Alcohol use disorders in multidrug resistant tuberculosis (MDR-TB) patients and their non-tuberculosis family contacts in Nigeria

Introduction: the main aim of this study was to determine the prevalence and associated factors of alcohol use disorder (AUD) in patients with Multi-Drug Treatment-Resistant Tuberculosis (MDR-TB) compared with their non-tuberculosis control, and its association with disease pattern and associated medical comorbidities. Methods: MDR-TB patients (128) and their respective caregivers were interviewed in a treatment unit in Nigeria. Diagnosis of AUD was made using the Structured Clinical Interview for DSM-IV Axis I Disorder, information was obtained on the severity of the TB and associated health problems. Results: prevalence of AUD was (21.9%) and was significantly higher among cases than in controls (2.3%), p = 0.006. Severe TB, OR = 3.33 (1.56-6.83), hematological diseases, OR = 2.34 (1.06-4.33) and HIV/AIDS, OR = 3.01 (1.67-7.01) were the strongest predictors of AUD at 95% CI. Conclusion: AUD was highly prevalent in MDR-TB and was associated with certain medical comorbidities and increased severity of the illness

Burnout among Nurses in a Nigerian General Hospital: Prevalence and Associated Factors

Objective. To evaluate the prevalence and associated factors of burnout among nurses in a Nigerian general hospital. Methods. A total sampling method was utilized. Measurements. Burnout was evaluated using the Maslach Burnout Inventory; GHQ-12 was used to determine the presence of psychiatric morbidity. Results. A high level of burnout was identified in 39.1% of the respondents in the area of emotional exhaustion (EE), 29.2% in the area of depersonalization and 40.0% in the area of reduced personal accomplishment. Multivariate analysis showed that doctor/nurse conflict (OR = 3.1, 95% CI: 1.9−6.3), inadequate nursing personnel (OR = 2.6, 95% CI: 1.5–5.1), and too frequent night duties (OR = 3.1, 95% CI: 1.7–5.6) were predictors of burnout in the area of EE, doctor/nurse conflict (OR = 3.4, 95% CI: 2.2–7.6) and too frequent night duties (OR = 2.4, 95% CI 1.5–4.8) in the area of D, high nursing hierarchy (OR = 2.7, 95% CI: 1.5–4.8), poor wages (OR = 2.9, 95% CI: 1.6–5,6), and too frequent night duties (OR = 2.3, 95% CI: 2.3–4.5) in the area of RPA. Conclusions. Prevalence of burnout among these nurses was high. The government therefore needs to look into factors that will enhance nurses' recruitment and retention for effective health care delivery system

Association of Cohort and Individual Substance Use With Risk of Transitioning to Drug Use, Drug Use Disorder, and Remission From Disorder: Findings From the World Mental Health Surveys

Importance: Limited empirical research has examined the extent to which cohort-level prevalence of substance use is associated with the onset of drug use and transitioning into greater involvement with drug use. Objective: To use cross-national data to examine time-space variation in cohort-level drug use to assess its associations with onset and transitions across stages of drug use, abuse, dependence, and remission. Design, Setting, and Participants: The World Health Organization World Mental Health Surveys carried out cross-sectional general population surveys in 25 countries using a consistent research protocol and assessment instrument. Adults from representative household samples were interviewed face-to-face in the community in relation to drug use disorders. The surveys were conducted between 2001 and 2015. Data analysis was performed from July 2017 to July 2018. Main Outcomes and Measures: Data on timing of onset of lifetime drug use, DSM-IV drug use disorders, and remission from these disorders was assessed using the Composite International Diagnostic Interview. Associations of cohort-level alcohol prevalence and drug use prevalence were examined as factors associated with these transitions. Results: Among the 90 027 respondents (48.1% [SE, 0.2%] men; mean [SE] age, 42.1 [0.1] years), 1 in 4 (24.8% [SE, 0.2%]) reported either illicit drug use or extramedical use of prescription drugs at some point in their lifetime, but with substantial time-space variation in this prevalence. Among users, 9.1% (SE, 0.2%) met lifetime criteria for abuse, and 5.0% (SE, 0.2%) met criteria for dependence. Individuals who used 2 or more drugs had an increased risk of both abuse (odds ratio, 5.17 [95% CI, 4.66-5.73]; P \u3c .001) and dependence (odds ratio, 5.99 [95% CI, 5.02-7.16]; P \u3c .001) and reduced probability of remission from abuse (odds ratio, 0.86 [95% CI, 0.76-0.98]; P = .02). Birth cohort prevalence of drug use was also significantly associated with both initiation and illicit drug use transitions; for example, after controlling for individuals’ experience of substance use and demographics, for each additional 10% of an individual’s cohort using alcohol, a person’s odds of initiating drug use increased by 28% (odds ratio, 1.28 [95% CI, 1.26-1.31]). Each 10% increase in a cohort’s use of drug increased individual risk by 12% (1.12 [95% CI, 1.11-1.14]). Conclusions and Relevance: Birth cohort substance use is associated with drug use involvement beyond the outcomes of individual histories of alcohol and other drug use. This has important implications for understanding pathways into and out of problematic drug use

The Epidemiology of Alcohol Use Disorders Cross-Nationally: Findings from the World Mental Health Surveys

Background: Prevalences of Alcohol Use Disorders (AUDs) and Mental Health Disorders (MHDs) in many individual countries have been reported but there are few cross-national studies. The WHO World Mental Health (WMH) Survey Initiative standardizes methodological factors facilitating comparison of the prevalences and associated factors of AUDs in a large number of countries to identify differences and commonalities. Methods: Lifetime and 12-month prevalence estimates of DSM-IV AUDs, MHDs, and associations were assessed in the 29 WMH surveys using the WHO CIDI 3.0. Results: Prevalence estimates of alcohol use and AUD across countries and WHO regions varied widely. Mean lifetime prevalence of alcohol use in all countries combined was 80%, ranging from 3.8% to 97.1%. Combined average population lifetime and 12-month prevalence of AUDs were 8.6% and 2.2% respectively and 10.7% and 4.4% among non-abstainers. Of individuals with a lifetime AUD, 43.9% had at least one lifetime MHD and 17.9% of respondents with a lifetime MHD had a lifetime AUD. For most comorbidity combinations, the MHD preceded the onset of the AUD. AUD prevalence was much higher for men than women. 15% of all lifetime AUD cases developed before age 18. Higher household income and being older at time of interview, married, and more educated, were associated with a lower risk for lifetime AUD and AUD persistence. Conclusions: Prevalence of alcohol use and AUD is high overall, with large variation worldwide. The WMH surveys corroborate the wide geographic consistency of a number of well-documented clinical and epidemiological findings and patterns

Expert panel’s modification and concurrent validity of the Teacher Stress Inventory among selected secondary school teachers in Nigeria

Abstract Background The Teacher Stress Inventory (TSI) is an instrument used for assessing occupational stress among teachers but has not been adapted or validated for use in Nigeria. Objective This study aimed to modify and adapt the TSI for use in Nigeria and also assess its reliability and validity. An expert panel was constituted to modify the original version of the TSI. Thereafter, both the original and the modified versions were applied to 471 teachers from 15 schools in Oyo State, Nigeria. Result Of all the respondents, 227 (48.2 %) were men and 244 (51.8 %) were women. Mean age was 36.55 ± 8.80 years. Cronbach α for all items of the modified version was .943, and item mean score was 2.60 (1.86–3.56). Concurrent validity of the modified TSI demonstrated significant correlations p< 0.001 with the corresponding items of the original version. Test-retest reliability of the modified version was .988. There were significant inter-item correlations for all the items of the modified version of the TSI. Conclusion The modified version of the TSI is a valid and reliable instrument in the Nigerian population to assess teachers’ stress

CANNABIS USE AND ASSOCIATED HARMS AMONG SCHIZOPHRENIA PATIENTS IN A NGERIAN CLINICAL SETTING: A CASE CONTROL STUDY

Aim: The overall aim of this study was to determine the prevalence of cannabis use among patients with schizophrenia with associated levels of harm in a Nigerian clinical setting.Method: In this case-control study, consecutive 150 patients with schizophrenia were matched by age and gender with an equal number of patients that utilized the general outpatient department of the State Hospital, Ring Road Ibadan.The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was used to obtain prevalence of cannabis use and level of health risk as determined by the ASSIST score. The Positive and Negative Syndrome Scale (PANSS) was used to determine the severity of psychosis. Results: Prevalence of cannabis use among the cases was 10.0% and 2.7% among the control group, p = 0.03. Mean ASSIST score was significantly higher among the cases compared with the control, p < 0.001. Respondents of male gender and those who were not married were significantly more likely to be cannabis users among patients with schizophrenia, p < 0.001, p < 0.02 respectively. Conclusion: Cannabis use was prevalent among patients with schizophrenia and was associated with health risks. Thus, routine screening for cannabis use and brief intervention is suggested to be integrated into care for adolescents and adults with schizophrenia

Factors associated with paternal perinatal depression in fathers of newborns in Nigeria

Introduction: There is a lack of information on paternal postnatal depression in developing countries such as Nigeria. Methods: This study aims to assess the prevalence of depression in fathers at the birth of their infants and the incidence of paternal postnatal depression at 6 weeks postpartum. We also examined the correlation between paternal postpartum depression (PPD) at 6 weeks and maternal PPD as well as the sociodemographic and other correlates of paternal PPD at 6 weeks. Results: All the 331 fathers recruited at baseline completed the study. Prevalence of depression in fathers at birth of their babies was 10 (3%). After excluding the 3%, the incidence of PPD in fathers (N = 321) at 6 weeks was 19 (5.9%). In all, 29 (8.8%) fathers had PPD. The prevalence of depression in mothers at 6 weeks postpartum was 57 (17.8%). The prevalence of depression in mothers at 6 weeks was significantly higher than the incidence of depression in fathers at 6 weeks (X2 = 26.2, p < .001). There was no significant correlation between maternal PPD and paternal PPD. At baseline, prevalence of PPD among the unemployed fathers was higher than in the employed, 3 (21.4%) versus 7 (2.2%), this was significant (FE p < .01). There was no significant correlate of paternal PPD at 6 weeks. Discussion: Postpartum mental health services should be extended to fathers of newborns especially those who are unemployed. Our findings have implications for family health