• Hypertension, diabetes, obesity are silent killers of organ
• More than 90% of women in Ondo are acutely obese while 75% of population hypertensive
• Untreated epiglottitis in childhood, dirty environment associated with rising cases
• Survival rate in renal patients with HIV is low
Tayo Akindele, a 44-year-old, mother of seven children- five girls and two boys. Tayo is a petty trader at Ondo market. Tayo stands at about 5.5 feet and weights 92 kilogrammes.
Tayo is obese. She did not know she was also hypertensive until she was hospitalized after a bout of fever, dizziness and chronic fatigue.
Tayo and more than 90 per cent of women in Akure South and Ondo West Local Government Areas (LGAs) of Ondo State are obese and about 40 per cent of men and women in the State are hypertensive, says the Medical Director of Kidney Care Centre located at the Ondo State Medical Village, Dr. Akinwunmi Bodewa.
Bodewa, who is a consultant nephrologist by training told journalists: “We did a survey among market women and found that in Ondo State among our adults, hypertension is highly prevalence. About 40 percent are hypertensive and 35 percent have pre-hypertension. If you merged the two it is like 765 percent and it is scary. Now you find out more than 90 percent of our women have obesity from a study we did in Akure South and Ondo West as at 2014/2015. These are some of the biggest local government in Ondo state. And we pooled thousands of adults together. That was the data worked on. We find out that 75 percent of them already have hypertension related figures and more than 90 percent have diabetes. A few of them like 15 percent have abnormal level of protein in their urine and that tells us that they may be working around the streets with kidney diseases and you know it is not written on the face.”
On early signs of kidney disease, the nephrologist said: “When you go to sleep as an adult you are not expected to wake up more than once no matter how much water you have taken. If you wake up once, it is okay but if it is more than that, it could be that there is a problem with the kidney, heart, and prostate. We now have to find out why? We know that some people are on drugs, ordinarily if you are not on drugs that will make you urinate and you wake up twice, there may be something wrong either with your heart or kidney or prostate. Such a person needs to come and see a doctor especially a nephrologist because among the three things that can cause it, the kidney ranks number one.”
What are the causes of kidney disease in Nigeria? Bodewa said: “Now to prevent or minimise effect of chronic kidney disease, you have to know the causes. In our environment the number one cause is hypertension followed by inflammation of the kidneys, diabetes. Elsewhere in the world, it is diabetes because of changing lifestyle. If I re-analysed our data in 2015 you may find out that diabetes is number one or two in Nigeria. From this centre, we see more of diabetes and some are already placed on dialysis. If I know that hypertension can cause kidney disease then I need to go for an annual checkup, especially if any of my family has hypertension because diabetes, high blood pressure and obesity, they are silent killers of the kidney.”
What are the symptoms? “The person won’t know until more than 50 percent of the kidneys are destroyed. Then it will begin to manifest until then, the person is working about, going to work or school and enjoying his or her life. Suddenly you just find that the person will begin to vomit with swollen face in the morning, the legs will be swollen, and he or she is getting tired unusually. The person’s performance level will reduce. If it is a female; she can no longer pound yam, her menses begins to fail, she thinks that she is pregnant, she is pale and tired. The symptoms look like pregnancy but it is not. She will be feeling that a child is growing in her womb but not. These are some of the signs but before these signs, it is already almost irreversible. So to prevent it, that is our goal. To prevent it anybody that has hypertension must come for regular clinic, take drugs appropriately and avoid self-medications. Need to see a cardiologist, nephrologist and other relevant professionals,” Bodewa explained.
The Kidney Care Centre, the Mother and Child Hospital, the Gani Fawehimi Diagnostic Centre and the Trauma and Surgical Centre are all situated within the Ondo State Medical Village.
What is the Kidney Care Centre doing to address the situation? Bodewa said: “That is why we are going out counselling, screening and educating about kidney disease prevention and advocacy, community awareness on the development of chronic kidney disease. We have conducted more than 3,000 sessions so far. We go at the rate of seven to 10 sessions per day and between 210 to 300 sessions per month and it is quiet challenging. Here we combine the efforts of three to four hospitals together. Most centres do like 60 a month. It is quiet a busy centre.
We have six geopolitical zones in Ondo, three senatorial districts and local government. What we have done is to have a map; we have covered Ondo East and bring data from specific localities. When we go out we make a lot of noise to draw people’s attention to our course. We are planning to visit Akoko, Igbakada, and Ilajesiodu.
“We also take care of Human Immuno-deficiency Virus (HIV) and hepatitis; we have dedicated machines for HIV and hepatitis patients. HIV is one of the causes of kidney disease and when it does, the survival rate of the patients is low. Kidney disease is not a death sentence; a patient with the disorder can recover.”
Does this Centre conduct research? Bodewa said: “This is a research centre. We are combining our primary healthcare with third level of care, which is research. We have a standing research team called the DELVER. They analyse our figures/data and try to find out why it is happening like that. We are partnering with Orange FM to educate the masses once a month.”
What is the role of diet in all in obesity, diabetes, hypertension and kidney disease? He explained: “There is an ongoing study looking at our foods. In Nigeria we take a lot of palm oil; we saw that in our environment palm oil has a lot of fats. We are doing this to find out if our food is really safe. We have gone out to look at our children and our parents. Like our women are fat now. Why are they fat? Is it because they are taking a lot of fatty foods? When we do such a research we will be able to now tell the people, it is better you reduce the oil you are taking and go for soya oil; we can sound more convincing to them. We have to look into their blood and urine.”
Bodewa added: “If you are diabetic, you must see an endocrinologist, not a general practitioner that will manage a diabetic and also a nephrologist to avoid kidney disease. From day one a diabetic patient should see a nephrologist to prevent rapid progression of end stage of renal disease.”
The nephrologist said epiglottitis (Belu-belu in Yoruba) in childhood causes inflammation of the kidney called glomerulonephritis.
Glomerulonephritis is acute inflammation of the kidney, typically caused by an immune response.
Glomerulonephritis is a type of kidney disease in which the part of human kidneys that helps filter waste and fluids from the blood is damaged. The following may increase risk of this condition: blood or lymphatic system disorders; exposure to hydrocarbon solvents; history of cancer; and infections such as strep infections, viruses, heart infections, or abscesses.
He said epiglottitis is characterized by inflamed tissue in one’s epiglottis. It is a potentially life-threatening illness.
The epiglottis is at the base of the tongue. It is made up of mostly cartilage. It helps prevent food from entering one’s windpipe. The tissue that makes up the epiglottis can swell and block one’s airway. This requires immediate medical attention.
A bacterial infection is the most common cause of epiglottitis. Bacteria can enter your body when you breathe in. They can then infect your epiglottis. The most common strain of bacteria that causes this condition is Haemophilus influenzae type b, also known as Hib. You can catch Hib by inhaling the germs spread when an infected person coughs, sneezes, or blows their nose.