A qualitative study of alcohol risk perceptions among drinkers in Benue State, Nigeria

There is evidence in the scientific literature linking alcohol-related deaths and morbidities with excessive alcohol consumption, yet individuals are often undeterred by their experiences of negative alcohol-related outcomes. In seeking to understand this behavior, this exploratory qualitative study was undertaken among Benue State civil servants in Makurdi, Nigeria to explore their reasons for drinking, perception of alcohol risk and, how these shape their alcohol consumption behaviors. Utilizing a purposive and network/snowball sampling technique, twenty-nine self administered open ended questionnaires were administered and analyzed. Findings indicated that drinking was primarily undertaken for enhancement and coping motives. Also, drinkers had knowledge of, and had experienced some alcohol-related dangers such as fights, rape, injury, and driving under the influence of alcohol. However, their drinking motives were valued over and above these experiences of negative alcohol effects, thereby minimizing the perception of personal susceptibility to alcohol related risk. Problem drinking status, the availability of alternative substitutes to drinking and, drinking motives together determine alcohol risk perceptions and drinking behavior. Therefore, in order to fully understand drinking behavior, the influences of drinking motives, personal experiences, drinking status, availability of alcohol substitutes and, risk perceptions should be considered.Keywords: Alcohol risk perceptions, drinking motives, and hazardous drinkin

Patterns of substance use among internally displaced persons in Borno State, Nigeria

The activities of Boko Haram in the past eight years have forced over a million people to flee their homes. This has resulted in individuals living in  internally displaced people (IDP) camps and host communities, leading to crises such as psychological disorders and drug abuse. This study investigated patterns of drugs use among these IDPs in Borno State, Nigeria, using a mix method (qualitative, quantitative and observations)  approach. A total of 137 participants comprising of 135 (98.5%) males and 2 (1.5%) females (age range of 16-42 years) were purposively selected. Also, 77 (56.2%) participants were selected in Maiduguri and 60 (43.8%) in Bama. The WHO Youth Drug Survey Questionnaire (WHOYDSQ) was used for data collection. The quantitative data were analyzed using descriptive techniques; qualitative data were transcribed. The findings of objective 1 showed that a majority of the respondents who reported using rugs did so frequently, using them on > 20 days a month. The findings of Objective 2 indicate that the most commonly used drugs are tobacco product, sniffing or inhaled things to get high, sedatives and cannabis. Objective 3findings showed that friends and family were the major sources of introduction to drug use. Enjoyment, relief from psychological distress, and to be sociable, were the main reasons why IDPs take drugs, consistent with the findings of Objective 4. Objective 5 showed that there are presently no  organizations working in camps and host communities to tackle the problem of drug abuse. The study recommends using psychotherapy and psycho-education as the main interventions to control the serious problem of drug abuse among IDPs. Keywords: Drug Use, IDPs, Camp, Host Communit

In the mind of the predator: the possibility of psychological distress in the drone pilot community

In light of the increasing use of Remotely Piloted Aircraft (RPA), commonly known as drones, and the equally increasing prevalence of post-traumatic stress disorder (PTSD) among U.S. veterans of recent wars, this study investigated the possible effects of piloting a drone aircraft and PTSD. Using a simulated drone aircraft in a computer game, the results showed that participants who simulated a drone attack and viewed the post-drone attack video reported significantly higher distress than those who viewed only the post-drone attack video. Females also showed higher distress levels than males. These results suggest the potential risks of psychological trauma even among pilots who are apparently physically far removed from the battlefield

Ebola virus epidemiology, transmission, and evolution during seven months in Sierra Leone

The 2013-2015 Ebola virus disease (EVD) epidemic is caused by the Makona variant of Ebola virus (EBOV). Early in the epidemic, genome sequencing provided insights into virus evolution and transmission and offered important information for outbreak response. Here, we analyze sequences from 232 patients sampled over 7 months in Sierra Leone, along with 86 previously released genomes from earlier in the epidemic. We confirm sustained human-to-human transmission within Sierra Leone and find no evidence for import or export of EBOV across national borders after its initial introduction. Using high-depth replicate sequencing, we observe both host-to-host transmission and recurrent emergence of intrahost genetic variants. We trace the increasing impact of purifying selection in suppressing the accumulation of nonsynonymous mutations over time. Finally, we note changes in the mucin-like domain of EBOV glycoprotein that merit further investigation. These findings clarify the movement of EBOV within the region and describe viral evolution during prolonged human-to-human transmission

Lassa Fever in Post-Conflict Sierra Leone

Background: Lassa fever (LF), an often-fatal hemorrhagic disease caused by Lassa virus (LASV), is a major public health threat in West Africa. When the violent civil conflict in Sierra Leone (1991 to 2002) ended, an international consortium assisted in restoration of the LF program at Kenema Government Hospital (KGH) in an area with the world's highest incidence of the disease. Methodology/Principal Findings Clinical and laboratory records of patients presenting to the KGH Lassa Ward in the post-conflict period were organized electronically. Recombinant antigen-based LF immunoassays were used to assess LASV antigenemia and LASV-specific antibodies in patients who met criteria for suspected LF. KGH has been reestablished as a center for LF treatment and research, with over 500 suspected cases now presenting yearly. Higher case fatality rates (CFRs) in LF patients were observed compared to studies conducted prior to the civil conflict. Different criteria for defining LF stages and differences in sensitivity of assays likely account for these differences. The highest incidence of LF in Sierra Leone was observed during the dry season. LF cases were observed in ten of Sierra Leone's thirteen districts, with numerous cases from outside the traditional endemic zone. Deaths in patients presenting with LASV antigenemia were skewed towards individuals less than 29 years of age. Women self-reporting as pregnant were significantly overrepresented among LASV antigenemic patients. The CFR of ribavirin-treated patients presenting early in acute infection was lower than in untreated subjects. Conclusions/Significance: Lassa fever remains a major public health threat in Sierra Leone. Outreach activities should expand because LF may be more widespread in Sierra Leone than previously recognized. Enhanced case finding to ensure rapid diagnosis and treatment is imperative to reduce mortality. Even with ribavirin treatment, there was a high rate of fatalities underscoring the need to develop more effective and/or supplemental treatments for LF

Filovirus RefSeq Entries: Evaluation and Selection of Filovirus Type Variants, Type Sequences, and Names

Sequence determination of complete or coding-complete genomes of viruses is becoming common practice for supporting the work of epidemiologists, ecologists, virologists, and taxonomists. Sequencing duration and costs are rapidly decreasing, sequencing hardware is under modification for use by non-experts, and software is constantly being improved to simplify sequence data management and analysis. Thus, analysis of virus disease outbreaks on the molecular level is now feasible, including characterization of the evolution of individual virus populations in single patients over time. The increasing accumulation of sequencing data creates a management problem for the curators of commonly used sequence databases and an entry retrieval problem for end users. Therefore, utilizing the data to their fullest potential will require setting nomenclature and annotation standards for virus isolates and associated genomic sequences. The National Center for Biotechnology Information’s (NCBI’s) RefSeq is a non-redundant, curated database for reference (or type) nucleotide sequence records that supplies source data to numerous other databases. Building on recently proposed templates for filovirus variant naming [ ()////-], we report consensus decisions from a majority of past and currently active filovirus experts on the eight filovirus type variants and isolates to be represented in RefSeq, their final designations, and their associated sequences

Virus genomes reveal factors that spread and sustained the Ebola epidemic.

The 2013-2016 West African epidemic caused by the Ebola virus was of unprecedented magnitude, duration and impact. Here we reconstruct the dispersal, proliferation and decline of Ebola virus throughout the region by analysing 1,610 Ebola virus genomes, which represent over 5% of the known cases. We test the association of geography, climate and demography with viral movement among administrative regions, inferring a classic 'gravity' model, with intense dispersal between larger and closer populations. Despite attenuation of international dispersal after border closures, cross-border transmission had already sown the seeds for an international epidemic, rendering these measures ineffective at curbing the epidemic. We address why the epidemic did not spread into neighbouring countries, showing that these countries were susceptible to substantial outbreaks but at lower risk of introductions. Finally, we reveal that this large epidemic was a heterogeneous and spatially dissociated collection of transmission clusters of varying size, duration and connectivity. These insights will help to inform interventions in future epidemics

Behavioural and educational outcomes following extremely preterm birth : current controversies and future directions

As a consequence of improved survival rates for extremely preterm (EP; <28 weeks of gestation) births, there is a growing body of evidence detailing the impact of extreme prematurity on outcomes throughout childhood and adolescence. Historically, attention first focused on documenting rates of sensory impairments and severe neurodevelopmental disabilities. However, over recent years, there has been growing interest in the impact of EP birth on long term mental health and educational outcomes. In this chapter we review literature relating to the impact of EP birth on attention, social and emotional problems, psychiatric disorders and educational outcomes. We also outline current controversies in the field. In particular, we present emergent research exploring developmental trajectories to determine whether the sequelae associated with EP birth represent a developmental delay or persistent deficit, and we consider what approaches to intervention may be most fruitful in improving behavioural and educational outcomes in this population

Genome sequencing reveals Zika virus diversity and spread in the Americas

Although the recent Zika virus (ZIKV) epidemic in the Americas and its link to birth defects have attracted a great deal of attention, much remains unknown about ZIKV disease epidemiology and ZIKV evolution, in part owing to a lack of genomic data. Here we address this gap in knowledge by using multiple sequencing approaches to generate 110 ZIKV genomes from clinical and mosquito samples from 10 countries and territories, greatly expanding the observed viral genetic diversity from this outbreak. We analysed the timing and patterns of introductions into distinct geographic regions; our phylogenetic evidence suggests rapid expansion of the outbreak in Brazil and multiple introductions of outbreak strains into Puerto Rico, Honduras, Colombia, other Caribbean islands, and the continental United States. We find that ZIKV circulated undetected in multiple regions for many months before the first locally transmitted cases were confirmed, highlighting the importance of surveillance of viral infections. We identify mutations with possible functional implications for ZIKV biology and pathogenesis, as well as those that might be relevant to the effectiveness of diagnostic tests