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Experts list causes of sudden death in Nigeria




Researches conducted by some Nigerian teaching hospitals have identified stroke and heart attack as the major causes of over 93.7 percent of the sudden and unexpected deaths (SUD) in the country.

The researchers also found that more males than females, at a ratio of 2:1, are affected, and the average age of the victims is “47.3 years. They blamed the rise in SUD on rural to urban migration, increased salt and fat intake from the consumption of processed foods, increased tobacco use and sedentary lifestyle.

The studies were conducted by the Lagos University Teaching Hospital (LUTH), Idi-Araba; Obafemi Awolowo University Teaching Hospital (OAUTH); University of Port Harcourt Teaching Hospital (UPTH); and the University of Maiduguri Teaching Hospital (UMTH), among others.

To check the rising cases of sudden death, the medical experts called for urgent review and upgrading of critical care management facilities in the country as well as improvement upon the level of awareness, control and management of hypertension among the populace.

They also recommended that Nigerians should engage in physical activities in order to protect their heart health and reduce the risk of cardiovascular disease (CVD), including heart disease and stroke.

The Guardian learnt that the Nigerian Institute of Medical Research (NIMR) Yaba, Lagos has already started a nationwide study on the rising cases of SUD even as the Federal Ministry of Health (FMoH), with support from the World Health Organisation (WHO), is planning a national survey on Non Communicable Diseases (NCDs).

Investigation revealed that Nigeria does not have up-to-date national data on NCDs because the last survey was carried out over 20 years ago. However, according to the WHO country profile for Nigeria in 2014, it is estimated that NCDs account for 25 per cent of total deaths in Nigeria. Cardiovascular disease/heart-related disease (CVD) is responsible for seven per cent; cancers three per cent; diabetes two per cent; chronic obstructive respiratory diseases one per cent; and others were responsible for 11 per cent.

Cardiologists at LUTH, led by Prof. Jane Ajuluchukwu and Prof. Amam Chinyere Mbakwem, found that the commonest causes of sudden death are stroke (52.8 per cent) and heart failure (40.9 per cent).

The study published in the Nigerian Journal of Clinical Practice and titled “Trends in acute emergency room hypertension related deaths: an autopsy” investigated hypertension-related acute deaths in patients admitted to the emergency room of LUTH.

Autopsy reports for bodies deposited from the medical emergency room (ER) were reviewed. Details of the time of admission, time of death and blood pressure status prior to the event were obtained. The result shows there was 297 hypertension-related deaths, but 252 were analyzed. There were 168 (66.7 per cent) males and 84 (33.3 per cent) females, and the mean age was 47.33±12.18 years (14 to 85 year). Two thirds of the subjects (65.5 per cent) were 50 years of age. The mean duration of admission was 5.88±6.41 hours. One third (35.3 per cent) died within an hour of admission.

The commonest causes of death were stroke 149 (52.8 per cent) and heart failure 103 (40.9 per cent). Intra-cerebral hemorrhage was the commonest type of stroke seen, 69 (52.3 per cent). Intracerebral hemorrhage (ICH) is a type of stroke caused by bleeding within the brain tissue itself – a life-threatening type of stroke. A stroke occurs when the brain is deprived of oxygen and blood supply. ICH is most commonly caused by hypertension or head trauma.

Another study titled “Sudden Cardiac Death: Clinical Perspectives from the University of Maiduguri Teaching Hospital ” and published in World Journal of Cardiovascular Diseases concluded: “Sudden cardiac death is common among our patients admitted with cardiovascular diseases. The most common etiology is ischemic cardiomyopathy, followed by peripartum cardiomyopathy. Most of the victims were young, and there were no optimum resuscitative measures.”

A systemic analysis of sudden natural deaths at Braithwaite Memorial Specialist Hospital, Port Harcourt, Rivers State, published in The Nigerian Health Journal concluded: “Cardiovascular system pathologies, especially hypertensive heart disease, remain the leading cause of sudden natural deaths in this study.”

The result of the study showed that of the 9,164 bodies received, 2,415 (26.4 per cent) were autopsied for varied reasons, out of which 249 (2.7 per cent) were sudden natural deaths in persons without known significant medical history. The Male: Female Ratio (MFR) was 2.2:1. The mean age was 39.7 years with a range of three weeks to 97 years. Peak age group was 30 to 39 years with 27.7 per cent.

The commonest causes of these deaths were cardiovascular system related, with 218 cases (87.5 per cent). It included hypertensive heart disease, myocardial infarction, stroke, cardiac rupture, and coronary atherosclerosis with thrombosis.Nigeria recently lost former Captain and Coach of the Super Eagles, Stephen Keshi, and former Eagles Coach, Shuaibu Amodu to SUD.

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