Hidden heart disease in Nigeria is drawing concern as Dr Chinelo Chioma Madekwe urges earlier screening and better care for infection-related heart complications

Dr Chinelo Chioma Madekwe, a Nigerian physician and internal medicine resident at SUNY Upstate Medical University in Syracuse, New York, has urged Nigeria to strengthen the detection and treatment of heart disease linked to infectious illnesses, warning that complications associated with malaria, HIV, tuberculosis and other infections may remain unnoticed until patients develop serious cardiac problems.

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In an article published on 26 October 2026, Dr Madekwe called for closer cooperation between infectious disease specialists and cardiologists, wider access to appropriate heart investigations and a national registry to help Nigeria understand the scale of the problem.

The appeal brings renewed attention to an often overlooked aspect of public health: surviving an infection does not always mean escaping its consequences.

For some patients, the illness that initially appeared manageable can be followed by damage to the heart muscle, its valves or the protective sac surrounding the organ.

“Nigeria’s infections are quietly breaking Nigerian hearts,” Dr Madekwe wrote, capturing the central concern behind her call for a more coordinated approach to treatment.

Nigeria’s substantial infectious disease burden makes the issue particularly important. The World Health Organization’s World Malaria Report 2024 estimated that the country recorded approximately 68.1 million malaria cases in 2023, accounting for about 26 per cent of the global total.

The figures underline the scale of the challenge facing a health system already working to address a growing range of cardiovascular conditions.

Evidence also suggests that malaria can affect more than the blood and brain. A systematic review published in 2021 examined 43 studies of cardiovascular complications among people with symptomatic malaria.

Among adults included in the clinical studies, the researchers estimated that 7 per cent experienced a cardiovascular complication, although the findings varied across studies and populations.

Reported complications included myocarditis, which is inflammation of the heart muscle, and acute coronary syndromes.

The researchers cautioned that further investigation was needed to clarify the frequency and mechanisms of these complications.

The findings do not mean that every malaria infection causes heart damage. They do, however, support closer clinical attention when patients with severe malaria develop symptoms or signs suggesting cardiovascular involvement.

HIV presents another important dimension of the problem. Although antiretroviral treatment has substantially improved the prospects of people living with HIV, cardiovascular health remains an important part of long-term care.

A study involving 200 adults attending the HIV clinic at Jos University Teaching Hospital in north-central Nigeria found that 84 participants, or 42 per cent, had cardiac abnormalities identified through clinical assessment and echocardiography.

Most participants were receiving antiretroviral treatment.

The researchers identified abnormalities including impaired heart-muscle function, changes in the heart’s filling capacity and pericardial disease.

The study was hospital-based and cannot establish the prevalence of cardiac disease among all Nigerians living with HIV, but it illustrates why symptoms affecting the heart deserve attention alongside routine infection management.

Tuberculosis can also reach the heart, particularly the pericardium, the thin sac surrounding the organ. Inflammation and fluid accumulation can interfere with normal cardiac function, while prolonged disease may lead to constriction that prevents the heart from filling properly.

The Investigation of the Management of Pericarditis in Africa registry, which included patients treated in Nigeria, Cameroon and South Africa, enrolled 185 people with tuberculous pericarditis in 2004.

Forty per cent had clinical features of HIV infection, highlighting the overlap between two major infectious diseases in the region.

Although the registry reflects an earlier period and should not be treated as a measure of present-day prevalence, its findings remain relevant to understanding the clinical complexity of tuberculosis-related heart disease.

The COVID-19 pandemic offered a more recent reminder that infections can affect several organs at once.

A preliminary report examining 10 patients with COVID-19 and cardiac complications across three centres in Lagos documented new-onset heart failure in six patients.

Other reported presentations included myocarditis, probable pulmonary embolism and stress cardiomyopathy.

The small study was not designed to measure how frequently these complications occur among all people with COVID-19.

Its findings nevertheless demonstrated the range of cardiac problems that can accompany a serious viral illness, including in patients without extensive pneumonia.

Another preventable condition begins with a seemingly ordinary childhood illness. Rheumatic heart disease develops when the body’s immune response to a group A streptococcal infection damages the heart valves, often following untreated or inadequately treated strep throat.

The World Health Organization identifies rheumatic heart disease as a major cause of avoidable illness and disability, particularly in low- and middle-income countries.

Prompt diagnosis and appropriate antibiotic treatment of confirmed streptococcal infections can help prevent acute rheumatic fever and its potentially lasting effects on the heart.

For children who develop established valve damage, however, treatment can become considerably more complex. Some patients require long-term medical supervision or specialist procedures, placing additional pressure on families and already stretched health services.

These conditions illustrate why infection-related heart disease should not be viewed in isolation from Nigeria’s wider cardiovascular challenges.

Hypertension, diabetes and other non-communicable conditions are also contributing to the demand for cardiac care, making it essential to build services capable of addressing both infectious and chronic causes of illness.

The availability of specialists remains a significant concern. The Nigerian Cardiac Society has been cited in recent reporting as estimating that about 400 cardiologists serve a population exceeding 220 million people.

The uneven distribution of specialists, limited diagnostic capacity and the cost of treatment can make timely assessment difficult for patients outside major urban centres.

For households paying directly for healthcare, the financial consequences can be particularly severe when a condition is detected only after it has progressed.

Patients may require repeated consultations, investigations, prolonged medication or surgery, depending on the nature and severity of the damage.

Dr Madekwe’s proposed response centres on bringing the relevant services closer together.

She advocates considering electrocardiography and, where clinically indicated and available, echocardiography for patients with severe malaria, advanced HIV or tuberculosis when cardiac involvement is suspected.

An electrocardiogram records the heart’s electrical activity, while an echocardiogram uses ultrasound to assess its structure and function.

Neither investigation is necessary for every uncomplicated infection, and decisions should be guided by clinical assessment, available resources and established medical protocols.

The physician also argues that HIV services should pay greater attention to cardiovascular health, rather than concentrating exclusively on viral suppression.

Better coordination between HIV clinics, general medical services and cardiology teams could help identify patients who need further assessment before complications become advanced.

Training is another priority. Dr Madekwe wants Nigerian teaching hospitals to develop programmes that connect infectious disease medicine with cardiovascular care, drawing on collaboration with specialists and researchers in the diaspora.

Her own professional journey gives the proposal a personal dimension. Raised in Abuja, Dr Madekwe pursued medical education in Vinnytsia, Ukraine, before Russia’s full-scale invasion disrupted her studies and forced her to leave the country with other international students.

Returning to Nigeria created an unexpected interruption to the path she had planned. The experience also shaped her perspective on the gaps in care facing patients whose infectious illnesses later develop into serious cardiac problems.

She subsequently continued her medical training in the United States, where her research has focused on the cardiovascular effects of infectious diseases, including malaria, HIV and COVID-19.

Her work has also examined sex-based differences in cardiovascular outcomes.

The combination of clinical training and research has informed her argument that Nigeria needs a more deliberate way of identifying, recording and treating infection-related cardiac complications.

A national registry, she argues, would help policymakers and researchers establish the scale of the problem, identify gaps in care and determine where limited resources could have the greatest impact.

Such a registry would require clear diagnostic criteria, reliable reporting from hospitals and sufficient investment in data collection.

Screening programmes would also need to be designed carefully so that additional testing reaches patients most likely to benefit without placing unnecessary demands on facilities that already face shortages.

The wider policy challenge is therefore one of implementation as much as awareness.

Early detection can improve the chances of timely treatment, but it must be supported by affordable investigations, access to appropriate medicines, referral pathways and specialist care when necessary.

For patients and families, the message is equally practical. Persistent or worsening breathlessness, unexplained swelling of the legs, chest discomfort, fainting or a racing heartbeat following an illness should prompt medical assessment.

Such symptoms can have several causes, and their presence does not automatically mean that an infection has damaged the heart.

Severe breathlessness, chest pain or collapse requires urgent medical attention.

People recovering from malaria, tuberculosis, COVID-19 or other infections should follow their clinicians’ advice and seek reassessment if concerning symptoms develop.

Nigeria has made important gains in the prevention and treatment of infectious diseases, but the consequences of illness can extend beyond the initial infection.

Recognising that connection offers an opportunity to strengthen existing services rather than create an entirely separate system of care.

Dr Madekwe’s central argument is that protecting patients must include attention to the health of the heart, both during serious infections and in the months that follow.

Turning that principle into practice will require stronger evidence, coordinated medical teams and sustained investment in accessible healthcare.

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The task is demanding, but the potential benefit is clear: fewer patients reaching hospitals only after preventable cardiac damage has become difficult and costly to treat.

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Ogun gas emissions have reportedly led to over 300 hospitalisations since April, raising concerns over school safety and the unresolved source

More than 300 students and teachers have reportedly received hospital treatment following recurring incidents involving an unusual gaseous odour in Ogun State between April and October 2026.

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The incidents, concentrated around Ijebu-Ode and neighbouring communities, have repeatedly disrupted school activities, with students reportedly experiencing breathing difficulties, weakness, vomiting and fainting.

Although the Ogun State Government previously linked the incidents to underground geological activity and reported detecting methane in affected locations, the precise source of the recurring emissions remains unresolved.

The latest episode, reported on October 21, affected schools across Ijebu-Ode, Ijebu-Igbo and Ago-Iwoye, renewing concerns about the safety of pupils, teachers and residents.

Here is a timeline of the reported incidents and the response from authorities.

April 1: First Reported Incident

The first major incident occurred on April 1 at Our Lady of Apostles Secondary School in Epe Garage, Ijebu-Ode.

According to The PUNCH, at least 30 students and one teacher were taken to hospital after an unusual gaseous substance reportedly spread across the school shortly after morning assembly.

Some students reportedly collapsed, vomited or experienced difficulty breathing.

They were taken to the General Hospital in Ijebu-Ode for treatment.

At the time, the Commissioner for Environment, Ola Oresanya, said the substance responsible had not been conclusively identified.

Initial concerns included the possibility of fumes from a school laboratory or another nearby source.

On April 2, the state government ordered the school to close temporarily and directed security agencies to investigate.

Governor Dapo Abiodun also ordered the establishment of a situation room at the General Hospital, Ijebu-Ode, to coordinate the provision of free treatment for affected students and residents.

Reports indicated that those hospitalised were responding to treatment, with no deaths recorded during the incident.

May 15: Second Incident Affects More Than 100 People

A second major episode was reported on May 15, when more than 100 students and teachers across several schools in Ijebu-Ode were reportedly affected.

The schools included Anglican Girls Grammar School in Obalende and Our Lady of Apostles Secondary School in Epe Garage.

Witnesses described students complaining of stomach pain, weakness and breathing difficulties, with some collapsing and requiring assistance to reach medical facilities.

The growing number of affected people prompted renewed questions about the source of the emissions and whether the initial response had adequately addressed the danger.

The state government subsequently announced that air-quality monitoring equipment had detected elevated methane concentrations in parts of Ijebu-Ode.

Officials reported peak readings of approximately 13,500 parts per million in surrounding locations.

The government said the readings were below the lower explosive limit but still required environmental investigation.

However, a reading below that limit does not automatically establish that an atmosphere is safe to breathe, particularly where oxygen displacement or other hazards may be present.

Authorities also announced a multi-agency assessment involving environmental regulators, emergency responders and technical experts.

On May 17, the Commissioner for Health, Tomi Coker, said all patients admitted to the State Hospital in Ijebu-Ode following the incident had been discharged.

Coker explained that methane could displace oxygen and contribute to symptoms such as fatigue, a rapid heartbeat and breathing difficulties, depending on exposure conditions.

The government also outlined plans to strengthen emergency medical support in the area, including deploying ambulance teams and training teachers and interested parents to act as community first responders.

June 3: Third Incident Sends 69 Students to Hospital

Another episode occurred on June 3 at Our Lady of Apostles Secondary School, where students reportedly became unwell after noticing an unusual odour.

The PUNCH reported that 69 students were hospitalised following the incident.

Coker later confirmed that all 69 students had been discharged after receiving medical attention.

Most reportedly left hospital on June 3, while the remaining seven, who stayed overnight, were discharged the following day after their conditions improved.

The incident was reported as the third major occurrence in the area within approximately two months, intensifying anxiety among parents, teachers and residents.

Oresanya said government-installed gas analysers had detected methane in affected locations.

Reports identified several schools affected by or linked to the wider series of incidents, including Our Lady of the Apostles Secondary School, Anglican Girls Grammar School, Titilayo Agbaje Comprehensive High School in Imosan, Ifesowapo Comprehensive High School in Imosan and St Anthony Grammar School in the Ijebu-Imushin area.

The state government also announced plans for the temporary relocation of students from an affected school while investigations continued.

By June, officials had put forward a possible geological explanation, suggesting that underground gases could be escaping through fractures associated with geological and tectonic fault lines.

The government ruled out sabotage and gas pipeline leaks as explanations for the earlier incidents.

However, those assurances did not resolve concerns about why the emissions continued to recur.

October 21: Fresh Emissions Affect Three Communities

The latest reported episode occurred on October 21, with incidents recorded across parts of Ijebu-Ode, Ijebu-Igbo and Ago-Iwoye.

More than 100 students across several secondary schools were reportedly hospitalised after exposure to an offensive gaseous substance.

The affected schools included Anglican Girls Grammar School in Ijebu-Ode, Ijebu-Igbo Girls Grammar School and Itamerin Comprehensive High School in Ago-Iwoye, among others.

Students reportedly experienced shortness of breath, stomach discomfort and drowsiness.

Some fainted and were taken to hospitals, while others reportedly required oxygen to stabilise their condition.

Medical facilities receiving affected students included the State Hospital in Ijebu-Ode and the General Hospital in Ijebu-Igbo.

The incident also disrupted lessons, with some schools in Ago-Iwoye reportedly sending students home.

Concerns extended beyond school compounds when the chairman of Ijebu North Local Government Area reportedly detected the unusual odour at the council secretariat.

The development raised further questions about the geographical spread of the emissions and the potential risks to people outside the affected schools.

In response, the Ogun State Government said the situation was under control and that investigations were underway to determine the source and extent of the latest emissions.

Oresanya linked the episode to previous underground gas emissions reported in the Ijebu axis since April.

A team from the Nigerian Upstream Petroleum Regulatory Commission also joined the assessment.

However, reports published on October 21 did not establish a definitive cause for the latest incident.

The repeated episodes have raised questions about whether the incidents share a common source, why they continue to occur and what measures are needed to prevent further exposure.

In June, the state government attributed previous incidents to a possible natural geological process through which underground gases escape along fractures in the earth.

It also ruled out sabotage and pipeline leaks as explanations for those earlier episodes.

However, the underlying investigation had not produced a publicly confirmed, lasting explanation by the time of the latest reported incident.

TheCable reported on October 21 that the investigation initiated in June had remained incomplete as of September, citing information obtained after contacting the Commissioner for Environment.

The recurrence has therefore renewed calls for a conclusive scientific assessment, transparent communication of findings and effective protection for schools and nearby communities.

Key questions remain about whether the emissions originate from a shared underground source, what conditions trigger their appearance and how authorities can reliably detect and contain them before people are exposed.

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Until the source and risks are established, the safety of students, teachers and residents remains a central concern.