Publications by authors named "Dike B Ojji"

In sub-Saharan Africa (SSA), a rising burden of noncommunicable diseases (NCDs) coexists with a persistent high burden of human immunodeficiency virus (HIV). Integrating care for chronic conditions is potentially beneficial, but the optimal approach remains unclear. By use of a narrative review of 14 recent case studies from different SSA countries, examples of NCD and HIV healthcare integration were described.

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Introduction/background: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. The AF Atrial Fibrillation Registry, which commenced in June 2023, was designed to provide clinical epidemiological data on patients with AF in the country.

Objective(s): The objective is to describe the rationale, design, and early findings from the registry.

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Introduction/background: Chronic heart failure (CHF) has important gender-specific aspects, which are worthy of note, as they influence the haemodynamic state of patients the choice of therapy, aetiology, and clinical outcomes. Women are less frequently represented in CHF studies and clinical trials than males. While some published data are conflictive, more studies tailored to this critical discourse are necessary to inform patient care and improve outcomes in patients with CHF.

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Background: Single-pill combinations (SPCs) of three low-dose antihypertensive drugs can improve hypertension control but are not widely available. A key issue for any combination product is the contribution of each component to efficacy and tolerability. This trial compared a new triple SPC called GMRx2, containing telmisartan, amlodipine, and indapamide, with dual combinations of components for efficacy and safety.

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Background: In line with the WHO Global Action Plan's objective to achieve a 30% relative reduction in the mean population intake of sodium by 2025, the Nigeria Sodium Study (NaSS) team, which aimed to evaluate the implementation and scale-up of national sodium reduction programme, hosted a policy meeting May 22, 2023, in Abuja, the Federal Capital Territory of Nigeria. The aim was to deliberate on strategies for translating data on salt levels in food and dietary patterns, intending to strengthen sodium policies in Nigeria, with the ultimate goal of producing evidence-based information that can effectively guide strategies and policies for sodium reduction.

Methods: Policymakers from federal, state, and local government levels attended, as well as representatives from national and international universities and non-governmental organizations.

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Background: Healthcare workers (HCWs) including community health extension workers (CHEWs) in the Federal Capital Territory, Nigeria participated in a hypertension training series following the Extension for Community Healthcare Outcomes (ECHO) model which leverages technology and a practical peer-to-peer learning framework to virtually train healthcare practitioners. We sought to evaluate the patient-level effects of the hypertension ECHO series.

Methods: HCWs from 12 of 33 eligible primary healthcare centers (PHCs) in the Hypertension Treatment in Nigeria Program (NCT04158154) were selected to participate in a seven-part hypertension ECHO series from August 2022 to April 2023.

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Article Synopsis
  • A clinical trial tested a new single-pill combination of low-dose medications (telmisartan, amlodipine, and indapamide) to treat hypertension, comparing two doses against a placebo over four weeks.
  • Results showed significant reductions in home systolic blood pressure (SBP) for both medication doses compared to placebo, with reductions of -7.3 mm Hg and -8.2 mm Hg, respectively, and a notable increase in blood pressure control rates among those taking the medications.
  • Safety observations indicated low treatment discontinuation rates, with the ¼ dose showing only 1.6% discontinuations due to adverse effects, while the ½ dose had a 5
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Importance: With the high burden of hypertension in sub-Saharan Africa, there is a need for effective, safe and scalable treatment strategies.

Objective: To compare, among Black African adults, the effectiveness and safety of a novel low-dose triple-pill protocol compared with a standard-care protocol for blood pressure lowering.

Design And Setting: Randomized, parallel-group, open-label, multicenter trial conducted in public hospital-based family medicine clinics in Nigeria.

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Article Synopsis
  • - The text emphasizes the need for comprehensive approaches to combat hypertension, highlighting the importance of high-quality treatment and stakeholder collaboration to improve care services and retention in treatment.
  • - The study aims to evaluate how different simulated interventions can affect retention rates in hypertension care within the primary health care system in Nigeria, using system dynamics modeling that includes insights from diverse stakeholders.
  • - Results from stakeholder workshops showed that training health care workers could significantly enhance retention rates in hypertension care, suggesting it is a key strategy for addressing the issue in Nigeria.
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Background: Blood pressure (BP) control among treated patients in Africa is very suboptimal, with low levels of combination therapy use and therapeutic inertia being among the major barriers to effective control of hypertension. The VERONICA-Nigeria study aims to evaluate, among Black African adults with hypertension, the effectiveness and safety of a triple pill-based treatment protocol compared to Nigeria hypertension treatment protocol (standard care protocol) for the treatment of hypertension.

Methods: This study involves a randomized, parallel-group and open-label trial.

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We performed a systematic review and meta-analysis of hypertension in people living with human immunodeficiency virus (HIV) in sub-Saharan Africa (SSA). We searched the PubMed, Google Scholar, African Index Medicus, and Embase databases to identify studies published from January 1, 2010, to December 31, 2021. We used a random-effects model to estimate the pooled prevalence of hypertension and mean SBP/DBP level on a sex-specific basis.

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Introduction: Noncommunicable diseases (NCDs) are associated with high and rising burden of morbidity and mortality in sub-Saharan Africa, including Nigeria. Diabetes mellitus (DM) is among the leading causes of NCD-related deaths worldwide and is a foremost public health problem in Nigeria. As part of National policy, Nigeria has committed to implement the World Health Organization (WHO) Package of Essential Non-communicable Disease interventions for primary care.

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Background: There is minimal data on the number of adolescents in sub-Saharan Africa (SSA) with elevated blood pressure (BP) at increased risk of future cardiovascular events. Combining country-specific population data with data derived from two previously conducted meta-analyses (one African-specific, one based on international cohorts), we sought to address this knowledge deficit.

Methods: We used meta-analysis data from 37 926 adolescents participating in 36 contemporary SSA studies to generate sex-specific proportions of adolescents aged 10-14 and 15-19 years with elevated BP.

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Article Synopsis
  • Hypertension is identified as a major risk factor for cardiovascular disease (CVD) globally, especially impacting mortality rates in sub-Saharan Africa, including Nigeria.
  • This study calculated the contribution of hypertension to various CVD types in Nigeria, showing it is responsible for 13.2% of myocardial infarctions and 24.6% of strokes, with variations across different age and gender groups.
  • The findings emphasize the need for targeted public health strategies and policies focused on hypertension management to help reduce the overall burden of CVD in Nigeria.
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Article Synopsis
  • - Nigeria aims to limit industrial trans fatty acids (iTFA) in food to improve public health, specifically targeting ischaemic heart disease (IHD), but the impact and costs are unclear.
  • - Using Markov cohort models, researchers estimated that a mandatory iTFA limit would prevent nearly 10,000 IHD deaths and save around $90 million in healthcare costs over the first decade.
  • - The analysis suggests that implementing this policy is cost-effective and could lead to significant health benefits, supporting the idea of regulating iTFAs as a beneficial health strategy for Nigeria.
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Introduction: Noncommunicable diseases (NCDs) are associated with a high and rising burden of morbidity and mortality in sub-Saharan Africa, including Nigeria. Diabetes mellitus (DM) is among the leading causes of NCD-related deaths worldwide and is a foremost public health problem in Nigeria. As part of the National Multi-Sectoral Action Plan for the Prevention and Control of NCDs, Nigeria has committed to implementing the World Health Organization (WHO) Package of Essential NCD control interventions.

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Article Synopsis
  • - The systematic review focuses on the importance of regular patient engagement in hypertension care, aiming to assess interventions that improve retention for patients.
  • - It analyzed 18 studies from various countries, mostly involving randomized controlled trials, with a diverse participant age range and including interventions like education, team-based care, and SMS reminders.
  • - The review highlights gaps in existing literature and suggests that adapting successful models from other healthcare areas, like HIV care, may enhance retention strategies in hypertension management.
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Background: The Extension for Community Health Outcomes (ECHO) model has been used extensively to link care providers in rural communities with experts with the aim of improving local patient care.

Objective: The aim of this qualitative research study was to assess the feasibility, acceptability, perceived needs, and contextual factors to guide implementation of a hypertension focused ECHO program for Community Health Extension Workers (CHEWs) in the Federal Capital Territory, Nigeria.

Methods: From September 2020 to December 2020, key informant interviews were performed with seven global organizations (hubs) providing ECHO training focused on cardiovascular disease or nephrology to identify contextual factors and implementation strategies used by each hub.

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Background: Nigeria has one of the highest burdens of maternal deaths globally, and hypertensive disorders of pregnancy (HDP) are the leading cause of maternal morbidity and mortality in the country. There is a significant implementation gap in utilizing evidence-based practices for the management of HDP in Nigeria. This study evaluated facilitators and barriers to implementing a home blood pressure monitoring program to improve management of HDP.

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Purpose Of Review: Cardiovascular diseases (CVDs) are a leading cause of morbidity and mortality globally with an accelerated increase in CVD‑related death in Africa and other low‑middle‑income countries. This review is aimed at highlighting the burden of coronary artery disease CAD, its peculiarities as well as challenges of management in sub-Saharan Africa.

Recent Findings: Recent data revealed a shift from high incidence of CVDs associated with poverty and malnutrition (such as rheumatic heart disease) initially, which are now falling, to rising incidence of other non-communicable CVDs (such as hypertension, coronary artery disease (CAD), and heart failure).

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Background: There is rekindled interest in the cardiotoxicity of antimalarial medicines. Halofantrine is associated with QT interval prolongation. Fluconazole and kolanut alter the pharmacokinetics of halofantrine.

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Background: More people from sub-Saharan Africa aged between 20 years and 60 years are affected by end-organ damage due to underlying hypertension than people in high-income countries. However, there is a paucity of data on the pattern of elevated blood pressure among adolescents aged 10-19 years in sub-Saharan Africa. We aimed to provide pooled estimates of high blood pressure prevalence and mean levels in adolescents aged 10-19 years across sub-Saharan Africa.

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