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Background: The contribution of obesity to obstructive sleep apnea (OSA) is poorly described in Nigeria. We aimed to compare OSA risk between obese and nonobese adults in urban Nigeria., Materials and Methods: An analytic cross-sectional study was conducted. Participants were interviewed using the World Health Organization Non-Communicable Disease questionnaire. OSA risk assessment was performed using the STOP-BANG questionnaire. A total score of ≥3 on the STOP-BANG questionnaire indicated OSA risk, whereas a score ≥5 indicated high OSA risk. Obesity was defined as body mass index (BMI) >30 kg/m 2 . Relationship between obesity and OSA was tested using chi-square and logistic regression models used to control for confounding factors., Results: There were 744 respondents, with a mean age of 44 (standard deviation 10) years. A total of 206 [27.7%, 95% confidence interval (CI) 24.46-30.9] respondents were obese (BMI ≥30 kg/m 2 ). A total of 307 (41.3%, 95% CI 37.7-44.9) respondents scored ≥3 on the STOP-BANG questionnaire, whereas 37 (4.9%, 95% CI 3.6-6.7) scored ≥5. More number of obese than nonobese [57.8% (119/206) versus 34.9% (188/538)] respondents met the criteria for OSA risk ( P < 0.001). Similarly, more obese persons [10.3% (21/206)] met the criteria for high-risk OSA compared to the nonobese [3% (16/538)]; P < 0.001. In logistic regression models adjusted for cigarette smoking and alcohol consumption, the odds for OSA risk was 15.76 (95% CI 7.44-33.9) in persons with BMI >35 kg/m 2 compared to those with a BMI range of 18.5-24.99., Conclusion: Obesity and OSA may be more prevalent in Nigeria than previously predicted. Obesity independently increased OSA risk in this population., Competing Interests: Conflicts of interest There are no conflicts of interest.

Objective: To determine the prevalence and risk factors for chronic obstructive pulmonary disease (COPD) among HIV-infected adults in Nigeria., Design: Cross-sectional study., Methods: HIV-infected adults aged ≥ 30 years with no acute ailments accessing care at the antiretroviral therapy clinic of Jos University Teaching Hospital were enrolled consecutively. Participants were interviewed to obtain pertinent demographic and clinical information, including exposure to risk factors for COPD. Post-bronchodilator spirometry was carried out. HIV related information was retrieved from the clinic medical records. COPD case-definition was based on the Global Initiative for Obstructive Lung Disease (GOLD) criteria using post-bronchodilator FEV 1 /FVC <0.7. COPD prevalence was also calculated using the lower limit of normal for FEV 1 /FVC criteria (LLN) from the European Respiratory Society normative equation. Factors associated with COPD were determined using logistic regression models., Results: Study population comprised 356 HIV infected adults with mean age of 44.5 (standard deviation, 7.1) years and 59% were female. The mean time elapsed since HIV diagnosis was 7.0 (SD, 2.6) years and 97.5% of the respondents were on stable ART with virologic suppression present in 67.2%. Prevalence of COPD were 15.4% (95% confidence interval [CI] 11.7-19.2), 12.07% (95% CI 8.67-15.48), 22.19% (95% CI 18.16-26.83) using GOLD, ERS LLN and GLI LLN diagnostic criteria respectively. In multivariate analyses adjusting for gender, exposure to cigarette smoke or biomass, history of pulmonary tuberculosis, use of antiretroviral therapy, current CD4 T-cell count and HIV RNA, only age > 50 years was independently associated with COPD with OR 3.4; 95% CI 1.42-8.17 when compared to ages 30-40 years., Conclusion: HIV-associated COPD is common in our population of HIV patients.

Background: The Electronic Health Record (EHR) is a key component of medical informatics that is increasingly being utilized in industrialized nations to improve healthcare. There is limited information on the use of EHR in sub-Saharan Africa. This paper reviews availability of EHRs in sub-Saharan Africa., Methods: Searches were performed on PubMed and Google Scholar databases using the terms 'Electronic Health Records OR Electronic Medical Records OR e-Health and Africa'. References from identified publications were reviewed. Inclusion criterion was documented use of EHR in Africa., Results: The search yielded 147 publications of which 21papers from 15 sub-Saharan African countries documented the use of EHR in Africa and were reviewed. About 91% reported use of Open Source healthcare software, with OpenMRS being the most widely used. Most reports were from HIV related health centers. Barriers to adoption of EHRs include high cost of procurement and maintenance, poor network infrastructure and lack of comfort among health workers with electronic medical records., Conclusion: There has been an increase in the use of EHRs in sub-Saharan Africa, largely driven by utilization by HIV treatment programs. Penetration is still however very low.

Background: The industrial process of detergent production could be deleterious to lung function. This study describes respiratory symptoms and ventilatory function impairment among detergent workers in Jos, Northern Nigeria., Methods: Two hundred detergent plant workers and controls were studied for the presence of respiratory symptoms and ventilatory function impairment using the MRC questionnaire and Spirometry., Results: A significantly higher proportion of exposed detergent workers 178 (87.0%) reported respiratory symptoms compared to 52 (26.0%) controls [OR=23; 95% CI=12.9-41.3] (P<0.001). Commonest symptoms include rhinitis (57.5% versus 11.0%) and cough (48.5% versus 15%). Symptoms were most prevalent in the packaging section. FEV1, FVC and PEFR were significantly reduced among exposed detergent workers. Similarly, the predicted values of PEFR, FVC and FEV1, were significantly reduced among smokers (P<0. 001)., Conclusion: Respiratory symptoms are highly prevalent among detergent workers. This was associated with impaired pulmonary function. Protective equipment and periodic lung function tests could reduce these effects.

Background: The clinical characteristics and consequences of HIV-I infection observed in studies from developed countries cannot be generalized across the multiple virus subtypes that circulate in sub-Saharan Africa in general and Nigeria in particular. This study was therefore conducted to determine the commonest symptoms and signs at presentation in HIV-infected individuals at the Jos University Teaching Hospital., Method: This descriptive study was conducted at the antiretroviral clinic of the Jos University Teaching Hospital, Jos, between May and October 2004. Two hundred (200) newly diagnosed and laboratory confirmed adult cases of HIV infection without prior antiretroviral drug use were recruited after obtaining informed consent. Each qualified patient had a comprehensive history taken with emphasis on the clinical symptoms and detailed physical examination performed by the researchers. The data collected were analyzed using a multipurpose computer programme, Epi-info 2000 version 1.1.3 (Atlanta GA, USA)., Results: There were 86 (43.0%) males and 114 (57.0%) females whose mean ages were 39.0 +/- 7.8 and 32.0 +/- 8.1 years, respectively. The major symptoms in the study population were: weight loss (65.5%), fever (41.5%), chronic cough (38.5%), diarrhea (32.0%), pruritus (13.0%) and body rash (12.5%). The major signs were pallor (25.0%), oral thrush (20.5%), wasting (20.0%), lymphadenopathy (18.0%), dermatitis (16.0%), hyperpigmented nails (13.5%) and finger clubbing (8.5%)., Conclusion: The symptoms and signs of HIV/AIDS obtained were similar to those obtained by other workers from different parts of the world; however, the findings of hyperpigmented nails and finger clubbing have not been frequently reported for other populations.

Objective: A clinico-pathological study of cancer of the larynx in Jos from 1983 to 1995., Setting: Jos University Teaching University., Subjects: 38 patients., Results: 38 (100%) patients were seen. Thirty four (89.5%) were Black African males. Mean age was 47.7 years. Twenty nine (76.3%) smoked cigarettes and drank alcohol. Hoarseness (100%) was the commonest symptom. Mean duration of symptoms was 13.5% months. Transglottic (42.1%) was the commonest site and squamous cell carcinoma (97.4%) was the predominant histologic type., Conclusion: There was a male preponderance. The mean age was lower than in other series. Patients often presented late. Squamous cell carcinoma was the commonest cell type.

A study of determine the seroprevalence rate and clinical presentation of HIV-associated pulmonary tuberculosis was carried out in Jos between October 1990 and September 1991. Out of the 180 newly diagnosed pulmonary tuberculosis patients, 11(6.1%) were confirmed seropositive for HIV-1 and 2. The peak age range for both tuberculosis and HIV infection in both sexes is 20-40 years. The risk of HIV infection was associated with multiple sex partners and blood transfusion. There was no significant difference in the clinical presentation of pulmonary tuberculosis between HIV-seropositive and seronegative patients (P > 0.1). However, diarrhoea, lymphadenopathy and marked weight loss were found to be significantly associated with HIV infection (P < 0.05). The mean lymphocyte count of HIV seropositives was significantly lower than seronegatives (P < 0.01).

A 33-year-old Nigeria male developed fever, malaise, headache, muscle weakness and polyneurutis 24 hours after administration of tetanus toxoid. These manifestations however cleared within 72 hours. No other identifiable agents or predisposing factors were identified to explain this phenomenon.

A case of giant lymph node hyperplasia (Castleman's disease) of the lung presented with pleural effusion (which was recurrent), an unusual complication. The patient was treated with pneumonectomy and has survived for three years without relapse. This is the first report of the disease from black Africa.

Hypertension is a major cause of morbidity and mortality in US black populations. There are however limited data available on college educated blacks in either the United States or Africa. The purpose of the present study was to examine blood pressure and its correlates in a Nigerian college population in comparison with US data. The study population comprised 211 Nigerian male college students (mean age, 20.9 years). The means and standard deviations for systolic and diastolic blood pressures among the Nigerians were 119.9 (12.6) and 73.3 (10.0) mm Hg, respectively. Weight, height, and body mass index means for the Nigerians were 133.6 pounds, 68.5 inches, and 20.1 kg/m2, respectively. Compared with US college-educated blacks, the Nigerians had higher systolic blood pressures but were leaner than their US counterparts. There was however a significant positive correlation between weight and systolic blood pressure for the Nigerians, which was similar to that observed among US college students. These data suggest that in a lean population, the Nigerian males' weight is still an important correlate of blood pressure as is seen in the US.

Major haemoptysis is a very uncommon presentation of sarcoidosis inspite of the high rate and extent of pulmonary involvement in this disease. We report a 37-year-old Nigerian who presented with cough and weight loss and in whom haemoptysis was prominent. In developing tropical countries this mode of presentation is almost invariably due to pulmonary tuberculosis. In this case the haemoptysis was found to be due to ulcerations of nasopharyngeal granulomata due to sarcoidosis. Involvement of the upper respiratory tract in itself is an uncommon finding in sarcoidosis.

This study describes 6 years' experience of flexible fibre optic bronchoscopy (FFB) at the University College Hospital, Ibadan. Ninety-three bronchoscopies were carried out in 83 patients. The study revealed 22 patients with primary lung malignancies, four with tuberculosis, three with secondary malignancies, three with sarcoidosis, and two with interstitial fibrosis. The yield from FFB was 44% and complications were encountered in only three patients, with no mortality.

The problems of caring for diabetic patients in the developing world have been getting increasing attention recently. While the focus has often been on peculiar clinical characteristics such as pancreatic diabetes, malnutrition diabetes, J-type and other similar forms, there is a need to explore further the impact of the prevailing social, cultural and economic milieu on the patients and the management of their disease. The socio-economic status of 147 Nigerian diabetic patients was assessed by the use of an interview format and also their knowledge, attitudes, beliefs, expectations and concerns about diabetes was determined. The study confirmed that most of the patients are illiterate, poor and with very little understanding of the nature of their disease. Their greatest concern was the impact of diabetes on their ability to work and the extreme difficulty in getting their medications regularly and at affordable prices. A survey of twelve pharmacies revealed that many of the oral hypoglycemic agents, insulin, syringes, needles and materials for urine testing are not stocked by most of them. Some suggestions have been made as to possible solutions which will involve efforts on the parts of health care providers, patients, governments, pharmacies and private organizations in these countries and the international community as well, including the international drug companies. It is hoped that the problem will remain high on the agenda of all those concerned about diabetes and the care of diabetic patients throughout the world.