Prevalence and predictors of sub-optimal medication adherence among patients with severe mental illnesses in a tertiary psychiatric facility in Maiduguri, North-eastern Nigeria

Introduction: Sub-optimal adherence constitutes a significant impediment to the management of severe mental illnesses (SMIs) as it negatively impacts on the course of the illness and the treatment outcome. In this study, the levels of adherence, prevalence and the predictors of suboptimal adherence were assessed in a sub-Saharan African setting. Methods: Three hundred and seventy (370) respondents with diagnoses of schizophrenia, bipolar disorder or severe depression were randomly enrolled and interviewed at the out-patient department of the Federal Neuropsychiatric Hospital, Maiduguri in northeastern Nigeria. An anonymous sociodemographic questionnaire and a clinical proforma designed bythe authors, Oslo social support scale and the 8-item Morisky Medication Adherence Scale (MMAS-8) were used for data collection. Results: The prevalence of sub-optimal adherence was 55.7%. The independent predictors of sub-optimal adherence were; seeking for traditional/ spiritual treatment (Odds Ratio (O.R.) = 6.523, 95% C.I. = 3.773 - 11.279, P = < 0.001), male gender (O.R. = 3.307, 95% C.I. = 1.907 - 5.737, P = < 0.001), low levels of insight (O.R. = 1.753, 95 C.I. = 1.220 - 2.519, P = 0.002), and low social support levels (O.R. = 1.528, 95% C.I. = 1.097 - 2.129, P = 0.012). Conclusion: Based on the outcome of the study, we recommend the development of psycho-educational programmes on adherence and the active involvement of the relations and significant others in the management of patients with SMIs in sub-Saharan Africa.Keywords: Mental illnesses, Sub-optimal adherence, Maiduguri, Nigeri

Psychoactive substance use disorders among females in northern Nigeria: Findings of a five-year descriptive survey at the Federal Neuropsychiatric Hospital, Maiduguri

The aim of this study was to determine a five-year prevalence trend of substance use disorders and the modes of presentaton of female drug users in North-Eastern Nigeria. It was a retrospectve, cross sectonal study in which sociodemographic, clinical and drug-related data of 2,731 clients who were atended to, at the Federal Neuropsychiatric Hospital, Maiduguri over a fve year period were extracted from their clinical records. The overall prevalence of psychoactve substance use disorders among the female partcipants was 9.3% [n = 253] with rising rates from 8.2% in 2012 to 12.2% in 2016, and The prevalence trend shows a statstcally signifcant change (χ2 = 51.764, p = < 0.001). One hundred and sixty fve [65.2%, 95% C.I. = 45.81 - 79.45] met the ICD-10 diagnostc criteria for dependence. Codeine-containing cough syrup, 73 [28.8%, 95% C.I. = 22.18 - 42.27], and Tramadol, 41 [16.2%, 95% C.I. = 10.24 - 25.18] were the commonest substances of abuse. Most of them were either compelled by relatves, 103 [40.71, 95% C.I. = 29.46 - 53.17] or were accidentally found to be using drugs at presentaton, 58 [22.92, 95% C.I. = 15.75 - 28.93]. Based on these outcomes, the design and adaptaton of culturally appropriate and gender-specifc educatonal programmes and stgmareducton strategies, are recommended. Keywords: Psychoactve substance use, Females, North-Eastern Nigeri

The impact of comorbid clinical depression on the health-related quality of life of adults on highly active antiretroviral therapy in Maiduguri, northeastern Nigeria

Background: Globally, depression compromises the quality of life (QOL) of people suffering from it. We assessed the impact of comorbid depression on the health-related quality of life (HRQOL) of adults on highly active antiretroviral therapy (HAART) in northeastern Nigeria in this study. Materials and Methods: Three hundred and three adults on HAART were recruited for this study from the ART clinic of the University of Maiduguri Teaching Hospital in northeastern Nigeria. The depressive disorder module of the Composite international diagnostic interview (CIDI version 3.0) and the WHO quality of life instrument (WHOQOL-BREF) were used for the evaluation of depression and quality of life respectively. Results: The prevalence of depression in this study was 19.8%. The depressed respondents rated their HRQOL poorer than their nondepressed counterparts on the physical, psychological, social relationships and environmental domains as well as the global outcome, as shown by these statistically significant findings (T = 9.739, P = <0.001), (T = 8.972, P = <0.001), (T = 6.533, P = <0.001), (T = 8.913, P = <0.001), and (T = 10.018, P = <0.001), respectively. Female gender, CD4 counts <200/mm 3 and diagnosis of depression were significant predictors poor QOL. Conclusion: Depression has a negative impact on the QOL of the respondents. We therefore recommend incorporation of the routine screening of this important psychiatric comorbidity into the care of this vulnerable group in order to optimize patient care

Convergent validity of self‑administered addiction severity index in a sample of Nigerian patients in a residential treatment facility

Background: Substance use disorders present with multiple drug-related problems that need to be evaluated with a view to planning and administering holistic interventions that could potentially improve addiction treatment outcomes. Many valid instruments are available for assessing the problems that occur in addiction but most of them require some training and they take a lot of time to administer. This study validates a shorter self-administered version of the Addiction severity Index (ASI) against the Clinician-administered ASI with a view to cutting the time needed to administer the instrument. Methods: The study recruited 142 patients in a residential treatment center. Correlation coefficient and t-test were used to assess for the convergence of the two version. Results: The correlation coefficients ranged from 0.52 to 0.97 for the different domain of the ASI with higher endorsement of problems in the self-administered than clinician administered version in most domains. Conclusion: The self-administered ASI is a valid alternative to the clinician-administered ASI and it saves valuable time especially in resource-constrained settings

Prevalence, correlates and under-diagnosis of clinical depression among adults on highly active antiretroviral therapy in a Tertiary Health Institution in northeastern Nigeria

Clinical depression is a highly debilitating illness, which is often under-diagnosed and negatively impacts on the quality of life of its sufferers. When it co-exists with other medical conditions, its effect is even more incapacitating. Undiagnosed depression in the context of HIV infection leads to accelerated decline in CD4+ cell counts with concomitant increase in the viral load and poor adherence to the antiretroviral medications which lead to viral mutation and the evolution of resistant strains. This study examined the prevalence of depression, its correlates and the frequency of the diagnosis of the condition among HIV+ subjects on highly active antiretroviral therapy (HAART) by the internists and general physicians at the University of Maiduguri Teaching Hospital in Northeastern Nigeria. Three hundred and fifty representative samples of HIV+ adults on HAART were drawn from the Antiretroviral Therapy Clinic of the Institution. Diagnosis of depression was made using the International Classification of Diseases-10 criteria based on Composite International Diagnostic Interview generated data. Socio-demographic and clinical variables were also analyzed for their correlation with depression in the subjects. About 20% of the respondents were diagnosed with clinical depression and no diagnosis of the condition was hitherto entertained in all the respondents. The independent determinants of depression in the participants were: female gender [odds ratio (OR)=3.87 (95% confidence interval, CI: 2.089-7.183)], past history of psychiatric illness [OR=43.81 (95% CI: 9.731-197.30)] and family history of psychiatric illness in first-degree relatives of the subjects [OR=14.364 (95% CI=5.327- 38.729)]. Depression is a relatively common psychiatric condition among adults on HAART, there is therefore the need for routine screening of this condition among HIV+ subjects in order to optimize patient care and improve clinical outcomes

Prevalence, correlates and under-diagnosis of clinical depression among adults on highly active antiretroviral therapy in a Tertiary Health Institution in northeastern Nigeria

Clinical depression is a highly debilitating illness, which is often under-diagnosed and negatively impacts on the quality of life of its sufferers. When it co-exists with other medical conditions, its effect is even more incapacitating. Undiagnosed depression in the context of HIV infection leads to accelerated decline in CD4+ cell counts with concomitant increase in the viral load and poor adherence to the antiretroviral medications which lead to viral mutation and the evolution of resistant strains. This study examined the prevalence of depression, its correlates and the frequency of the diagnosis of the condition among HIV+ subjects on highly active antiretroviral therapy (HAART) by the internists and general physicians at the University of Maiduguri Teaching Hospital in Northeastern Nigeria. Three hundred and fifty representative samples of HIV+ adults on HAART were drawn from the Antiretroviral Therapy Clinic of the Institution. Diagnosis of depression was made using the International Classification of Diseases-10 criteria based on Composite International Diagnostic Interview generated data. Socio-demographic and clinical variables were also analyzed for their correlation with depression in the subjects. About 20% of the respondents were diagnosed with clinical depression and no diagnosis of the condition was hitherto entertained in all the respondents. The independent determinants of depression in the participants were: female gender [odds ratio (OR)=3.87 (95% confidence interval, CI: 2.089-7.183)], past history of psychiatric illness [OR=43.81 (95% CI: 9.731-197.30)] and family history of psychiatric illness in first-degree relatives of the subjects [OR=14.364 (95% CI=5.327- 38.729)]. Depression is a relatively common psychiatric condition among adults on HAART, there is therefore the need for routine screening of this condition among HIV+ subjects in order to optimize patient care and improve clinical outcomes

Personality traits as key determinants of COVID-19 vaccine uptake among healthcare workers in Nigeria

Background: The coronavirus disease 2019 (COVID-19) pandemic has posed a significant global challenge, necessitating the development and administration of vaccines to halt its spread. Nevertheless, there is limited information on the predictors, patterns, and personality variables influencing COVID-19 vaccine uptake among Nigerian health-care workers (HCWs). Aim: The study set to assess level of factors including personality factors that influence acceptance of the COVID-19 vaccines among.HCWs in Nigeria. Materials and Methods: From August 9 to October 11, 2021, a web-based, cross-sectional survey was conducted on 300 HCWs in Nigeria, aged 19 and above, with social media access and English language proficiency. Descriptive statistics, Chi-square, and binary logistic regression were used to analyse the data on the SPSS version 20. Results: The findings revealed that while 64% of those who participated in the study received the first dosage of the COVID-19 vaccine, only 48.3% returned for the second dose. The impression of heightened susceptibility to contracting COVID-19 was the primary reason for vaccination uptake. Although education level was associated with vaccination uptake, it did not predict it independently. The age distribution, agreeableness, conscientiousness, and high vulnerability as a rationale for receiving a vaccine were all the independent predictors of vaccine uptake. Conclusion: This study reveals that despite their role as vaccination advocates, HCWs can exhibit hesitancy toward novel vaccines. To increase vaccine uptake among HCWs and the general population, it is crucial to recognise the factors that influence vaccine acceptance among them, including individual personality variables, and incorporate this understanding into vaccination promotion programs