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The aim of this study was to determine, using meta-analysis, the prevalence of diabetes mellitus (DM) and to explore the influence of method of diagnosis, DM types, and study year on the prevalence of DM with the view to evaluating the trend and the burden of DM in KSA. Prevalence estimates were derived using a random effect model on carefully selected population-based studies in KSA. The derived estimates were applied to the total populations in the country to give an estimated burden of DM. Twenty-one studies, with 376,998 participants out of whom 54,837 had DM, were selected. The prevalence of DM was 20.9%, 0.9%, and 12.6% for T2DM, T1DM, and combined T1/T2DM, respectively. Subgroup analysis using the method of DM diagnosis showed that the prevalence of DM was 14.2% (95% confidence interval [CI]: 9.3% to 19.0%) in the fasting plasma glucose group, 6.8% (95% CI: 2.6% to 11%) in oral glucose tolerance group, and 12.5% (6.2%–18.9%) in glycated hemoglobin group. Meta-regression revealed 4.6 × 10−3 increase in prevalence per year. The prevalence of DM in Saudi Arabia is high. There is a rising trend in the prevalence of DM in KSA and it is accompanied by a proportionate increase in the burden of DM.

Background Studies on prevalence of epilepsy in Nigeria yielded figures ranging between 3.1 and 37 per 1000, giving one of the widest variations in prevalence of epilepsy world over. In order to accurately estimate clinical and public health impacts of epilepsy in Nigeria, robust and reliable epidemiological data are required for an appropriate estimation of logistical, economical, and social impacts of epilepsy. Objective The objectives of the study were to determine, using meta-analysis, the prevalence of epilepsy by pooling data from community-based door-to-door surveys conducted in various parts of Nigeria, explore the existing variation in prevalence of epilepsy in Nigeria along geopolitical regions and settlement setting of the country, and then evaluate the burden of epilepsy in Nigeria. Methods Prevalence estimates were derived from a random effects meta-analysis of observational studies reporting the prevalence of epilepsy in Nigeria. The derived estimate for the prevalence of epilepsy was applied to the total populations in Nigeria to give an estimated burden of epilepsy in Nigeria. Result Nine community-based door-to-door surveys, with quality data from different regions in Nigeria, were included. I-squared (I2) heterogeneity was 88.5%. Random effects model (REM) estimate of overall prevalence of epilepsy from the studies was 8 per 1000 (95% confidence interval (95% CI): 6–10). The prevalence was highest (11 per 1000) in the south western part of the country. It was also higher among the rural (15 per 1000 people) than the urban (6 per 1000) dwellers. The burden of epilepsy in Nigeria, based on the prevalence estimate was 1,280,000 persons (95% CI: 960,000–1,600,000 persons). Conclusion In Nigeria, the estimated prevalence of epilepsy is 8 per 1000 people indicating a substantial burden of the disease in the country.

Ibrahim D Gezawa,1 Andrew E Uloko,1 Baffa A Gwaram,1 Daiyabu A Ibrahim,1 Ejiofor T Ugwu,2 Idris Y Mohammed3 1Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria; 2Department of Medicine, Enugu State University of Science and Technology, Enugu, Enugu State, Nigeria; 3Department of Chemical Pathology, Aminu Kano Teaching Hospital, Kano, NigeriaCorrespondence: Ibrahim D GezawaDepartment of Medicine, Aminu Kano Teaching Hospital, Kano, Kano State 700001, NigeriaTel +234 803 22150 92Email gezawa01@yahoo.comPurpose: Type 2 diabetes poses a major global health threat both in the developed and developing countries. Factors responsible for the soaring epidemic of T2DM in the developing countries include urbanization, ageing population, physical inactivity and increasing obesity rates. Our aim was to determine the pattern of obesity among patients with T2DM at the Aminu Kano Teaching Hospital (AKTH), Kano, Northwestern Nigeria.Patients and methods: We consecutively recruited 220 patients with type 2 diabetes attending the diabetes clinic of AKTH for the study. Patients with Type 1 diabetes, patients who could not stand or are wheelchair bound and pregnant women were excluded from the study. A pretested questionnaire was used to collect data on socio-demographic characteristics, treatment history for diabetes and history of hypertension from each participant.Results: Of the 220 patients recruited for this study, 97(44.1%) were men, while 123(55.9%) were women. The prevalence of generalized obesity among the study participants was 27.4% (women −30.9% vs men- 22.7%, X2=4.76, p=0.190). Grades I. II and III obesity were found in 17.3%, 5.9% and 3.2% of the study participants, respectively. All the participants with grade III obesity were women. Central obesity defined by WC was detected in 111(50.5%) [20(20.6%) men and 91(73.9%) women, X2=1.93, p=0.001]. Obesity defined by WHR was recorded in 182(82.7%) participants [80(43.9%) men and 102(56.0%) women, X2= 1.97, 0.001]. Using a cut-off of ≥0.5, abnormal WhtR was detected in 179(81.4%) [72(40.2%) men and 107(59.8%) women, X2= 5.82, p=0.01], while using a cut-off of ≥0.6, abnormal WhtR was detected in 84(38.2%) participants [29 (34.5%) men and 55(65.5%) women, X2=6.38, p=0.09]. Hypertension was detected in 103(46.8%) participants, with a higher prevalence among women compared with men [46.3. % vs 47.4%, X2= 1.03 p=0.87].Conclusion: The prevalence of obesity in our cohort of patients with type 2 diabetes was high. The predominant form of obesity was central obesity, which was most prevalent when indexed by WHR. The WhtR was as good as the WHR, but fared better than WC in detecting central obesity in our patients.Keywords: type 2 diabetes, obesity, central obesity, prevalence, Nigerians

Objective To evaluate the prevalence, highlight the variation and determine the trend over time, of epilepsy treatment gap (ETG) in Sub-Saharan Africa (SSA). Methods We systematically searched PubMed, MEDLINE, Embase, ISI databases, and African Journal Online (AJOL). We determined the pooled prevalence estimate of ETG and the degree of heterogeneity in the region. Further subgroup analysis by sub-region, settlement setting, and cutoff adopted for active epilepsy in the studies was carried out. Meta-regression technique was also used to determine the trend of the ETG magnitude over time. Results Twenty-three studies from SSA met the inclusion criteria. We found a high level of discordance among the studies that were included. Collectively, the estimated ETG was 68.5% (95% CI: 59.5%-77.5%). On subgroup analysis, the prevalence of the ETG was 67% (95% CI: 52%, 83%) in the Western, 68% (95% CI: 56%, 80%) in the Eastern, and 63% (95% CI: 53%, 73%) in the Southern Africa sub-regions. On stratified analysis based on 1-year, 5-year, and 2-year cutoffs for definition of active epilepsy, the prevalence figures for the ETG were 71% (95% CI: 56%, 85%), 55% (95% CI: 33%, 77%), and 57% (95% CI: 43%, 71%), respectively. Meta-regression result suggested that the prevalence of the ETG decreases by approximately by 0.006 per year. Conclusion The study showed a high prevalence of ETG, higher than the average for resource poor countries, and twice in rural compared with urban settlements in SSA.

Introduction : type 2 diabetes poses a major global health threat both in the developed and developing countries. Factors responsible for the soaring epidemic of T2DM in the developing countries include urbanization, ageing population, physical inactivity and increasing obesity rates. Our aim was to determine the prevalence and pattern of obesity among type 2 diabetics at the Aminu Kano Teaching Hospital (AKTH), Kano, North-western Nigeria. Methods : a total of 220 patients with type 2 diabetes attending the diabetes clinic of AKTH, were consecutively recruited for the study. Type 1 diabetics, patients who are unwell, cannot stand or are wheelchair bound, pregnant women as well as non-consenting patients were excluded from the study. We used a pretested questionnaire to collect data on socio-demographic characteristics, treatment history for diabetes and history of hypertension from each participant. Results : out of the 220 patients recruited for this study, 97(44.1%) were males, while 123(55.9%) were females. The prevalence of generalized obesity among the study subjects was 27.3% and was more prevalent among females than males (30.8% vs. 22.7%, X 2 = 4.76, p = 0.190). Central obesity defined by WC was detected in 111(50.5%) subjects [20(20.6%) males and 91(73.9%) females, X 2 = 1.93, p = 0.001]. On the other hand, central obesity defined by WHR was recorded in 182(82.7%) subjects [80(36.4%) males and 102(46.34%) females, X 2 = 1.97, 0.001]. Abnormal WhtR was detected in 179(81.4%) subjects [72(74.2%) males and 107(86.9%) females, X 2 = 5.82, p = 0.01]. Hypertension was detected in 103(46.8%) subjects, with a higher prevalence among females compared with males [46.3.5% vs. 47.4%, X 2 = 1.03 p = 0.87]. Conclusion : the prevalence of obesity in our cohort of type 2 diabetics is high. The predominant form of obesity among our subjects was central obesity the prevalence of which was highest when indexed by WHR. Both generalized and central obesity in our study were more prevalent among females. A relatively high prevalence of hypertension was also found in this study. The detection and effective management of obesity among patients with type 2 diabetes will go a long way in reducing the excess cardiovascular risk and other complications associated with the disease.

Adherence to artemisinin-based combination therapy (ACT) is not clearly defined. This meta-analysis determines the prevalence and predictors of adherence to ACT. Twenty-five studies and six substudies met the inclusion criteria. The prevalence of ACT adherence in the public sector was significantly higher compared to retail sector (76% and 45%, resp., P

Foramen magnum tumors are rare in neurofibromatosis type 1. They may present with bizarre symptoms and may mimic many neurological conditions. We report a case of foramen magnum syndrome secondary to tumor misdiagnosed as cervical spine tuberculosis.