Socio-demographic and clinical correlates of subjective quality of life among Nigerian outpatients with schizophrenia

This study aimed to measure the subjective quality of life (QOL) of Nigerian outpatients with schizophrenia and to examine its socio-demographic as well as clinical determinants. A total of 313 outpatients with schizophrenia participated in the study. Data were collected on socio-demographics, outpatient clinic attendance, perceived social support, perceived satisfaction with hospital care, medication adherence, illness severity and QOL. Multiple linear regression analysis was used to determine the amount of variance in the QOL domain scores explained by socio-demographic and clinical variables. Employment status, perceived social support, satisfaction with outpatient care, antipsychotic medication dose, Brief Psychiatric Rating Scale (BPRS) scores and medication adherence had significant relationships with all the QOL domains. Average monthly allowance and outpatient clinic default were significantly associated with all QOL domains except social relationship. Socio-demographic and clinical factors explained only a modest part (29.4%) of the variance in the QOL scores. It is likely that unmeasured ‘internalised’ determinants contribute in a much larger sense to the variation in subjective QOL.     

Suicide risk among adults with epilepsy in Kaduna,Nigeria

Objective

There is paucity of information on epilepsy and suicide in Nigeria. The objective of this study therefore was to assess the prevalence and determinants of suicide risk among adults with epilepsy (AWE) in Kaduna, Nigeria.

Method

We administered the suicidality module of the Mini International Neuropsychiatric Interview, the three-item Oslo Social Support Scale and the Hospital Anxiety and Depression Scale to 170 consecutive AWE attending the outpatient clinic of Federal Neuropsychiatric Hospital, Kaduna, between January and June 2011 to determine the prevalence of suicide risk, the level of social support and the psychological symptoms, respectively. We also recorded the sociodemographic and clinical characteristics of the subjects.

Results

There are 99 males and 71 females. The subject’s mean age was 28.7±12.1 years. The prevalence of suicide risk was 20.0%. Short seizure-free periods (χ²= 4.658, P= .031), previous suicide attempts (χ²= 12.216, P< .001), anxiety symptoms (χ²= 5.075, P= .024) and depressive symptoms (χ²= 5.093, P= .016) were significantly associated with suicidal tendencies. However, after a logistic regression analysis, none of the above variables predicted suicide risk.

Conclusion

Suicide risk is common among AWE. Poor seizure control, previous suicidal attempts and emotional distress are associated factors.     

Demographic factors related to male involvement in reproductive health care services in Nigeria

Objectives Men play a well-recognised role in reproductive health care. They are pertinent to the achievement of female reproductive health. This study assessed male involvement in reproductive health issues in Nigeria and identified relevant factors.

Methods This was a cross-sectional study of 1530 married men aged 25 to 45 years selected by a multi-stage sampling procedure. Bivariate and logistic regression analyses were performed, with male involvement in reproductive health care as the dependent variable.

Results The mean age of the respondents was 38.64 (± 5 SD) years. Although 65.9% of the respondents discussed reproductive health issues with their wife, only 39.6% accompanied them during visits to clinics. Less than one-third (30.9%) of the respondents were involved in reproductive health care. Male involvement in reproductive health care is predicted by having completed at least secondary education (OR 4.337; p = 0.007), having one or no living child (OR 2.002; p = 0.001), and approval of family planning (OR 2.637; p = 0.000).

Conclusions Male involvement in reproductive health care is predicted by level of education, number of living children and approval of family planning. There is a need to focus on the identified factors in order to strengthen and increase male participation in reproductive health care.     

A systematic review of trends and patterns of congenital heart disease in children in Nigeria from 1964–2015

BackgroundCongenital heart diseases cause significant childhood morbidity and mortality. Several restricted studies have been conducted on the epidemiology in Nigeria. No truly nationwide data on patterns of congenital heart disease exists.ObjectivesTo determine the patterns of congenital heart disease in children in Nigeria and examine trends in the occurrence of individual defects across 5 decades.MethodWe searched PubMed database, Google scholar, TRIP database, World Health Organisation libraries and reference lists of selected articles for studies on patterns of congenital heart disease among children in Nigeria between 1964 and 2015. Two researchers reviewed the papers independently and extracted the data. Seventeen studies were selected that included 2,953 children with congenital heart disease.ResultsThe commonest congenital heart diseases in Nigeria are ventricular septal defect (40.6%), patent ductus arteriosus (18.4%), atrial septal defect (11.3%) and tetralogy of Fallot (11.8%). There has been a 6% increase in the burden of VSD in every decade for the 5 decades studied and a decline in the occurrence of pulmonary stenosis. Studies conducted in Northern Nigeria demonstrated higher proportions of atrial septal defects than patent ductus arteriosus.ConclusionsVentricular septal defects are the commonest congenital heart diseases in Nigeria with a rising burden.     

Rotavirus diarrhoea hospitalizations among children under 5 years of age in Nigeria, 2011–2016

BackgroundThe high burden of rotavirus acute gastroenteritis (AGE) is well documented among children under 5 years of age, with the majority of mortality occurring in developing countries. Nigeria ranked second worldwide in the number of rotavirus deaths in 2013. As Nigeria plans to introduce rotavirus vaccine soon, a pre-vaccine documentation of rotavirus disease burden is necessary to determine vaccine impact.MethodsRoutine rotavirus surveillance was conducted during 2011–2016 in 3 sentinel sites in Nigeria using the standard WHO protocol. Children under 5 years of age hospitalized for acute gastroenteritis were enrolled and demographic, clinical and outcome data were collected. A stool sample was subsequently obtained and tested for human rotavirus antigen using the Enzyme-linked immunosorbent assay (ELISA).Results2694 children with acute gastroenteritis were enrolled during January 2011 to December 2016; of these, 1242 (46%) tested positive for rotavirus. Among the rotavirus positive cases, 66% and 94% were younger than 12 months and 24 months respectively. Marked peaks in rotavirus positivity were seen in January of each year. Vomiting, and use of oral and intravenous fluids occurred more often in rotavirus positive cases as compared to rotavirus negative cases.ConclusionThe high prevalence of rotavirus disease highlights the need for urgent introduction of rotavirus vaccine in Nigeria. Additionally, this study provides pre-vaccine introduction disease-burden data that will serve as a baseline for rotavirus vaccine impact-assessment once vaccine has been introduced in the national immunization program.     

Bradypacing: indications and management challenges in Nigeria

Background: Permanent pacemaker implantation is a life-saving procedure that is performed worldwide. There is paucity of reports on pacemaker surgery in Nigeria. The aims of the study were to determine the indications for pacemaker insertion, the demographic distribution of the patients requiring it, the electrocardiographic (ECG) changes, and the management challenges in Nigeria. MATERIALS AND METHOD: One hundred consecutive patients who had pacemaker insertion done by our team from 1999 were included in the study. The patients' biodata, indications for pacemaker insertion, ECG changes, and the treatment profile were recorded. RESULTS: There was female preponderance (93.0%) among the patients studied. Third-degree heart block was the indication in 86.0% of the patients and most patients did well with single lead ventricular pacing which is generally cheaper than the dual chamber pacing. CONCLUSION: The majority of bradyarrhythmia patients in this environment can be maintained on single lead ventricular pacemaker.     

Serotype of Nigerian rotavirus strains

Summary Three hundred and fourteen stool samples collected from children >5 years between December 1993 and August 1995 were analysed by PAGE, ELISA, PCR and Dot-blot hybridization technique for electropherotype and serotype distribution of rotavirus infection among Nigerian paediatric patients. 14.3% of the children were positive for rotavirus antigen. Children aged 6–9 months were most often infected, accounting for 35.6% of all positive samples. 91.1% of rotavirus-positive samples could be serotyped. Serotypes G2, G4 and G8 were not detected. Serotype G3 predominated (62.5%) in southern Nigeria, while mixed infection specificity was more widespread (63.6%) in northern Nigeria. The presence of some untypeable samples may indicate serotypes which the serotype-specific primers and cDNA probes used could not detect. Electropherotypes of 26 (57.7%) of the positive samples were determined. Two and 3 migration patterns were observed among the short and long-pattern electropherotypes, respectively. Implications for vaccine development and utilization in the country are discussed.     

Polymorphisms in Plasmodium falciparum dhfr and dhps genes and age related in vivo sulfadoxine-pyrimethamine resistance in malaria-infected patients from Nigeria

Mutations in Plasmodium falciparum dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) genes have been used as means to predict treatment failure to sulfadoxine-pyrimethamine (SP) and for monitoring/surveillance of resistance to the drug in many areas where malaria is endemic. However, patients responses to treatment are significantly dependent on factors like host immunity profile of treated patients. In order to investigate the relationship between molecular markers of SP resistance, host immunity and clinical outcome, the association between pre-treatment dhfr and dhps genotypes, age and treatment outcomes was evaluated in 109 children treated with SP for acute uncomplicated malaria in Ibadan, Nigeria. Seventy-three percent of the children were cured with the drug, while 27% failed treatment after 28 days of follow-up. All children infected with parasites harboring less than two dhfr/dhps mutations were cured with SP. The dhfr triple (Asn-108/Ile-51/Arg-59) mutants or the dhps double mutants (Gly-437/Glu-540) were independently associated with SP treatment failure in children aged less than 5 years, but not in older children. The dhfr and dhps quintuple mutant (dhfr triple mutant+dhps double mutant) was the genotype most strongly associated with SP treatment failure (OR=24.72, 95%CI=8.24-74.15) in both younger and older children.     

Self-assessed health as predictor of objective health status among rural aged in Nigeria

Structured interviews of 112 old males and females in three rural locations in Nigeria examine the relationship between self-assessed health and four objective health indicators. Results show that although almost all of the respondents describe their health as better or much better than that of their peers, other health indicators reveal evidence of a generally poor health status. There was no significant association between self-assessed health and three out of the four objective health indicators. The best predictor of both objective and subjective health status was the degree of stress experienced by the respondents in the six months preceding the survey. Discussions examine possible reasons for the finding and pay particular attention to those factors which may encourage the overestimation of good health and underestimation of objective health failings among rural elderly in Nigeria.