Background:
Patients with chronic kidney disease (CKD) often complain of taste dysfunction. The prevalent taste dysfunction among patients with CKD predisposes them to malnutrition, poor quality of ...life, and worsen disease prognoses. To appropriately treat the taste dysfunction in this group of patients, it’s imperative that factors that predict taste dysfunction and its severity are identified for prompt treatment.
Aim:
To identify factors associated with taste dysfunction and its severity among patients with CKD.
Materials and Methods:
This was a hospital-based case–control study of adult patients with CKD at the University College Hospital, Ibadan, Nigeria. The control group was made up of age- and gender-matched healthy volunteers with no clinical and laboratory evidence of CKD. Relevant clinical and social data obtained include demographics, symptoms, and signs of taste dysfunction and its risk factors. The 4 basic taste modalities namely sweet, sour, bitter, and salt taste senses of the participants were tested with validated “taste strips.” Factors that predict taste dysfunction were identified among the spectrum of the disease.
Results:
There were 100 patients with CKD and 100 healthy controls, age ranges between 19 and 86 years (mean ± standard deviation SD = 46.3 ± 13.9 years) and 20 and 85 years (mean ± SD = 43.4 ± 14.9 years), respectively. There was no statistically significant difference between cases and control gender distribution (P = .57). Hypogeusia was found in 27.0% of patients with CKD, while total taste function score of all the control was within normal range. Increasing duration of CKD was identified as a predictor of taste dysfunction among patients with CKD (odds ratio: 4.889, P = .038). The stages of CKD had no statistically significant relationship with the severity of taste dysfunction (P = .629).
Conclusion:
The prevalence of taste dysfunction among patients with CKD was high and this showed significant correlation with increasing duration of CKD; in contrast, the severity of CKD is not significant in the development of taste dysfunction.
Hearing loss is the most common sensory deficit in humans with causative variants in over 140 genes. With few exceptions, however, the population-specific distribution for many of the identified ...variants/genes is unclear. Until recently, the extensive genetic and clinical heterogeneity of deafness precluded comprehensive genetic analysis. Here, using a custom capture panel (MiamiOtoGenes), we undertook a targeted sequencing of 180 genes in a multi-ethnic cohort of 342
GJB2
mutation-negative deaf probands from South Africa, Nigeria, Tunisia, Turkey, Iran, India, Guatemala, and the United States (South Florida). We detected causative DNA variants in 25 % of multiplex and 7 % of simplex families. The detection rate varied between 0 and 57 % based on ethnicity, with Guatemala and Iran at the lower and higher end of the spectrum, respectively. We detected causative variants within 27 genes without predominant recurring pathogenic variants. The most commonly implicated genes include
MYO15A
,
SLC26A4
,
USH2A
,
MYO7A
,
MYO6
, and
TRIOBP.
Overall, our study highlights the importance of family history and generation of databases for multiple ethnically discrete populations to improve our ability to detect and accurately interpret genetic variants for pathogenicity.
Individuals of African descent are at higher risk of developing kidney disease than their European counterparts, and HIV infection is associated with increased risk of nephropathy. Despite a safe ...renal profile in the clinical trials, long-term use of tenofovir disoproxil fumarate (TDF) has been associated with proximal renal tubulopathy although the underlying mechanisms remain undetermined. We aim to establish the prevalence of and risk factors for TDF-induced kidney tubular dysfunction (KTD) among HIV-I and II individuals treated with TDF in south-west Nigeria. Association between TDF-induced KTD and genetic polymorphisms in renal drug transporter genes and the APOL1 (Apolipoprotein L1) gene will be examined.
This study has two phases. An initial cross-sectional study will screen 3000 individuals attending the HIV clinics in south-west Nigeria for KTD to determine the prevalence and risk factors. This will be followed by a case-control study of 400 KTD cases and 400 matched controls to evaluate single nucleotide polymorphism (SNP) associations. Data on socio-demographics, risk factors for kidney dysfunction and HIV history will be collected by questionnaire. Blood and urine samples for measurements of severity of HIV disease (CD4 count, viral load) and renal function (creatinine, eGFR, phosphate, uric acid, glucose) will also be collected. Utility of urinary retinol binding protein (RBP) and N-acetyl-beta-D-glucosaminidase (NAG) levels as surrogate markers of KTD will be evaluated. Genomic DNA will be extracted from whole blood and SNP analyses performed using the rhAMP SNP genotyping assays. Statistical analysis including univariate and multivariate logistic regression analyses will be performed to identify factors associated with KTD.
In spite of TDF being the most commonly used antiretroviral agent and a key component of many HIV treatment regimens, it has potential detrimental effects on the kidneys. This study will establish the burden and risk factors for TDF-induced KTD in Nigerians, and explore associations between KTD and polymorphisms in renal transporter genes as well as APOL1 risk variants. This study may potentially engender an approach for prevention as well as stemming the burden of CKD in sub-Saharan Africa where GDP per capita is low and budgetary allocation for health is inadequate.
To determine the prevalence and correlates of tinnitus among community elderly and its impact on their quality of life.
Longitudinal cohort.
Yoruba-speaking communities in Nigeria.
Face-to-face ...interviews of 1302 subjects 65 years or older selected by the use of a multistage stratified sampling of households. Subjects were assessed for subjective tinnitus, chronic health conditions, functional impairment, and quality of life by use of the brief version of the World Health Organization quality of life instrument.
Tinnitus was reported in 184 (110 female and 74 male subjects), giving a prevalence of 14.1 percent (SE = 0.49). Gender, age, economic status, educational level, residence, smoking, and alcohol consumption were not significantly associated with tinnitus. Univariate analysis revealed a history of recurrent otitis media (odds ratio OR = 4.5, 95% confidence interval 95% CI 3.1-6.6, P = 0.01), head injury (OR 3.4, 95% CI 2.1-5.6, P = 0.01), rhinosinusitis (OR 2.4, 95% CI 1.5-4.0, P = 0.01), dizziness (OR 2.1, 95% CI 1.4-3.1, P = 0.01), and hypertension (OR 1.7, 95% CI 1.0-2.7, P = 0.05) as significant correlates. However, in multivariate analysis, only a history of otitis media and of head injury remained significant. Compared with those without, persons with tinnitus had a more negative perception of their overall health and a poorer quality of life as well as twofold likelihood to experience impairment in both activities of daily living and instrumental activities of daily living.
Tinnitus is common among elderly Nigerians and is associated with treatable health conditions, such as otitis media, rhinosinusitis, head injury, and hypertension. Its association with functional impairment and reduced quality of life highlights the need for inclusion in any comprehensive health care for the elderly.
Objectives:
We sought to determine the prevalence of insomnia and its impact on the quality of life (QoL) among community elderly subjects (at least 65 years of age) with subjective tinnitus.
...Methods:
After household selection with multistage stratified area probability sampling, face-to-face interviews were used to obtain self-reports of subjective tinnitus and insomnia, and QoL was assessed with the WHOQoL-Bref instrument.
Results:
Among 1,302 elderly subjects, there were 183 subjects (109 female and 74 male) with tinnitus. Among those with tinnitus, insomnia was encountered in 95 (51.9%) and was found to be significantly more common among those with tinnitus than among those without (378 of 1,119, or 33.8%; p = 0.002). The insomnia symptoms included difficulty in maintaining sleep in 73.4% of subjects, difficulty in falling asleep in 70.0%, early morning wakefulness in 64.3%, non-restorative sleep in 35.1%, and daytime sleepiness in 34.7%. Univariate analysis revealed difficulty with falling asleep (p = 0.01) and early morning wakefulness (p = 0.05) to be significantly associated with tinnitus among the symptoms. Student's t-test and logistic regression analysis revealed significant deterioration in the total QoL and in the physical, psychological, social, and environmental QoL domains among elderly subjects who had tinnitus with insomnia as compared with those without insomnia.
Conclusions:
We believe that insomnia is significantly more common among elderly subjects with tinnitus than among those without, and that its presence further depreciates the QoL in these elderly individuals.
Abstract Introduction The implementation of Neonatal Hearing Screening (NHS) program is still at the preliminary stage particularly in developing countries despite the burden of permanent congenital ...and early-onset hearing impairment. There has been an earlier report of NHS in a city in Nigeria, however, this is a report of a preliminary NHS carried in a rural/sub-urban area in Nigeria. Method This prospective study, which took place between October 2009 and April 2010, involved all newborns delivered at the University College Hospital, Ibadan and the Bilal Missionary Maternity, Agodi, Ibadan, a small maternity service located in Agodi community serving predominantly low socioeconomic class people. All the neonates delivered during the study period were included in the screening. The screening was performed within 72 h of delivery using automated auditory brainstem response (AABR) and repeated after 6 weeks among those with referral result. Subsequently the neonates were referred to diagnostic audiology. Result Among the 453 newborns (231 males and 222 female), AABR screening showed referral, in 43.7% of neonates. At first screening, 224 (49.4%) were referred while 229 (50.6%) passed, however, during the post-natal period 40/229 (17.5%) reported for second screening, out of these 26 showed pass to the screening. This gave a total pass of 255/453 (56.3%). The presence of maternal pre-ecclampsia ( P = 0.05) was found to be a significant morbidity factor associated with referral in the screening, while parental socioepidemiological variables; and the neonates’ birthweight, gestational age and APGAR score were not. Conclusion The proportion of referral on hearing screening encountered was far higher than previously reported, however, continuation of infant screening in future should be comprehensive with viral and genetic analysis in order to address the issue of aetiologic diagnosis; in addition, the implementation should factor the high drop out from the first stage screening in order to substantiate the findings in our region.
Mutations in the POU3F4 gene cause X-linked deafness type 3 (DFN3), which is characterized by inner ear anomalies.
Three Turkish, one Ecuadorian, and one Nigerian families were included based on ...either inner ear anomalies detected in probands or X-linked family histories. Exome sequencing and/or Sanger sequencing were performed in order to identify the causative DNA variants in these families.
Four novel, c.707A>C (p.(Glu236Ala)), c.772delG (p.(Glu258ArgfsX30)), c.902C>T (p.(Pro301Leu)), c.987T>C (p.(Ile308Thr)), and one previously reported mutation c.346delG (p.(Ala116ProfsX26)) in POU3F4, were identified. All mutations identified are predicted to affect the POU-specific or POU homeo domains of the protein and co-segregated with deafness in all families.
Expanding the spectrum of POU3F4 mutations in different populations along with their associated phenotypes provides better understanding of their clinical importance and will be helpful in clinical evaluation and counseling of the affected individuals.
Abstract Introduction Little is known about the molecular epidemiology of deafness in sub-Saharan Africa (SSA). Even in Nigeria, the most populous African nation, no genetic studies of deafness have ...been conducted. This pioneering work aims at investigating the frequencies of gene mutations relatively common in other parts of the world (i.e. those in GJB2 , GJB6 , and mitochondrial DNA) among subjects from Nigeria with hearing loss (HL) with no evidence of acquired pathology or syndromic findings. In addition, we review the literature on the genetics of deafness in SSA. Method We evaluated 81 unrelated deaf probands from the Yoruba tribe residing in Ibadan, a suburban city in Nigeria, for the aetiology of their deafness. Subjects underwent genetic testing if their history was negative for an environmental cause and physical examination did not find evidence of a syndrome. Both exons of GJB2 and mitochondrial DNA flanking the 1555A>G mutations were PCR-amplified followed by Sanger sequencing. GJB6 deletions were screened via quantitative PCR. Result We identified 44 probands who had nonsyndromic deafness with no environmental cause. The age at study time ranged between 8 months and 45 years (mean = 24 years) and age at onset was congenital or prelingual (<age 2 years) in 37 (84%) probands and postlingual in 7 (16%) probands. Among these, 35 probands were the only affected members of their families (simplex cases), while there were at least two affected family members in nine cases (multiplex). Molecular analyses did not show a pathogenic variant in any one of the 44 probands studied. Conclusion GJB2 , GJB6 and mitochondrial DNA 1555A>G mutations were not found among this initial cohort of the deaf in Nigeria. This makes imperative the search for other genes in the aetiology of HL in this population.
This cohort study of 1302 persons aged ≥65 years, conducted in the Yoruba-speaking regions of Nigeria, determines the prevalence and correlates of hearing impairment (HI) in the elderly population. ...Self-reports of HI and its putative risk factors among several indices were obtained using face-to-face interviews, and confirmed by observer's evaluation. Hearing impairment was found in 79 respondents, giving a prevalence of 6.1%. Gender difference was not significant but increasing age was associated with higher prevalence. Logistic regression analysis, adjusted for age and sex, revealed that history of recurrent suppurative otitis media odds ratio (OR)
=
4.6, 95% CI 2.34–8.99,
P
=
0.01, head injury (OR
=
2.2, 95% CI 1.14–4.26,
P
=
0.02) and current hypertension (OR
=
2.1, 95% CI 1.18–3.57,
P
=
0.01) were significantly associated with HI. No identifiable risk factors were found in 32 (40.5%) of the 79 respondents with HI. We conclude that the prevalence of HI among the elderly in Nigeria is comparable to reports from other countries. Identified risk factors were preventable or controllable. The large proportion of elderly with no identifiable risk factors, presumably presbyacusis, suggests a need for further study. The strategies for control of these risk factors and hearing aid support should be integrated into health care policy initiatives for elderly persons in sub-Saharan Africa.
Dizziness is common among older people, but little is known about its prevalence and risk factors in the sub-Saharan population. We conducted a cross-sectional study to determine the prevalence of ...dizziness and its sociodemographic, lifestyle, and clinical correlates in 1,299 subjects--551 men (42.4%) and 748 women (57.6%), aged 65 years and older (mean: 77.3 ± 6.3)--who lived in the Yoruba-speaking areas of Nigeria. Among this group, 318 persons reported dizziness, which represents a prevalence of 24.5%. Univariate analysis of sociodemographic and lifestyle variables revealed that low economic status (p = 0.05) and smoking (p = 0.01) were significantly correlated with dizziness; however, on logistic regression analysis, only smoking (p = 0.01) was found to be significant. Neither sex (p = 0.07), age (p = 0.71), area of residence (p = 0.34), education level (p = 0.74), nor alcohol consumption (p = 0.44) had a significant correlation with dizziness. On multivariate modeling, significant clinical correlates in patients with dizziness included self-reports of a history of suppurative otitis media (p = 0.01), head injury (p = 0.03), and recurrent rhinosinusitis (p = 0.01); no significant correlation was seen between dizziness and hypertension, transient ischemic attack, and diabetes. Finally, balance testing conducted in a subset of 1,006 subjects revealed poor balance in 93 of 250 persons with dizziness (37.2%) and in 189 of 756 subjects without dizziness (25.0%) (p = 0.01). Logistic regression analysis of sex and age revealed that the probability of poor balance was 1.5 times greater among those persons with dizziness. We conclude that the high incidence of dizziness among community-dwelling elderly and its significant correlations with remediable medical conditions suggest the need for policy formulation for the care of the elderly in Nigeria.
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