steady progress being documented. Overall, long term prevention strategies for typhoid fever should be based on improved sourcesof drinking water, good sanitation and hygiene, food safety and poverty allevi

关键词： Enteric fever Typhoid fever Epidemiology Africa Public health

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Neutrophil Lymphocyte Ratio as an Inflammatory Marker in Chronic Kidney Disease: Determinants and Correlates

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Open Journal of Nephrology 2022年第1期12卷 23-35页

作者： Peter Kehinde Uduagbamen Adesola Temitope Oyelese Abdallah Olukayode AdebolaYusuf Mary Umoh Thompson Boladale Ajani Afeez Alalade osaze ehioghae Division of Nephrology and Hypertension Department of Internal Medicine Ben Carson (Snr) School of Medicine Babcock University/Babcock University Teaching Hospital Ilishan-Remo Nigeria Department of Haematology and Blood Transfusion Ben Carson (Snr) School of Medicine Babcock University/Babcock University Teaching Hospital Ilishan-Remo Nigeria Division of Radiodiagnosis Department of Surgery Ben Carson (Snr) School of Medicine Babcock University/Babcock University Teaching Hospital Ilishan-Remo Nigeria Endocrine Diabetes and Metabolism Unit Department of Internal Medicine Federal Medical Centre Abeokuta Nigeria

Introduction: Inflammation has been implicated as a major reason for the higher morbidity and mortality in chronic kidney disease (CKD) compared to the diseases that commonly precedes it. The neutrophil lymphocyte ratio (NLR) has increasingly been reported to be a marker of systemic inflammation. We studied the neutrophil lymphocyte ratio and its relationship with kidney function and other markers of inflammation in health and in CKD. Methods: Two hundred and forty four participants in three cohorts: healthy, CKD stage 1 - 2 and, stage 3 - 4, were studied. Data of clinical, NLR, uric acid, urine albumin creatinine ratio (UACR), electrolytes were documented and independent associates of NLR were determined. Results: The NLR was higher in the CKD cohorts, P Conclusion: The NLR as an inflammatory marker is elevated in chronic kidney disease, and increases with disease severity hence it can be a useful tool in determining the presence and severity of inflammation in CKD.

关键词： Neutrophil Lymphocyte Ratio Inflammation Chronic Kidney Disease Platelet Lymphocyte Ratio Hyperuricemia Albuminuria

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Pre-Operative Hyponatremia in a High Dependency Cardiovascular Surgical Center of a Tertiary Health Facility in Nigeria: Risk Factors, Prevalence, Clinical Correlates and Treatment Outcome. A Retrospective Cohort Study

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Open Journal of Internal Medicine 2020年第3期10卷 288-301页

作者： Peter K. Uduagbamen Michael Sanusi Olumide B. Udom Omotayo F. Salami Adedeji D. Adebajo Oluwaseyi J. Alao osaze ehioghae Division of Nephrology and Hypertension Department of Internal Medicine Ben Carson (Snr) School of Medicine Babcock University/Babcock University Teaching Hospital Ilishan-Remo Nigeria Tristate Heart and Vascular Centre Babcock University Teaching Hospital Ilishan-Remo Nigeria Intensive Care Unit Department of Surgery Ben Carson (Snr) School of Medicine Babcock University/Babcock University Teaching Hospital Ilishan-Remo Nigeria

Introduction: Hyponatremia is the commonest electrolyte derangement seen in medical and surgical wards and in high dependency treatment units. It is associated with prolonged hospital stay, high economic burden and increased morbidity and mortality. Hyponatremia is well reported in medical and surgical conditions but literature is scanty concerning its relationship with treatment outcome in patients managed in high dependency heart and vascular surgical centers. Objectives: To determine the prevalence, determinants, clinical correlates and outcome of pre-operative hyponatremia. Methods: Retrospective study involving patients that had surgery (cardiac and vascular) between January 2015 and December 2019. Data were obtained from patients’ case files, perioperative and intensive unit charts. All participants with preoperative hyponatremia had their serum sodium corrected to ≥135 mmol before surgical incision and those with hypernatremia had their sodium corrected to Results: Of the 305 participants (186 males and 119 females), pre-operative hyponatremia was found in 30.8% and normonatremia in 59.7%. Pre-operative hyponatremia was more common in advance age, overweight, those presenting for open heart and other major surgeries and those with background chronic heart failure and chronic liver disease. Participants with pre-operative hyponatremia had shortened and also prolonged hospital stay and higher risk of death than with normonatremia. Conclusion: Pre-operative hyponatremia is common in high dependency surgical unit particularly in the elderly, those with comorbidities and those presenting for major heart surgeries. It impacts negatively on the morbidity and mortality as it could shorten hospital stay through death, and could prolong hosp

关键词： Hyponatremia Normonatremia Comorbidities Pre-Operative Sodium

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The Pattern of Eosinophil Count among Nigerians with Frequent Use of the Commonly Available Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

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International Journal of Clinical Medicine 2020年第10期11卷 605-617页

作者： P. K. Uduagbamen A. T. Oyelese A. O. Adebola Yusuf O. F. Salami C. M. Nwinee M. I. Ogunmola O. ehioghae Division of Nephrology and Hypertension Department of Internal Medicine Ben Carson School of Medicine Babcock University/Babcock University Teaching Hospital Ilishan-Remo Nigeria Nephrology Unit Department of Internal Medicine Federal Medical Centre Abeokuta Nigeria Department of Haematology and Blood Transfusion Ben Carson School of Medicine Babcock University/Babcock University Teach-ing Hospital Ilishan-Remo Nigeria Division of Radiology Department of Surgery Ben Carson School of Medicine Babcock University/Babcock University Teaching Hospital Ilishan-Remo Nigeria Intensive Care Unit Department of Surgery Ben Carson (Snr) School of Medicine Babcock University/Babcock University Teaching Hospital Ilishan-Remo Nigeria

Introduction: Non-steroidal anti-inflammatory drugs (NSAIDs) use is very common. NSAIDs use could be associated with elevated eosinophil count which could be a class effect or patient-related. Inflammation could be the link between NSAIDs use and eosinophilia. Aims: To compare the pattern of eosinophil count in the peripheral blood of frequent users of NSAIDs and healthy controls. Methodology: Two hundred (one hundred frequent users of NSAIDs and 100 healthy controls) participants who had no known risk factor for kidney disease and had given informed consent were recruited. Blood was taken to determine the white cell count and differentials, serum electrolyte and creatinine, and random blood sugar. Results: The mean age of NSAIDs users was not significantly different from controls, P = 0.3. The mean eosinophil count was higher in males than females. The incidence of eosinophilia in NSAIDs users was 4%. The mean Eosinophil count of NSAIDs users was insignificantly higher than controls, 164.3 ± 51 6 vs 135. 6 ± 53.4, P = 0.4. The mean platelet count of NSAIDs users was significantly higher compared to controls, P = 0.04. The mean hematocrit of NSAIDs users was significantly lower than the controls, P = 0.02. Propionic acid derivatives were associated with the highest eosinophil count. Eosinophil count was positively related to age and serum creatinine and inversely related to blood glucose, hematocrit and glomerular filtration rate. Conclusion: The incidence of eosinophilia was 4%. The eosinophil count was higher in frequent NSAIDs users than occasional and non-users, in males than females and with use propionic acid derivatives compared to other NSAIDs. The Eosinophil count was positively related to age and platelet count. Being commoner in inflammatory states, the tissue destruction associated with elevated EC can be avoided by the prevention and prompt treatment of inflammatory con

关键词： Eosinophilia Kidney Function Non-Steroidal Anti-Inflammatory Drugs Hematocrit Platelet Count Propionic Acid

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