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Background: Hypertension is the most common cardiovascular disease in Nigeria. Adequate knowledge of healthcare practitioners on current guidelines management of hypertension have been associated with a reduction in its morbidity and mortality. Objective: This study aimed to determine the knowledge and awareness of health workers on current guideline in management of hypertension. Methods: This was a descriptive cross-sectional web-based survey of 396 Nigerian health workers. An adopted self-administered e-questionnaire was used to collect data related to health workers' characteristics. SPSS version 22.0 was used to determine awareness, knowledge scores/grades and descriptive statistics. Results: Data analyzed showed 54.7% were male and predominant age group 38.5% was 40-49 years. A proportion of 50.8% were specialists and 60.1% practice in tertiary hospitals. Only 41.2% were very familiar with current guidelines though majority 76.7% of the participants were very confident that patients should continue taking their drugs when blood pressure is controlled. The median knowledge score was 2/6 and very few 6.8% had good knowledge grade(5-6/6). No association was found between knowledge grade and studied factors. Conclusions: The knowledge of the current guidelines is not optimal, even though both international and national hypertension guidelines are available to health workers. There is urgent need for comprehensive nationwide increased awareness and advocacy for its use among healthcare practitioners for effective improvement in the care of patients with hypertension in Nigeria.

Background: There is a paucity of nationally representative data on the pattern of morbidity of hospitalised medical patients in Nigeria. We hereby provide insights from the MOHOPA (Pattern of Morbidities, Mortality and Healthcare Financing of Hospitalised Medical Patients in Hospitals) study on the pattern of morbidity among patients admitted to the medical wards of Nigerian tertiary-level hospitals., Methods: At least 100 patients admitted to the medical and emergency wards of 7 tertiary-level hospitals, spread across the 6 geopolitical zones of Nigeria and the Capital City of Abuja, were consecutively recruited to join the study after obtaining written informed consent., Results: A total of 705 patients were recruited consecutively between May 2023 and March 2024, from Aminu Kano Teaching Hospital, University of Maiduguri Teaching Hospital, Federal Medical Centre Lokoja, University College Hospital, Ibadan, University of Nigeria Teaching Hospital, Enugu, Delta State University Teaching Hospital, and University of Abuja Teaching Hospital. Their mean age was 51.3 ± 18.3 years and 44.7% were females. Cardiovascular disease was the primary cause of admission in 22.1% of patients, followed by neurological (16.5%) and renal (14.3%) diseases. 74.2% of the patients had an important co-morbidity; the most common being cardiovascular (21.3%) followed by infectious (13.3%) and renal (9.7%) diseases. These patterns however varied significantly by region (Northern vs Southern) but not by gender (males vs females)., Conclusion: Cardiovascular, neurological, and renal disorders were the most common indications for admission and infectious diseases were important co-morbidities. The results will be vital for strategic planning and policy formulation., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2024 by West African Journal of Medicine.)

Background: Stroke is a leading cause of disability and mortality worldwide, but little is known about the contribution of secondhand smoke exposure (SHSE) to stroke epidemiology among indigenous Africans., Objective: To evaluate the association of SHSE with stroke among indigenous Africans., Methods: We analyzed the relationship of SHSE with stroke among 2990 case-control pairs of adults who had never smoked (identified in the SIREN study) using conditional logistic regression at a two-sided P < 0.05., Results: Multivariable-adjusted odds ratio and 95% confidence interval; 1.25 (1.04, 1.50; P = 0.02) revealed SHSE was positively associated with stroke independent of stroke subtypes., Conclusion: Culturally relevant primary prevention strategies targeted at SHSE might be promising in preventing stroke among Africans., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The SIREN study was a multi-centre case-control study among West Africans from Nigeria and Ghana. The overall coordinating Institutional Review Board (IRB) for the SIREN study was the University of Ibadan/University College Hospital Ibadan, Nigeria (UI/EC/13/0105). IRB at all study sites approved the study, and all respondents provided written informed consent before participation in the study., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background and Purpose: To identify the qualitative and quantitative contributions of conventional risk factors for occurrence of ischemic stroke and its key pathophysiologic subtypes among West Africans., Methods: The SIREN (Stroke Investigative Research and Educational Network) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria. Cases include adults aged ≥18 years with ischemic stroke who were etiologically subtyped using the A-S-C-O-D classification into atherosclerosis, small-vessel occlusion, cardiac pathology, other causes, and dissection. Controls were age- and gender-matched stroke-free adults. Detailed evaluations for vascular, lifestyle, and psychosocial factors were performed. We used conditional logistic regression to estimate adjusted odds ratios with 95% CI., Results: There were 2431 ischemic stroke case and stroke-free control pairs with respective mean ages of 62.2±14.0 versus 60.9±13.7 years. There were 1024 (42.1%) small vessel occlusions, 427 (17.6%) large-artery atherosclerosis, 258 (10.6%) cardio-embolic, 3 (0.1%) carotid dissections, and 719 (29.6%) undetermined/other causes. The adjusted odds ratio (95% CI) for the 8 dominant risk factors for ischemic stroke were hypertension, 10.34 (6.91-15.45); dyslipidemia, 5.16 (3.78-7.03); diabetes, 3.44 (2.60-4.56); low green vegetable consumption, 1.89 (1.45-2.46); red meat consumption, 1.89 (1.45-2.46); cardiac disease, 1.88 (1.22-2.90); monthly income $100 or more, 1.72 (1.24-2.39); and psychosocial stress, 1.62 (1.18-2.21). Hypertension, dyslipidemia, diabetes were confluent factors shared by small-vessel, large-vessel and cardio-embolic subtypes. Stroke cases and stroke-free controls had a mean of 5.3±1.5 versus 3.2±1.0 adverse cardio-metabolic risk factors respectively ( P <0.0001)., Conclusions: Traditional vascular risk factors demonstrate important differential effect sizes with pathophysiologic, clinical and preventative implications on the occurrence of ischemic stroke among indigenous West Africans.

Introduction: The WHO has proposed the concept of mobile health (mHealth) to support healthcare systems delivery worldwide. mHealth basically involves the use of Information and Communication Technology for healthcare provision or delivery services. Africa has seen a remarkable increase in mobile phone availability and usage in the last decade. The incidence and prevalence of diabetes mellitus (DM) in Africa have also been on the increase in the last decade, in sharp contrast to an ailing healthcare system. We aim to review the extent of implementation of mHealth in the management of DM in Africa, and estimate its impact in helping patients achieve desired glycaemic target, sustain control and prevent complications in the past decade., Methods and Analysis: Studies assessing the utilisation of mhealth in the management of patients with DM in Africa will be considered based on the PICO method: Population, Intervention, Comparator, and Outcomes. Medline, PubMed, SCOPUS and the Pan African Clinical Trials Registry, among others will be searched. Two authors independent of each other shall screen titles and abstracts retrieved using the search strategy, retrieve the full text articles and assess them for eligibility and extract data. A third reviewing author will be brought in to resolve any disagreement between the two authors by discussion. The 'Cochrane Collaboration Risk of Bias Tool' will be used to assess the quality of included studies. A narrative synthesis of extracted data and, where the characteristics of the eligible studies permit, a meta-analysis (which will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines) will be done., Ethics and Dissemination: No ethical approval will be required since only published data will be used. Dissemination of results will be through peer reviewed publication and conference presentation., Prospero Registration Number: CRD42021218674., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)