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BACKGROUND: There are limited data on large-scale, multi-level implementation research studies to improve hypertension diagnosis, treatment, and control rates at the primary health care (PHC) level in Africa. We describe the characteristics, treatment, and control rates of patients with hypertension in public PHC centers in the Hypertension Treatment in Nigeria Program. METHODS: Data were collected from adults ≥18 years at 60 public PHC centers between January 2020 and November 2020. Hypertension treatment rates were calculated at registration and upon completion of the initial visit. Hypertension control rates were calculated based on systolic and diastolic blood pressures

More than 1.2 billion adults worldwide have hypertension. High retention in clinical care is essential for long-term management of hypertension, but 1-year retention rates are less than 50% in many resource-limited settings.To evaluate short-term retention rates and associated factors among patients with hypertension in primary health care centers in the Federal Capital Territory of Nigeria.In this cohort study, data were collected by trained study staff from adults aged 18 years or older at 60 public, primary health care centers in Nigeria between January 2020 and July 2021 as part of the Hypertension Treatment in Nigeria (HTN) Program. Patients with hypertension were registered.Follow-up visit for hypertension care within 37 days of the registration visit.The main outcome was the 3-month rolling average 37-day retention rate in hypertension care, calculated by dividing the number of patients who had a follow-up visit within 37 days of their first (ie, registration) visit in the program by the total number of registered patients with hypertension during multiple consecutive 3-month periods. Interrupted time series analyses evaluated trends in retention rates before and after the intervention phase of the HTN Program. Mixed-effects, multivariable regression models evaluated associations between patient-, site-, and area council-level factors, hypertension treatment and control status, and 37-day retention rate.In total, 10 686 patients (68.3% female; mean [SD] age, 48.8 [12.7] years) were included in the analysis. During the study period, the 3-month rolling average 37-day retention rate was 41% (95% CI, 37%-46%), with wide variability among sites. The retention rate was higher among patients who were older (adjusted odds ratio [aOR], 1.01 per year; 95% CI, 1.01-1.02 per year), were female (aOR, 1.11; 95% CI, 1.01-1.23), had a higher body mass index (aOR, 1.01; 95% CI, 1.00-1.02), were in the Kuje vs the Abaji area council (aOR, 2.25; 95% CI, 1.25-4.04), received hypertension treatment at the registration visit (aOR, 1.27; 95% CI, 1.07-1.50), and were registered during the postintervention period (aOR, 1.16; 95% CI, 1.06-1.26).The findings suggest that retention in hypertension care is suboptimal in primary health care centers in Nigeria, although large variability among sites was found. Potentially modifiable and nonmodifiable factors associated with retention were identified and may inform multilevel, contextualized implementation strategies to improve retention.

RESEARCH OBJECTIVE: The prevalence of hypertension among adults in Nigeria is high (29‐45%), yet awareness (14‐30%), treatment (

Background: Septicemia is one of the major causes of morbidity and mortality in the neonatal period and it often has a rapid and fulminant course. Aims: To determine the incidence, predisposing factors, clinical features, bacteriologic pattern and antibiotic sensitivity of neonatal septicemia. Design: A prospective study was undertaken over a 1 ½-year period in the neonatal unit of Ebonyi State University Teaching Hospital, Abakaliki, Southeastern Nigeria. Methods: All newborns (age 0-28 days) admitted with clinical features and/or risk factors suggestive of neonatal septicemia were selected and screened for septicemia. Results: The study identified 33 septicemic neonates of the 138 neonates (23.9%) screened, 19/92 (20.7%) for inborns and 14/46 (30.4%) for outborns, representing an incidence of 7.98/1000 live births. Prolonged/obstructed labor, severe birth asphyxia, maternal pre-partum/peripartum pyrexia and home/traditional birth attendant deliveries were the main predisposing perinatal factors. Respiratory distress, fever and jaundice were the predominant presenting clinical findings. Gram-positive organisms were cultured from 18 neonates with Staphylococcus aureus accounting for 45.5% of the cases, while Escherichia coli was the predominant Gram-negative organism accounting for 18.2% of the cases. Group B streptococcus accounted for only one case and there was no case of Listeria monocytogenes. Early onset septicemia was commoner in in born while late onset septicemia was commoner with out born (Χ 2 =10.45, P < 0.05). The bacterial isolates showed a high degree of in vitro antimicrobial resistance to conventional antibiotics and the antibiotic sensitivity pattern of the organisms indicated the use of ceftriaxone and gentamicin as initial therapy while awaiting culture results. The overall mortality rate was 26.7%. Early onset septicemia and concomitant meningitis were associated with high mortality. Conclusion: Neonatal septicemia is a major cause of morbidity and mortality in the study site. Most of the predisposing factors were due to poor obstetric care and unsterile delivery practices which could be avoided and prevented, and the causative organisms were different from those in the developed countries. There was appreciable resistance to commonly used antibiotics. Simple and sustainable interventions such as promotion of clean and timely deliveries, modern newborn care and specialized diagnostic facilities, hand washing and barrier nursing, and restriction of antibiotics may help reduce the burden of neonatal infection in the study community.