Nigerian Journal of Family Practice

Prevalence and factors associated with obesity among adults in the general outpatient clinic of Dalhatu Araf Specialist Hospital Lafia

C.T. Amanyam — 2023-11-07

Background: Obesity is a non-communicable disease-causing morbidity and mortality worldwide with at least 2.8 million adult deaths yearly. Many people ignorantly look at obesity as evidence of good living. For this, they do not consult physicians on how to reduce and maintain healthy weight. They subsequently develop obesity-related medical conditions like diabetes mellitus, cardiovascular diseases, and pathological fractures. This study aimed at determining the prevalence and factors for obesity among adults.

Methods: This was a cross-sectional study in the GOPC of Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria. A semi- structured interviewer administered questionnaire was used to recruit 125 adults using systematic random sampling technique. Their weight in kilograms and height in meters were measured using standard techniques and were used to calculate their BMI. SPSS version 2020 was used for data analysis.

Results: The mean age of the participants was 42.6±15.3 years and there were more females (64%) than males (36%). The prevalence of obesity was 17.6% (Females 14.4% and 3.2% in males). Class I obesity was the commonest type. Eight participants (6.4%) were underweight (BMI below 18.5 kg/m² ). Majority (55.2%) had normal weight (BMI 18.5 – 24.9 kg/m² ). The risk factors for obesity were hypertension (p=0.0097), fatty food (p=0.0009) and red meat (0.0001). Family history of obesity (p=0.0148) was an independent risk factor following logistic regression.

Conclusion: The 17.6% prevalence of obesity in this study was higher but close to the Nigerian national prevalence of 14.3% as at the year 2020. There is growing prevalence of obesity among adults with associated risk factors like eating fatty food, preference of red meat to fish, personal history of hypertension and family history of obesity. There is the need to regularly screen and counsel adult patients to reduce the growing burden of obesity.

Pregnancy outcomes among women with pre-eclampsia attending Tertiary Antenatal Clinic in South-East Nigeria: A 3-year review

S.I. Ezemenahi — 2023-11-07

Background: Hypertensive disorders in pregnancy are associated with high fetomaternal morbidity and mortality. Globally, about 5-10% of women experience hypertensive disorders during pregnancy, hence adequate understanding of this disorders can contribute greatly to its prevention, control and management in order to achieve optimal care of the patients at risk. This study sought to assess the pregnancy outcomes in women with preeclampsia who attended the antenatal clinic of Chukwuemeka Odumegwu Ojukwu University Teaching Hospital Amaku Awka (COOUTH), in Anambra State, South-Eastern, Nigeria.

Materials and Methods: This was a retrospective descriptive study from data that were obtained from health records of women with pre-eclampsia , who attended antenatal care in the facility from January 1^st , 2016, to December 31^st 2018. Data was analyzed using statistical package for Social Sciences (SPSS) version 25.0. The level of significance for this study was set at P< 0.05 for all analyses.

Results: Out of the 143 women with pre-eclampsia seen within the study period 3(4.6%) didn't deliver at the index hospital. Their mean age was 31.14 ± 5.12years. There was no maternal mortality recorded in this study. Majority (87.1%) had a Caesarean delivery; mean birth weight of the babies was 2.71 ± 0.92kg and mean APGAR score at 1and 5minutes were 7.67 ± 1.08 & 9.64 ± 0.77 respectively.

Conclusion: The optimal utilization of antenatal care services reduced the risk of maternal mortality, although operative deliveries was high probably to reduce complications to the fetus as well as the mother. Hence high quality ANC should be provided for pregnant women and they should be encouraged to comply with the recommendations during ANC.

Teaching aids and skills acquisition materials in family medicine training in the Democratic Republic of Congo

K.S. Kalala — 2023-11-07

Background: Family Medicine (FM) is a new discipline in the Democratic Republic of the Congo (DRC). The use of teaching aids and skills
acquisition materials in family medicine training has provided a better learning experience for trainers and trainees. However, some training centres, trainers and trainees fall short of these.

Aim: The study sought to determine the awareness, availability and use of teaching aids and skills acquisition materials in family medicine training centres in DRC.

Methods: We conducted a descriptive, cross-sectional study among 25 Family Doctors (FD) made up of six trainers and 19 trainees in the four hospitals accredited for residency training in family medicine by the Protestant University of Congo. An electronic questionnaire was used to obtain information from participants on sociodemographic characteristics, awareness, availability and use of teaching aids and skills acquisition materials. Data were analysed using epi info 3.5.4. Descriptive statistics were used to summarise data.

Results: Atotal of 25 respondents consisting of 6 trainers and 19 trainees took part in the study. The mean age of respondents was 39±7 years with majority (44.0%) working in mission hospitals and residing in urban settings (72.0%). Most of the trainers (66.7%) had less than 5 years of training experience. There was a generally high level of awareness among respondents on areas where modern teaching aids can be deployed to enhance Family Medicine training. Both trainers and trainees in all the family medicine training centres in the DRC were willing to use modern teaching aids in their training but were however limited by cost. They were however, satisfied with the use of the available teaching aids.

Conclusion: Most family medicine trainers and trainees were aware of and supported the use of teaching aids/skills acquisition materials but were constrained by the cost of acquiring them.

Factors influencing the development and determination of homosexuality with acceptance of one's sexual orientation, among homosexuals, bisexuals and transgender people in the City of Kinshasa in the Democratic Republic of Congo

K.M. Kapitene — 2023-11-07

Background: In the Democratic Republic of Congo, the expansion of homosexuality is probably boosted by several factors that must influence the development and determination of homosexuality with acceptance of one's sexual orientation, especially among adolescents. The aim of this study was to describe among homosexuals, bisexuals and transgenders in the city of Kinshasa, the factors which influenced the development and determination of their homosexuality, and which lead them to accept their sexual orientation.

Methods: This was a cross-sectional and analytical study conducted from February 1, 2021, to March 30, 2022, in the homosexual, bisexual and transgender population of Kinshasa. The selection was made in homosexual associations and the snowball method was used to constitute the sample. The statistical significance level was P< 0.005.

Results: The study involved 555 participants. Most respondents had discovered their sexual orientation while growing up next to a homosexual (60.5%), the relationship between the parents of the respondents was made up of life as a couple with disharmony or a life of divorce (74, 9%). Most of them had discovered their sexual orientation between the ages of 10 and 17, and in situations of alcoholism (64.5%). The natives of Kinshasa are distinguished from their counterparts in the interior of the country, by the relational problems between their parents and the level of alcohol and tobacco intoxication.

Conclusion: Growing up next to a homosexual, bisexual or transgender person mostly allows the discovery of sexual orientation. A relationship made up of life as a couple with disharmony or a life of divorce between the parents, has a great influence on the development and determination of homosexuality in children. The age group of 10 to 17 years is that of the discovery of homosexual orientation (first homosexual act), mostly in situations of alcoholism.

Body Mass Index and demographic profile of elderly out-patients with knee osteoarthritis at a Teaching Hospital, Southwest Nigeria

O.A. Ogungbemi — 2023-11-07

Introduction: Osteoarthritis is a common chronic disorder involving joints, the commonest joint being the knee joint. OAis related to age and associated with both modifiable and non-modifiable risk factors, including obesity, occupational injury, trauma and gender among others. Age and female gender are constant non modifiable risk factors while obesity is a common modifiable risk factor.

Aim: This study was done to describe age, gender, body mass index (BMI) profile in elderlies with knee osteoarthritis patients attending Geriatrics and Orthopedics clinic, UNIOSUN Teaching Hospital (UTH), Osogbo, Southwest Nigeria.

Methods: This was a hospital-based cross-sectional descriptive study carried out between April 2019 to June 2019 in both Geriatric and Orthopedic clinics of UTH, Osogbo. The target population for this research were the elderlies aged 60 years and above with knee OA. Sample size of 135 was arrived at using 19.6% prevalence of depression in elderly with knee OAand correcting for population size less than 10,000, Asystematic random sampling technique was used at both clinics to recruit participants for this study based on the sample frame from each clinic.

Results: All one hundred and thirty-five participants of this study had knee OA. The age range of participants was between 60-79 years. Mean age was 68.55+/-4.69. Male to female ratio (M: F) was 1:1.54. Majority were obese (49.6%) compared to those overweight (35.6%) and those that had normal weight (14.8%). More females were overweight and obese than males.

Conclusion:This study revealed that majority of elderlies with knee OAosteoarthritis were females and obese.

Knowledge and risk perception of the complications of maternal obesity among pregnant women attending the Antenatal Clinic at a Tertiary Hospital, Kaduna State

M.J. Ibrahim — 2023-11-07

Background: Obesity is a worldwide epidemic with major health and economic consequences. Pregnancy is a trigger point for the
development of obesity, and maternal obesity is associated with short- and long-term adverse effects in the mother and child. Many African countries, including Nigeria are experiencing a double burden of under- and over-nutrition with rising levels of obesity particularly in women.

Objectives: The study aims to determine the knowledge and risk perception of the complications of maternal obesity during pregnancy among women attending antenatal clinic at Ahmadu Bello University Teaching Hospital (ABUTH), Shika, Zaria.

Methodology: Across-sectional descriptive study was conducted among 154 pregnant women attending antenatal clinic in ABUTH, Shika. Respondents were selected via a multi-stage sampling technique. Data was collected with an interviewer-administered questionnaire. Analysis was done with IBM SPSS Statistics version 20 and results were presented in frequency tables. Appropriate tests of association were done, and the level of statistical significance was set at 0.05.

Results: The mean age of respondents was 28.5 ± 3.66 years. Of the 154 respondents, 69.5% and 51.9% were aware that excess weight could adversely affect mother and baby respectively causing complications such as hypertension (58.4%), gestational diabetes (52.6%). Only 13% of the respondents had a good knowledge score. Majority (83.8%) had positive perception of excess weight gain in pregnancy. There was a statistically significant relationship between knowledge score and perception of complications of maternal obesity (p =0.001).

Conclusion: Half of the respondents (51.9%) had a fair level of knowledge regarding the consequences of obesity on maternal health. Due to the low proportion with good knowledge, generation of awareness on consequences of obesity on reproductive health is required to bring about behavioural change regarding obesity prevention among women in this setting.

Simple fracture of the tibia and fibula following a road traffic accident in a child street hawker

E.O. Uwaka — 2023-11-07

Background: Street hawking remains one of the major health challenges in Nigeria. The involvement of children in street hawking, as was seen in this case study, constitutes child labour and is a form of child abuse. The major reason given by all hawkers engaging in the trade was the 3 need to contribute to the family income. Motor vehicular accident, topped the list of problems faced by street hawkers in Nigeria. Astudy done in South-eastern Nigeria showed that 70% of road traffic accidents victims were pedestrians who were either crossing the major roads unguarded or were hawking along the road.

Methods: This is a case report of an 11-year-old boy who was knocked down by a motorbike while hawking on the street. He presented to the accident and emergency unit of the hospital within 30 minutes of the accident with pains and swelling of the right leg. The patient had difficulty walking with the injured leg and had to be carried to the hospital.

Results: On examination the patient was found to be anxious and in painful distress. He was not pale, anicteric and not dehydrated. He was afebrile to touch with a temperature of 36.8^o C. He did not have peripheral lymphadenopathy or pedal oedema. There was a swelling at the middle third of the right leg with some deformity. There was no differential warmth on palpation, but he had marked tenderness and crepitus around the swelling. There were also bruises on both knees and elbows.

Conclusion: Prevention of fracture complication will include reporting early to hospital which is important because infection of an open fracture could lead to osteomyelitis, which is a dreaded complication that could be extremely difficult to treat requiring long-term antibiotics and debridement of the bone to achieve control. Prevention of street hawking especially in children involves proper education of parents against undue exposure of their children to risks is one of the ways to reduce this fracture.