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Background: Type 2 diabetes mellitus (T2DM) is a disease of public health importance globally with an increasing burden of undiagnosed pre-diabetes and diabetes in low- and middle-income countries, Nigeria in particular. Pre-diabetes and diabetes are established risk factors for cardiovascular complications. However, data are scanty on the current prevalence of these conditions in Nigeria, based on haemoglobin A1c (HbA1c) diagnosis as recommended by the WHO in 2009. We aimed to determine the prevalence of pre-diabetes, diabetes, and undiagnosed diabetes among the adult population of Nigeria using HbA1c., Methodology: A cross-sectional, multi-site population study was carried out in selected states in Nigeria (namely, Ekiti, Lagos, Osun, Oyo, and Kwara states) involving 2,708 adults (≥18 years) in rural and urban community dwellers, without prior diagnosis of pre-diabetes or diabetes. Participants with ongoing acute or debilitating illnesses were excluded. Data were collected using an interviewer-administered pretested, semi-structured questionnaire. Socio-demographic, clinical (weight, height, blood pressure, etc.), and laboratory characteristics of participants including HbA1c were obtained. Data were analysed using STATA version 16., Results: The mean age of participants was 48.1 ± 15.8 years, and 65.5% were female. The overall prevalence of pre-diabetes and undiagnosed diabetes was 40.5% and 10.7%, respectively, while the prevalence of high blood pressure was 36.7%. The prevalence of pre-diabetes was the highest in Lagos (48.1%) and the lowest in Ekiti (36.7%), while the prevalence of diabetes was the highest in Kwara (14.2%) and the lowest in Ekiti (10%). There was a significant association between age of the participants (p< 0.001), gender (p = 0.009), educational status (p = 0.008), occupation (p< 0.001), tribe (p = 0.004), marital status (p< 0.001), blood pressure (p< 0.001), and their diabetic or pre-diabetic status. Independent predictors of diabetes and pre-diabetes include excess weight gain, sedentary living, and ageing. Participants within the age group 45-54 years had the highest total prevalence (26.6%) of pre-diabetes and diabetes., Conclusion: Over half of the respondents had pre-diabetes and diabetes, with a high prevalence of undiagnosed diabetes. A nationwide screening campaign will promote early detection of pre-diabetes and undiagnosed diabetes among adult Nigerians. Health education campaigns could be an effective tool in community settings to improve knowledge of the risk factors for diabetes to reduce the prevalence of dysglycaemia., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ajayi, Balogun, Olopade, Ajani, Soyoye, Bolarinwa, Olamoyegun, Alatishe-Muhammad, Odeniyi, Odukoya, Fasanmade, Diyaolu, Otrofanowei, Akase, Agabi, Adejimi, Ajetunmobi, Durowade, Gabriel-Alayode, Ibrahim, Ezekpo, Elegbede, Lamidi, Owolabi, Yusuf, Adetunji, Ogunmodede, Ameen, Biliaminu and Nasiru.)

Introduction: Thyrotoxicosis is one of the most common endocrine disorders seen in clinical practice. This study aims to determine the etiologies and treatment modalities of thyrotoxicosis in Africa., Areas Covered: The study design is a systematic review with a meta-analysis. Medical databases and the gray literature were systematically searched following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies done in Africa on the etiology and treatment of thyrotoxicosis were selected., Expert Opinion: In Africa, it is still believed that autoimmune diseases, generally, are not as common as what is seen in the western world. The frequency of Graves' disease is reportedly lower in Africa. The treatment of thyrotoxicosis depends on the cause. Therefore, it is of substantial importance to establish the etiology following the diagnosis of the clinical syndrome.

Background: Chronic kidney disease (CKD) has become an epidemic with many recognised risk factors. However, the role of pre-hypertension in CKD is yet to be fully studied in our environment., Objectives: We set out to determine the magnitude of pre-hypertension and traditional CKD risk factors. We also determined their relationships to proteinuria., Subjects and Methods: This was a descriptive, cross-sectional study conducted in two urban local government areas (Akure South and Ondo West) in Ondo State, Southwest Nigeria in March 2014. A total of 1,183 adults (M:F, 0.63:1) were studied. Their bio-data, history of cigarette smoking, alcohol intake, herbal usage, non-steroidal anti-inflammatory drugs (NSAIDs), diabetes and hypertension were obtained. A total of 1,183 adults (M:F, 0.63:1) blood pressure (BP) and anthropometry were determined. Urinalysis was conducted using Combi-Uriscreen® 10SL. Data were analysed using the Statistical Package for the Social Sciences version 20.0., Results: A total of 1183 adults (M:F, 1:1.6) were studied with a mean age of 44.7 ± 17.4 years. Their mean systolic BP, diastolic BP and body mass index were 129.6 ± 23.7 mmHg, 79.8 ± 14 mmHg and 26.2 ± 5.8 kg/m2, respectively. Pre-hypertension was present in 32.3% of the subjects, while hypertension was present in 43.4% of the subjects; 6.2% gave history of diabetes, 4.5% smoked cigarette, 68.3% used herbs and 44.1% used NSAIDs. Proteinuria was present in 25.9% of the subjects, while haematuria was present in 1.7% of the subjects. BP and age showed significant association to proteinuria., Conclusion: Pre-hypertension and known risk factors of CKD are prevalent in the people of Ondo State, Nigeria. Individuals with persistent pre-hypertension should be routinely screened for CKD and referred to the Nephrologist for early intervention.