USAfrica: Why “Death after a brief illness” is common in Nigeria. By Clement Anyiwo, MD

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Special to USAfricaonline.com – USAfrica magazine, Houston

By CLEMENT E. ANYIWO, MD and Professor of Medical Microbiology and Immunology, Specializing in Infectious Diseases. Former Dean/Provost of the Nnamdi Azikiwe University, College of Health Sciences, Nnewi, Nigeria, and was President, Federation of African Immunological Societies. This is his third commentary as a contributing Editor of USAfricaonline.com and USAfrica magazine.

Obituaries indicating “Death after a brief illness” are common in the Nigerian media, billboards and in posters. I witnessed this during my recent visit to Nigeria. Dr. Sylvester Ikhisemojie, who wrote an article titled “Death after brief illness” calls it Nigerian disease. 

Conditions with brief manifestations before death include:

1. Drug overdose. 

2. Poison (cyanide)

3. Suffocation from smoke or gas

4.Fatal motor accident

5. Electric shock

6. Gun shot

7. Post-partum hemorrhage (bleeding after giving birth)

8. Complicated surgery. Patient passes on operation table.

9. A fatal fall

Some” Brief illnesses” used as euphemism for diseases that the family considers a taboo and want to keep secret are:

1. Cancer (breast, cervical, colorectal, prostrate etc.)

2. AIDS

3. Tuberculosis 

4. Pneumonia

5. Sepsis complicating as aseptic shock- a very serious medical condition that can lead to heart failure, stroke and death

6. Sexually Transmissible Diseases (syphilis, gonorrhea etc.)

7. Cardiac arrest (heart attack)

8. Diabetic coma

9. Chronic kidney failure due to uncontrolled diabetes and hypertension.

10.COVID-19 ( A severe acute respiratory syndrome caused by a coronavirus)

At times we hear news that somebody died of prostate cancer when he actually died of AIDS, using prostate cancer, which is less stigmatizing, as euphemism for AIDS.

We need not hide our medical problems because according to Joyce Meyer- a famous evangelist-“Anything buried alive will never die”. 

Diseases incubate in the human body. Some self-limiting (flu, common cold etc.) But they can get complicated when the immune system gets compromised and then cause disease. Some illnesses incubate for a long time without causing diseases. However, some incubate and later give symptoms but not all the time. Examples of such are Tuberculosis, Diabetes, AIDS and Prostrate hypertrophy ( enlargement) particularly at terminal stages. Some illnesses disguise their symptoms and warning signs and therefore often go undetected or unnoticed. If too much time passes without treating the disease it may cause serious complications and sometimes death. Chances are high that people may be living with such dangerous diseases without being aware. It is therefore mandatory to have regular medical checkups so that unexplained or disguised symptoms can be diagnosed early and possibly save lives. This brings me to what we call “silent killers” and “silent carriers”.

The first “culprit” in the list of silent killers is high blood pressure. There is a particular one called essential (primary) hypertension. Cause unknown. According to Centers of Disease Control (CDC) of the United States about 70 million of American adults have high blood pressure. Diabetes is another. The International Diabetic Federation has estimated that some 387 million people worldwide have diabetes and 1 in 4 do not know they have it. To add salt to injury diabetes may be incubating cancer because cancer cells feed on sugar and grow bigger and bigger. Colon cancer is the most common cancer in the United States. Non-cancerous polyp progress to carcinoma when untreated or ignored. No early warning signs. However, it is advisable to go for a simple checkup should one notices diarrhea, bloody stool, unusual gas, abdominal pain, vomiting and nausea. Cervical cancer is the fourth most common cancer in women, especially in developing countries according to World Health Organization. Cancer occurs in the cells of the cervix and usually causes no symptoms during early stages. If not diagnosed on time it may spread to the bladder, liver, intestines, and the lungs. At later stages one may experience pelvic pain and vaginal bleeding what is often confused with menses. Another example is hepatitis which is inflammation of the liver caused by hepatitis viruses. Different hepatotropic viruses (viruses that have predilection to the liver) cause different types of the disease, including hepatitis A B C D E. A and E are caused by eating and drinking contaminated food and water. Hepatitis B, C and D are contracted through transfusion of contaminated blood and blood products, sexual contact and during childbirth. Virus can be in the body for many years without causing any symptoms. However, to be on the safe side, when one notices low-grade fever, muscle ache, jaundice, vomiting and diarrhea seek a checkup.

“Silent carriers”, according to American Public Health Association, are asymptomatic carriers infected but not affected and can transmit infection to contacts. This is a potential source of infection. These carriers can harbor HIV and hepatitis C and certain sexually transmitted infections such as chlamydia and genital herpes to mention a few. According to well documented reports from research at least some 12 million HIV silent carriers roam the world!