West Africa Journal of Medicine

Beyond the Shadows: Strengthening Nigeria's Health System in the Wake of Lassa Fever and Covid-19 Challenges

2024-06-07T06:49:02+00:00

BACKGROUND: The COVID-19 pandemic caused by the L a s s a Feve r i s a n a c u t e v i r a l haemorrhagic fever caused by the Lassa
virus belonging to the Arenaviridea family. First described in 1969 in a village called Lassa in Borno State, 1 Nigeria, the disease is found in other countries in West Africa, particularly Sierra Leone, Guinea, and Liberia.
Approximately 300,000–500,000 cases occur annually with > 5000 deaths and Severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2) led to an unprecedented disruption in global trade, economies and social systems and overwhelmed the health systems in developed and developing nations alike. In nations such as Nigeria, characterized by fragile healthcare infrastructure and inadequate preparedness levels within the health system, a notable consequence of the COVID-19 pandemic was the challenge
of maintaining healthcare services and mounting an efficient response to other prevalent infectious diseases with significant mortality rates, such as Lassa Fever.

Intrathoracic Transposition of a Pedicled Latissimus Dorsi Muscle Flap for Complicated Chronic Empyema Thoracis: A Plea for its Popularity in our Subregion

2024-06-05T21:35:35+00:00

INTRODUCTION: Empyema thoracis is a debilitating disease that
still constitutes a significant burden among thoracic surgical diseases
in our environment. It sometimes occurs secondary to ruptured lung
abscess with varying degrees of lung destruction and bronchopleural
fistula.

CASE REPORT: A 65-year-old woman presented to our unit with a
two-month history of cough which subsequently became productive
of purulent sputum and posture-dependent, and fever, with
progressive dyspnea on exertion. She was subsequently managed for
chronic right empyema thoracis secondary to a ruptured lung
abscess. We briefly describe the evaluation, indication and technique
for intrathoracic transposition of a pedicled latissimus dorsi muscle
flap for operative management of this index disease, and the very
good medium and long-term outcomes observed for this patient.

CONCLUSION: Where indicated and with meticulous preoperative
planning, transposition of a pedicled latissimus dorsi
muscle flap for complicated chronic empyema thoracis can prevent a
surgical albatross with a reduced hospital stay, cost of treatment and
excellent patient satisfaction at the meagre expense of about 30
minutes or less extra intra-operative time.
WAJM 2024; 41 (1): 82 - 86.

KEYWORDS: Lung abscess, pedicled latissimus dorsi, empyema
thoracis, outcomes.

Differential Clubbing and a Triad of Patent Ductus Arteriosus, Ventricular Septal Defect and Supravalvular Ring Mitral Stenosis: A Case Report

2024-06-05T21:47:26+00:00

It is not uncommon for congenital heart defects to occur in clusters.
Those involving a right to left heart shunt commonly cause cyanosis
and finger clubbing. Differential clubbing involving only the lower
limb digits is a strong pointer to the presence of patent ductus
arteriosus with reversal of shunt.
We report a case of 25-year-old man with effort intolerance and
differential clubbing. He was found to have the uncommon triad of
patent ductus arteriosus, ventricular septal defect and supravalvular
ring mitral stenosis.
The presence of differential clubbing on a background of patent
ductus arteriosus usually indicates a reversal of shunt and negates
surgical intervention. This general rule may however not apply with
co-existing mitral stenosis as the elevated pulmonary pressure may be
predominantly post capillary. The finding of mitral stenosis in a
patient with patent ductus arteriosus and differential limb clubbing
may signify a good prognostic surgical outcome.
WAJM 2024; 41 (1): 87 - 91.

KEYWORDS: differential clubbing, patent ductus arteriosus,
ventricular septal defect, supravalvular ring mitral stenosis.

Typhoid Fever Presenting with Ileal Perforation and Gastric Perforation

2024-06-07T05:40:40+00:00

Typhoid fever is caused by Salmonella typhi and Salmonella paratyphi.
It is a disease of developing countries and is seen among people of
low socio-economic status. Patients can develop complications like
typhoid intestinal perforation which is associated with higher
mortality.
A 15-year-old female presented to the emergency pediatric unit with
fever, abdominal pain and abdominal distension. She was septic, in
respiratory distress, and had marked generalized abdominal
tenderness with guarding. An assessment of generalized peritonitis
secondary to typhoid intestinal perforation was made. She had
exploratory laparotomy with intra-operative findings of ileal
perforation and gastric perforation. She had repair of the intestinal
and gastric perforations.
Our patient presented late with concurrent use of NSAIDs and
overwhelming sepsis which likely contributed to the gastric
perforation as this is not a usual finding in patients with typhoid
intestinal perforation.
Gastric perforation is an unusual finding in patients with typhoid
intestinal perforation. Typhoid fever and its complications can be
easily prevented by the provision of safe water, proper facilities for
sanitation, and practicing good hygiene. WAJM 2024; 41 (1): 92 - 96.

KEYWORDS: typhoid fever, intestinal perforation, gastric
perforation

Squamous Cell Carcinoma of the Supraglottis Presenting as Hoarseness

2024-06-07T05:47:59+00:00

BACKGROUND: Hoarseness is a well-known condition in primary
care offices, with over 1% of primary care visits secondary to this
1 ailment. The most common causes are
Most of these cases are secondary to viral infections and do not
require antibiotics on most occasions. These viral infections s
WAJM 2024; 41 (1): 97 - 99. acute laryngitis (40%),
functional dysphonia (30%), benign and malignant tumors (2.2 to
30%), neurogenic factors such as vocal cord paralysis (8%),
physiological aging (2%), and psychogenic factors (2.2%).
ubside after 1 to 2 weeks and in the case of persistent hoarseness (above 4
weeks), the American Academy of Otolaryngology recommends
direct visualization with a laryngoscopy before treatment with
proton pump inhibitors, antibiotics, or steroids.
Our patient presented with prolonged hoarseness (greater than eight
weeks) but had a quick turnaround time interval between primary
care visit and laryngoscopy evaluation (less than 2 weeks). This led to
her diagnosis and treatment with chemo and radiation therapy
within three months of diagnosis with Squamous Cell Carcinoma of
the Supraglottis.
The primary care physician serves as the number one point of
visitation by sufferers of hoarseness. It is important that they are
knowledgeable and up to date with recommendations and guidelines
for managing this condition, as unwarranted delay can affect the
overall outcome on the part of the patient. This is especially
important in patients such as ours with high-risk factors including
Nicotine dependence, alcohol use, asbestos exposure, and HPV
infection.

KEYWORDS: Laryngoscopy, Supraglottis, Larynx, hoarseness

Unmet Need for Care of Older Persons in our Healthcare System

2024-06-03T20:56:29+00:00

First and Second Waves of Covid-19: A Comparative Study of the Clinical Presentation and Outcome among Hospitalized Patients in Lagos Nigeria

2024-06-03T21:25:11+00:00

OBJECTIVE: Nigeria experienced many waves of the COVID-19
pandemic. This study compared the clinical presentations and
mortality among hospitalized patients during the first and second
waves of the pandemic in Lagos State, Nigeria.

METHODS: A retrospective cohort study was conducted. Deidentified
medical records of laboratory-confirmed COVID-19
patients admitted into 15 isolation centers in Lagos, Nigeria between
February 27, 2020, and September 30, 2020 (first wave) and October
1, 2020, and April 30, 2021 (second wave) were reviewed. IBM
Statistics version 25 was used for data analysis

RESULTS: More patients were hospitalized during the first wave of
the pandemic. The mean age of patients was higher during the
second wave (54.5±15.8 years vs. 42.2±15.5 years, p <0.001). More
patients admitted during the second wave had comorbidities (56.0%
vs 28.6%, p <0.001), were symptomatic (90.8% vs 52.0%, p <0.001),
had severe COVID-19 disease (58.9% vs 25%, p <0.001) and died
(14.9% vs 6.4%, p<0.001) compared with the first wave. The odds of
death increased with age and severity of COVID-19 disease during
the first and second waves.

CONCLUSION: A higher proportion of the patients admitted in
Lagos, Nigeria during the second wave were older, had
comorbidities, and had severe COVID-19 disease than the first wave.
Despite the fewer hospitalized patients, there were more deaths
during the second wave.

Knowledge and Practice of the Referral System under the National Health Insurance Scheme among Medical and Dental Practitioners of A Large-Accredited Facility in Kano, Nigeria

2024-06-05T17:18:21+00:00

BACKGROUND: Studies on healthcare professionals' knowledge
about the National Health Insurance Scheme (NHIS) are scarce.
Therefore, we assessed the knowledge and practice of the NHIS referral
system among Medical and Dental practitioners in a tertiary hospital in
Northwest Nigeria.

METHODS: This cross-sectional study involved 242 medical and
dental practitioners randomly selected from nine departments for over 6-
weeks. A structured self-administered questionnaire was used to collect
data. Data were analyzed using descriptive and inferential statistics.

RESULTS: The respondents' mean age was 35.7±6.0 years; they were
predominantly males (64.9%). Their mean overall knowledge score was
58.9±23.0%, with 66.9% of respondents having inadequate overall
knowledge of the NHIS referral system. Practice department (Fishers
exact, P=0.0019), perceived knowledge of the referral system (ꭓ2 =8.169,
P=0.004), and having been referred as an enrolee (ꭓ2 = 6.358, P=0.012)
were associated with overall-knowledge. Obstetrics-and-Gynaecology
(odds ratio[OR]=0.29, 95% confident interval [CI] [0.88-0.98]), Dentaland-
Maxillofacial-Surgery (OR=0.08, 95%CI[0.01-0.98]), and
Otorhinolaryngology (OR=0.18, 95%CI[0.04-0.80]) respondents were
less likely to have adequate overall-knowledge. Although 56.2%, 50.4%,
20.7%, and 89.7% were enrolees, had received treatment as enrolees, had
been referred as enrolees and treated other enrolees, respectively, an
unimpressive proportion had sighted a referral letter (64.9%) or
authorization code on the letter (25.2%), referred an enrolee from their
department previously (51.2%) or used the NHIS referral form to write
referrals (38.8%).

CONCLUSION: The overall knowledge of the NHIS referral system
was inadequate. The practice of the referral system was below
expectation. Therefore, training medical and dental practitioners on the
NHIS referral system is necessary. Training should target those who are
least likely to have adequate overall knowledge.

KEYWORDS: Knowledge and Practice, Medical Practitioners,
National Health Insurance Scheme, Nigeria, Referral

Assessment of Right Ventricular Systolic Function using Tricuspid Annular Plane Systolic Excursion (TAPSE) among HIV Patients on HAART and Its Relationship with Viral Load and CD4 Cell Count

2024-06-05T17:24:56+00:00

BACKGROUND: The introduction of highly active antiretroviral
therapy (HAART) has decreased the morbidity and mortality associated
with HIV infection; however, this survival advantage is not free from
complications. HIV patients are more likely to develop cardiovascular
disease compared with the general population, and right ventricular
systolic dysfunction is said to be associated with worse outcomes. We
therefore sought to assess right ventricular systolic function using
tricuspid annular plain systolic excursion (TAPSE) among HIV patients
on HAART and its relationship with viral load and CD4 cell count.

METHODS: The study was a cross-sectional conducted among HIV
patients receiving HAART at the Federal Medical Centre, Nguru, Yobe
State, Northeastern Nigeria. Right ventricular systolic function was
assessed using tricuspid annular plane systolic excursion.

RESULTS: One hundred and seven (107) subjects were recruited into the
study comprising thirty-seven (34.6%) males and seventy (65.4%)
females. The mean CD4 cell count and viral load of the studied patients
were 612.65 ± 347.62 cells/μL and 315.44±271.11copies/mL,
respectively. The distribution of RVSF according to CD4 cell count
showed, fifteen (14.01%) patients with CD4 cell count less than 250 had
reduced right ventricular systolic function (RVSF), 30 (28.03%) patients
with CD4 cell count 250 – 500 had reduced RVSF, 1 (0.93%) patient with
CD4 cell count 250 – 500 had normal RVSF, 47 (43.92%) patients with
CD4 cell count 501 -1,000 had normal RVSF and 14(13.08%) patients
with CD4 cell count greater than 1,000 had normal RVSF. Fourteen
(13.08%) patients with undetectable viral load had normal RVSF,
47(43.92%) patients with viral load 50 – 1,500 had normal RVSF,
1(0.93%) patient with viral load 1,501 – 10,000 had normal RVSF,
30(28.03%) patients with viral load 1,501 – 10,000 had reduced RVSF and
15(14.01%) patients with viral load 10,000 – 50,000 had reduced RVSF.
There was a positive and significant correlation between tricuspid
annular plain systolic excursion with CD4 cell count and a negative but
significant correlation HIV viral load.

CONCLUSION: We therefore concluded that asymptomatic right
ventricular systolic dysfunction exists among patients with HIV infection
and there was positive and significant correlation between tricuspid
annular plain systolic excursion with CD4 cells count and a negative but
significant correlation HIV viral load.

KEY WORDS: Right ventricular systolic function, tricuspid annular
plane systolic excursion (TAPSE) CD4 cells, viral load.

Kidney Function in Hypertensive Patients with Left Ventricular Hypertrophy

2024-06-05T17:47:05+00:00

BACKGROUND: Impairment of kidney function is one of the
long-term sequelae of hypertension and it contributes to increased
morbidity and mortality in hypertensive patients. Left ventricular
hypertrophy (LVH) is a common complication of hypertension
which can worsen the outcome in affected patients. This study was
designed to compare kidney function in hypertensive patients with
LVH with that in hypertensive patients without LVH.

METHODS: The study was conducted among hypertensive patients
attending cardiology clinics at two tertiary hospitals in Nigeria. A
questionnaire was used to obtain demographic and clinical
information from the participants. Kidney function was determined
by measuring serum urea and creatinine, urinary creatinine and
microalbumin. Echocardiography was performed to detect LVH.
Results of kidney function tests were compared between participants
who had LVH and those who did not.

RESULTS: Of the 105 participants recruited, 58 (55.2%) were
males. The median age of all participants was 52 (interquartile range
(IQR) 40-61) years and LVH was confirmed in 48 (45.7%) of them.
Participants with LVH were older (55 vs 49 years; p=0.02) but had
lower weight (74 vs 78 kg; p=0.04). Participants without LVH had
higher microalbuminuria (5.2 vs 4.05 mg/dl; p=0.03), lower
2 estimated glomerular filtration rate (62 vs 92 ml/min/1.73 m ;
p=0.004), and higher stages of CKD.

CONCLUSION: Hypertensive patients with LVH had lower levels
of microalbuminuria, higher estimated GFR, and lower stages of
CKD compared to those with no LVH. WAJM 2024; 41 (1): 30 - 35.

KEYWORDS: Left ventricular hypertrophy, Hypertensive, Kidney
function, Chronic kidney disease

Exposure History, Post-Exposure Prophylaxis Use, and Clinical Characteristics of Human Rabies Cases: A Twelve-Year Retrospective Review at a Tertiary Facility in Ghana

2024-06-05T17:54:33+00:00

BACKGROUND: Robust monitoring and reporting systems for
rabies are lacking thus increasing the risk of under reporting.
Highlighting the rabies cases brings to bear the needed urgent
attention for more efforts at preventing and controlling the disease.

OBJECTIVE: To describe the epidemiological characteristics of
patients managed for clinical rabies at the largest referral facility in
Ghana.

METHODS: A retrospective single-center hospital-based chart
review and data extraction were conducted for persons managed for
clinical rabies infection at the Korle-Bu Teaching Hospital from
January 2008 to December 2019. Data analysis was done using
STATA. Descriptive statistics were used to summarize the
epidemiological and clinical characteristics. Fisher's exact test, the
Kruskal-Wallis test, and Spearman's correlation coefficient were
used to explore significant associations.

RESULTS: A total of 28 cases were recorded over the period of
review. All of them died and most (68%) of them were males.
Twenty-one percent of them were less than 15 years old. Their
median age interquartile range (IQR) was 31 years (25.5 years) and
the median incubation period for rabies (IQR) was 60 days (60 days).
The source of rabies for cases was mainly dog bites. The vaccination
status of all the animals could not be ascertained. Majority (80%) of
the patients took neither anti-rabies vaccine nor immunoglobulin as
post-exposure prophylaxis after the dog bite. The median time of
admission before death (interquartile range) was 2 days (2 days).
Majority (82%) of the cases were furious rabies.

CONCLUSION: Attention should be directed at mass vaccination
of dogs as dog bites are common. Ensuring availability and access to
post-exposure prophylaxis (PEP) is also critical in averting rabiesrelated
deaths. WAJM 2024; 41 (1): 36 - 41.

KEYWORDS: Rabies, dog bite, post-exposure, prophylaxis, mass
vaccination.

Influence of Adhesive Incise Drape Use on Surgical Site Infection Rates in Contaminated and Dirty Abdominal Operations

2024-06-05T20:34:25+00:00

BACKGROUND: Surgical Site Infection (SSI) remains the most
common cause of Healthcare Associated Infections (HCAIs). In
particular, contaminated and dirty abdominal wounds are attended by
a high rate of SSI which in turn is associated with a huge burden on
patients, caregivers and the entire health care system.

OBJECTIVE: To compare SSI rates following the use of iodine
impregnated adhesive incise drapes (Ioban) with routine conventional
drapes in contaminated and dirty abdominal surgical wounds in a
Nigerian tertiary hospital.

METHODOLOGY: Consecutive, consenting adult patients who
underwent laparotomy for cases classified as contaminated and dirty
were prospectively enrolled into the study. Patients in the investigation
arm had in addition to conventional drapes, iodine impregnated
adhesive incise drapes (Ioban) applied on the skin of the abdomen
through which incisions were made, while patients in the control arm
only had routine conventional drapes applied. All patients were
followed up to 30 days after operation. Surgical site infection rates were
compared between the two groups.

RESULTS: Sixty-two consecutive patients were enrolled into this
study, of which 55 completed the 30 days follow-up. The mean ages of
patients in the two groups were 37.96 ± 19.59 years and 36.74 ± 16.93
year (p=0.81). Males were 36 (65.5%) and females were 19 (34.5%).
Overall, 30 (54.5%) patients had surgical site infection (SSI) in this
study. Thirteen (46.4%) patients had SSI in iodine impregnated
adhesive incise drape group while 17 (63%) patients had SSI in the
conventional drape group, a difference that was not statistically
significant (p=0.22). The most commonly isolated organism from
infected wounds was Klebsiella species.

CONCLUSION: The use of iodine-impregnated surgical incise drape
was associated with a lower, though non-statistically significant SSI
rates compared to the use of conventional drapes. This marginal
benefit will require a larger population study to examine its potential
cost-effectiveness in our setting. WAJM 2024; 41 (1): 42 - 48.

KEYWORDS: Contaminated and dirty wounds, Adhesive incise
drape, Surgical Site Infection (SSI)

Haematological Indices and Iron Status in Pre-Dialysis Chronic Kidney Disease Patients

2024-06-05T20:47:38+00:00

BACKGROUND: Chronic kidney disease (CKD) is associated with
haematological changes, the commonest being anaemia. The
number and function of white blood cells (WBC) and platelets are
equally affected. Iron deficiency is a common cause of anaemia in
the CKD population and anaemia has been associated with reduced
cardiac function, increased rates of hospitalization, morbidity and
mortality. This study aimed to determine the haematological indices
and iron status among pre-dialysis CKD patients.

METHOD: A hospital-based cross-sectional study involving 95 predialysis
CKD patients and 95 age- and sex-matched apparently
healthy controls. Full blood count, peripheral blood film, serum
ferritin, transferrin saturation, C-reactive protein (CRP), electrolytes,
urea and creatinine, serum folate and vitamin B12 were done in all
study participants. Comparisons were made between results
obtained from participants in both groups.

RESULT: The mean ages were 58.1 ± 14.9 years and 58.3 ± 15.0
years in the CKD group and controls, respectively. The male:female
ratio was 1:0.9 in both groups. The prevalence of anaemia was 51.6%
and 3% in patients with CKD and controls, respectively. There was
no significant difference in the total WBC count, neutrophil and
lymphocyte differentials, platelet count, serum vitamin B12 and
folate in patients with CKD and controls. The prevalence of iron
deficiency among patients with CKD was 32.6%, of which 62.5%
were absolutely iron-deficient while 37.5% were functionally irondeficient.
The median ferritin and CRP were also higher in CKD. (p
=0.001).

CONCLUSION: Anaemia and iron deficiency are common in predialysis
CKD patients. Early diagnosis and treatment are important
to avoid the problems associated with them.

KEYWORDS: Chronic kidney disease, Anaemia, Iron deficiency,
Pre-dialysis

Compliance With Guidelines on Seasonal Malaria Chemoprevention in Kwara State, Northcentral Nigeria

2024-06-05T20:56:57+00:00

BACKGROUND: Seasonal malaria chemoprevention (SMC) is an
effective strategy for reducing malaria morbidity and mortality in
children aged 3-59 months in areas with seasonal malaria transmission.
Sulphadoxine-pyrimethamine plus amodiaquine is given to an eligible
child at monthly interval during the peak malaria transmission season.
The aim of this study was to determine the level of compliance with SMC
guidelines by community drug distributors during SMC implementation
in Kwara State.

METHOD: Caregivers of eligible children from six Local Government
Areas were interviewed using structured questionnaire on KoboCollect
app downloaded on hand-held android devices. The questionnaire was
composed of questions on caregiver's demographics, SMC drug
administration, and adherence to SMC protocol.

RESULTS: A total of 1,314 caregivers were interviewed, most of them
were female 1076 (81.9%), married 1200 (91.3%) and literate 795
(60.5%). The mean SMC coverage for the 4 cycles was 1183(88.5%).
SMC information was received by 1166 (88.7%) of caregivers. Most of
the caregivers 1166 (88.7%) heard about SMC. Overall, SPAQ
administration was directly observed in most cases 1169 (91.5%), second
dose was given 1226 (96.0%) and drugs were fully ingested 1140(89.3%).
Poor compliance was observed in home visits by lead mothers 988
(77.4%). The report of adverse drug reactions was low 132 (10.3% [95%
CI: 8.8-12.3%]), the commonest being severe vomiting 50 (37.9%). There
were significant (P<0.05) variations in SMC implementation across the 6
LGAs in virtually all the performance indicators. SPAQ administration
to over-age children was low 128 (10.0%),

CONCLUSION: Overall, the compliance with SMC implementation
guidelines in Kwara state was good though significant differences in
performance were observed across the six LGAs. Home visits by lead
mothers were generally poor. The self-reported coverage of SMC by
caregivers was commendable. WAJM 2024; 41 (1): 55 - 64.

KEYWORDS: Seasonal Malaria Chemoprevention, SPAQ,
Compliance, Children, Northcentral Nigeria, Rainy season

Relationship between Lifestyle Indicators and Un-investigated Dyspepsia Among Adult Patients in a Primary Care Setting in Northern Nigeria

2024-06-05T21:03:58+00:00

BACKGROUND: Un-investigated dyspepsia has remained a
common encounter among patients seen in primary care in sub-
Saharan Africa. A preventive approach through counselling patients
on modifications of lifestyle factors related to dyspepsia could be a
cost-effective approach to dyspepsia management in primary care in
low- and middle- income settings.

OBJECTIVES: The objectives were to describe the
sociodemographic patterns of adult patients with un-investigated
dyspepsia in the Family Medicine Clinics, Federal Medical Centre,
Gusau, Nigeria, to describe the pattern of lifestyle factors among
adult patients with un-investigated dyspepsia, to determine the
relationship between lifestyle patterns and un-investigated dyspepsia
and to describe the specific food types that precipitate dyspepsia
among the respondents

METHODS: A hospital based cross- sectional study using the Short
Form Leeds Dyspepsia Questionnaire to describe the presence and
severity of dyspepsia and Simple Lifestyle Indicator Questionnaire to
describe the lifestyle pattern of participants.

RESULTS: Most respondents (66.9%) have healthy dietary patterns
however more respondents 66(52.4%) engaged in unhealthy levels of
physical exercise. The Stress level was intermediate in majority of
respondents (66.1%). There was no statistically significant
association between lifestyle indicators and severity of dyspepsia
among the respondents although the linear regression model with pvalue
< 0.01 and < 0.05, revealed stress as a predictor of dyspepsia in
this study.

CONCLUSION: There was no relationship between lifestyle
indicators and Uninvestigated dyspepsia among the study
participants. However, some specific local foods were identified as
precipitants of dyspepsia. Primary care physicians may consider a
targeted dietary modification counselling approach in managing
patients with uninvestigated dyspepsia. WAJM 2024; 41 (1): 65 - 73.

KEYWORDS: Uninvestigated Dyspepsia, Lifestyle indicators

Risk Factors of Metabolic Syndrome among Normal Weight Adolescents in Lagos, Nigeria

2024-06-05T21:17:24+00:00

BACKGROUND: In the last few decades, the global disease
epidemiology shift has resulted in the preponderance of noncommunicable
diseases such as Metabolic Syndrome (MetS).
Globally, an increasing prevalence is reported among children and
adolescents in whom the condition was once rare. There is a dearth of
data in Nigeria on MetS, especially among normal-weight adolescents.

OBJECTIVE: To determine the prevalence and risk factors of MetS
among normal-weight adolescents attending secondary schools at
Mushin Local Government, Lagos.

METHODS: This descriptive cross-sectional study recruited
adolescents using a multi-stage sampling technique. Self-administered
questionnaires were used to obtain data on socio-demographic
characteristics, physical activity, medical, family and dietary history.
Waist circumference (WC), was measured from the midpoint between
the lowest rib and the top of the iliac crest to determine central obesity,
Body mass index was calculated as weight (in kilograms) divided by
2 height (in meters ), and the World Health Organization (WHO)
growth charts were used to determine their BMI percentiles. An
appropriately sized bladder cuff of a sphygmomanometer was used in
obtaining the blood pressure,

RESULTS: A total of 259 normal-weight adolescents were recruited.
The mean ± SD of participants was 13.6 ± 2.3 years. The prevalence of
MetS among participants was 2.7%. The most common
cardiometabolic risk factors were central obesity and elevated blood
pressure in 7.7% and 7.3% of participants. Physical activity was
significantly associated with a lower prevalence of MetS. A family
history of hypertension and diabetes in first-degree relatives was
significantly associated with MetS.

CONCLUSION: Metabolic syndrome was documented among
apparently healthy normal-weight adolescent. A family history of
hypertension or diabetes and physical inactivity were significantly
associated with metabolic syndrome in study participants.
WAJM 2024; 41 (1): 74 - 81.

KEYWORDS: Metabolic Syndrome; Adolescents; Normal Weight;
cardiometabolic risk factors