Publications by authors named "Basden J Onwubere"

7 Publications

  • Page 1 of 1

Clinical and echocardiographic findings in a cross-sectional study of HIV-infected adults in Enugu, Nigeria.

Cardiovasc J Afr 2021 May 12;32:1-7. Epub 2021 May 12.

Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria.

Background: Human immunodeficiency virus (HIV) infection and highly active antiretroviral therapy (HAART) are implicated in cardiovascular diseases. The objective of this study was to evaluate the clinical and echocardiographic findings in HIV-infected adults.

Methods: One hundred HIV subjects on HAART, 100 HAART-naïve patients and 100 controls were recruited in this cross-sectional study.

Results: Mean CD4 cell count was significantly higher in the HAART-exposed (408.43 ± 221.62) than the HAART-naïve groups (250.06 ± 154.26) ( < 0.001). Weight loss (49%), skin lesions (14%), body weakness (24%), oral thrush (10%) and lymphadenopathy (10%) were more prevalent in HAART-naïve patients ( < 0.05). Dimensions of aortic root (2.71 cm), left atrium (3.27 cm) and left ventricular mass index (79.95) were significantly higher in HIV-positive subjects on HAART ( < 0.05).

Conclusions: Clinical features of HIV and the CD4 nadir were more prevalent in the HIV-positive, HAART-naïve subjects. Dimensions of the aortic root, left atrium and left ventricle were relatively larger in the HAART-exposed patients while wall thickness and ejection fraction were higher in the HAART-naïve subjects.
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May 2021

Echocardiographic assessment of left ventricular function in thyrotoxicosis and implications for the therapeutics of thyrotoxic cardiac disease.

Ther Clin Risk Manag 2015 5;11:189-200. Epub 2015 Feb 5.

Department of Radiography and Radiological Sciences, Imaging Unit, College of Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria.

Introduction: Thyrotoxicosis is an endocrine disorder with prominent cardiovascular manifestations. Thyroid hormone acts through genomic and non-genomic mechanisms to regulate cardiac function. Echocardiography is a useful, non-invasive, easily accessible, and affordable tool for studying the structural and physiological function of the heart.

Aim: We studied thyrotoxicosis patients in a Nigerian Teaching Hospital and employed trans-thoracic echocardiography to find out if there were abnormalities in the hearts of these patients.

Methods: Fifty adult thyrotoxicosis patients diagnosed with clinical and thyroid function tests in the medical out-patient unit of the hospital were recruited and we performed transthoracic echocardiography with a Sonos 2000 HP machine.

Results: We documented the presence of abnormalities in the following proportion of thyrotoxicosis patients: left ventricular enhanced systolic function in 30%, enhanced diastolic function in 34%, diastolic dysfunction in 34%, heart failure with preserved ejection fraction in10%, heart failure with reduced ejection fraction in 6%, and left ventricular hypertrophy in 34%.

Conclusion: Echocardiography was useful in the stratification of cardiac function abnormalities and is indispensable as a guide in the choice of therapeutic options in patients with thyrocardiac disease. The finding of left ventricular enhanced systolic and diastolic functions signify early echocardiographic detectable cardiac abnormalities in thyrotoxicosis, and the clinical management includes the use of anti-thyroid drugs and β-adrenoceptor blockade. Diastolic dysfunction in thyrotoxicosis patients asymptomatic for cardiac disease should be treated with anti-thyroid drugs, and β-adrenoceptor blockade. The judicious application of clinical therapeutics will guide the use of anti-thyroid drugs, diuretics, digoxin, angiotensin inhibitors, and β-adrenoceptor blockade in the successful management of thyrotoxicosis patients with heart failure and reduced, preserved, or increased ejection fraction: parameters which are derived from echocardiography.
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February 2015

The CURB-65 scoring system in severity assessment of Eastern Nigerian patients with community-acquired pneumonia: a prospective observational study.

Prim Care Respir J 2013 Jun;22(2):175-80

Department of Medicine, Federal Medical Centre, Owerri, Nigeria.

Background: Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality in Nigeria. Severity assessment is a major starting point in the proper management of CAP. The BTS guideline for managing this condition is simple and does not require sophisticated equipment. Adherence to this guideline will improve CAP management in Nigeria.

Aims: To assess the usefulness of the CURB-65 score in the management of CAP patients in Nigeria and to determine the outcome in relation to the degree of severity using CURB-65.

Methods: A prospective observational study of 80 patients with CAP was carried out in the University of Nigeria Teaching Hospital Enugu, Nigeria from December 2008 to June 2009. The patients were classified into three risk groups and the ability of the CURB-65 score to predict the 30-day mortality rate and the need for ICU admission was determined.

Results: Eighty patients were recruited, 39 of whom were men, giving a male to female ratio of 1:1.05. The mean age was 56 ± 18 years. Thirty-seven patients (46.3%) were outpatients, 13 with CURB score 0, 21 with CURB score 1, two with CURB score 2, and one with CURB score 3. Of the 43 patients (53.7%) admitted to hospital, six, 13, 14, and 10 had scores of 4, 3, 2, and 1, respectively. The ICU admission rate was 10%. Twelve patients died, 2.2% in the low-risk group, 12.5% in the intermediate-risk group, and 45% in the high-risk group.

Conclusions: The CURB-65 score is a simple method of assessing and risk stratifying CAP patients. It is particularly useful in a busy emergency department because of its ability to identify a reasonable proportion of low-risk patients for potential outpatient care.
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June 2013

Prevalence and determinants of hypertension in Abia State Nigeria: results from the Abia State Non-Communicable Diseases and Cardiovascular Risk Factors Survey.

Ethn Dis 2013 ;23(2):161-7

Ministry of Health, Nnamdi Azikiwe Secretariat, Umuahia, Abia State, Nigeria.

Objective: Hypertension is the most common non-communicable disease and risk factor for heart failure, stroke, chronic kidney disease and ischemic heart disease in sub-Saharan Africa. Few population-based studies have been conducted recently in Nigeria and, in Abia State, no previous study has been conducted on the prevalence and correlates of hypertension among the populace. The purpose of our study was, therefore, to determine the prevalence and determinants of high blood pressure in Abia State, southeastern Nigeria. We hypothesise that high blood pressure burden is high in Abia State.

Design: The study was a community based cross-sectional house-to-house survey aimed at ascertaining the burden/prevalence of hypertension in the state as well as identifying related risk factors associated with them.

Setting: The study was conducted in rural and urban communities in Abia State, Nigeria.

Participants: Participants in the study were men and women aged > or =15 years and were recruited from the three senatorial zones in the state.

Main Outcomes: A total of 2,999 respondents were selected for the survey and, 2,983 consented to be interviewed giving a response rate of 99.5%. The data for 2,928 participants were suitable for analysis. Of these, 1,399 (47.8%) were men. The mean age of the population was 41.7 +/- 18.5 years (range 18-96 years). About 54% of the population were < or =40 years. Ninety percent had at least primary education with about 47% having completed secondary education. Expectedly, 96% of the respondents were Ibos, the predominant tribe in the southeastern part of the country. Women had significantly higher BMI than the men. Similarly, waist circumference was also larger in women but waist-to-hip ratio was only significantly higher in women in the urban areas compared to those in rural areas. Thirty-one percent of all participants had systolic hypertension (33.5% in men and 30.5% in women). This sex difference was statistically different in the urban area. On the other hand, diastolic hypertension was 22.5% in all the population (23.4% in men and 25.4% in women). Age and indices of obesity were the strongest predictors of blood pressure.

Conclusion: The prevalence of hypertension was high in our study both in rural and urban settings. The major determinants of blood pressure in our participants included age, sex, indices of obesity and pulse rate.
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April 2013

Clinical findings associated with cardiovascular autonomic dysfunction in adult sickle cell anaemia patients.

Acta Cardiol 2012 Apr;67(2):169-75

Department of Medicine, University of Nigeria Teaching Hospital Enugu, Nigeria.

Background: Involvement of the cardiovascular autonomic nervous system in various diseases is often associated with increased morbidity and mortality.

Objective: The objective of this study was to examine the clinical features associated with cardiovascular autonomic neuropathy (CAN) in adult Nigerians with sickle cell anaemia.

Methods: A cross-sectional study was carried out on 62 steady state sickle cell anaemia patients recruited from the adult out-patient clinic. Cardiovascular autonomic dysfunction was determined based on abnormal values in at least two of five non-invasive tests: Valsalva manoeuvre, heart rate variation during deep breathing, heart rate response to standing, blood pressure response to sustained handgrip, and blood pressure response to standing. All the subjects were initially evaluated in the clinic for symptoms of cardiovascular disease and peripheral vascular disease, and then clinically examined to assess their cardiovascular and neurological status at rest.

Results: Out of the 44 patients with cardiovascular autonomic neuropathy 23 were males, while 21 were females. The mean ages were 28.3 +/- 5.8 y for patients with CAN and 28.0 +/- 5.0 y for patients without CAN (P = 0.817). Sickle cell anaemia patients with CAN had significantly lower ankle systolic blood pressure, reduced ankle brachial blood pressure index, mean arterial blood pressure and haematocrit than patients without CAN. Of all the variables evaluated leg ulcers, postural dizziness, erectile dysfunction in men, and history of recurrent acute chest syndromes were found significantly more in patients with CAN than without. Clinical abnormalities tend to worsen with increasing degree of cardiovascular autonomic dysfunction.

Conclusion: Significant cardiac morbidity is associated with abnormal cardiovascular autonomic function in sickle cell anaemia.
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April 2012

Total cardiovascular risk approach to improve efficiency of cardiovascular prevention in resource constrain settings.

J Clin Epidemiol 2011 Dec 6;64(12):1451-62. Epub 2011 May 6.

Noncommunicable Diseases and Mental Health Cluster, World Health Organization, Geneva, Switzerland.

Objectives: To determine the population distribution of cardiovascular risk in eight low- and middle-income countries and compare the cost of drug treatment based on cardiovascular risk (cardiovascular risk thresholds ≥ 30%/≥ 40%) with single risk factor cutoff levels.

Study Design And Setting: Using World Health Organization (WHO) and the International Society of Hypertension risk prediction charts, cardiovascular risk was categorized in a cross-sectional study of 8,625 randomly selected people aged 40-80 years (mean age, 54.6 years) from defined geographic regions of Nigeria, Iran, China, Pakistan, Georgia, Nepal, Cuba, and Sri Lanka. Cost estimates for drug therapy were calculated for three countries.

Results: A large fraction (90.0-98.9%) of the study population has a 10-year cardiovascular risk <20%. Only 0.2-4.8% are in the high-risk categories (≥ 30%). Adopting a total risk approach and WHO guidelines recommendations would restrict unnecessary drug treatment and reduce the drug costs significantly.

Conclusion: Adopting a total cardiovascular risk approach instead of a single risk factor approach reduces health care expenditure by reducing drug costs. Therefore, limited resources can be more efficiently used to target high-risk people who will benefit the most. This strategy needs to be complemented with population-wide measures to shift the cardiovascular risk distribution of the whole population.
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December 2011

High prevalence and low awareness of hypertension in a market population in enugu, Nigeria.

Int J Hypertens 2011 Jan 27;2011:869675. Epub 2011 Jan 27.

Renal Unit, University of Nigeria Teaching Hospital, Enugu 400001, Nigeria.

Background. A community-based study put the prevalence of hypertension in Nigeria at 32.8%. Market workers in Nigeria lead sedentary life style and often depend on salt-laden fast food while at work. Method. An unselected population of market workers were screened for hypertension and its risk factors by a pretested, structured questionnaire, clinical examination, and laboratory investigation. Hypertension was defined as BP ≥ 140 and/or ≥ 90 mmHg or being on drug therapy. Results. Forty-two percent of the screened population were hypertensive. Of this number, 70.6% did not know they were hypertensive before the screening. More males than females (P = .022) were hypertensive. Prevalence of hypertension increased with age from 5.4% in the age group <20 years to 80% in the age group ≥70 years. Conclusion. The prevalence of hypertension in market workers in this study was 42%, and the majority of them were unaware of their disease.
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January 2011