Survey of early predictive signs of poor mental health and socio-cultural beliefs about mental illness in Enugu state, Nigeria

BACKGROUND: The rising prevalence of mental disorder and the enormous emotional, financial, socio-economic and developmental burden is a source of concern and challenge to the global community. This study assessed the prevalence of major warning signs of poor mental health and socio-cultural beliefs about the mental illness among the urban and rural dwellers in Enugu State, Nigeria.METHODS: This was a descriptive, cross sectional study, using multistage sampling to recruit a total of 724 respondents, 371 from urban and 353 from rural Local Government Areas. A researcher constructed and pre-tested semi-structured questionnaire was the instrument of data collection used. William C. Menninger's questions for assessing warning signs of poor mental health was modified and adapted. Data was analysed using Epi-info version 3.5.3. Chi-square test and Student T-test statistics were used. Level of significant was set at p ≤0.05.RESULTS: Socio-cultural factors mostly believed to cause mental illness were evil spirits (51.8% Urban: 34.28% rural, X2 = 22.51, p= 0.000) and native charm (47.7% urban: 43.1% rural; X2 = 1.58, p = 0.209). Major alternative treatments recommended for the mentally ill were prayer/deliverance (59.8% urban: 54.7% rural, p=0.160) and herbal drugs/ traditional healers (31.0% urban: 35.7% rural, p=0.180). Mean scores of the signs of poor mental health among the urban and rural dwellers were 80.82±41.66 and 119.55±37.06 (t=13.19, p= 0.000); and prevalence of early warning signals of poor mental health were 21.7% for the urban and 33.87% for the rural respondents.CONCLUSION: Traditional beliefs about mental illness are still prevalent in the 21st century Nigeria. The rural dwellers have more warning signs of poor mental health than their urban counterparts. In-depth psychiatric evaluation, mental health education and counselling are advocated.Key Words: beliefs, mental health, mental illness, rural, signs, urba

A review of Lassa fever outbreaks in Nigeria From 1969 to 2017: Epidemiologic profile, determinants and public health response

Introduction: Lassa fever outbreaks have occurred in Nigeria since the 1969 till date. This is in spite of the fact that the reservoir and modes of transmission have been known for all these years. This review aimed at describing the epidemiology and determinants of the Lassa fever outbreaks in Nigeria from 1969 to 2017 and the public health response to these outbreaks.Method: The guidelines for the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were used to conduct the review between May 2017 and January, 2018. We searched PubMed, Science direct, WHO library databases and Google Scholar for articles published from 1970 till January 2018. Other relevant websites such as those of the World Health Organization, Nigeria Centers for Disease Control and Prevention were searched for Lassa fever outbreak reports.Results: Twenty-six articles and reports were included in the final review. These described twenty-one outbreaks involving 5442 suspect cases, 768 confirmed cases and 631 deaths from suspected or confirmed Lassa fever. Thirty-two states and the Federal Capital Territory have ever recorded outbreaks of Lassa fever. Lassa fever cases now occur in various states in Nigeria all year round with dry season peaks. Nosocomial transmission has remained a consistent determinant. Public health responses have changed over time starting from predominantly case management in initial outbreaks to a centrally coordinated response supporting states and institutions over the years.Conclusion; Lassa fever outbreaks have increased in frequency and geographic spread with case fatality ratio remaining unacceptably high. The same determinants have persisted with nosocomial transmission a consistent factor. Public health response has consistently improved with the last two years showing the most coordinated response. We recommend that the definition of Lassa fever in the Nigerian Integrated Disease Surveillance and Notification System (IDSR) be revised to reflect the current reality to ensure better Lassa fever control.Key words: Lassa fever, Outbreak, Viral haemorrhagic fevers, Nigeria

ABO histo-blood group and risk of respiratory atopy in children: a review of published evidence

Samuel N Uwaezuoke,1 Joy N Eze,1 Adaeze C Ayuk,1 Ikenna K Ndu2 1Department of Paediatrics, University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla Enugu, Nigeria; 2Department of Paediatrics, Enugu State University Teaching Hospital, Enugu, Nigeria Abstract: Besides their fundamental role in transfusion medicine, ABO and other histo-blood group antigens are associated with the pathogenesis of some human diseases such as malignancy and thrombosis. Reports also show a possible relationship with the risk of asthma and other forms of respiratory atopy. This paper aims to critically review the current evidence linking ABO histo-blood group with the risk of respiratory atopy in children and adults. A literature search was conducted with PubMed to gather baseline data about this relationship. The search extended to studies published within the past 45 years. First, the molecular mechanism underpinning the role of ABO antigenic system in human diseases comprises a fascinating relationship with von Willebrand factor and several pro-inflammatory and adhesion molecules. Second, specific blood group types vary with asthma phenotypes; severe asthma is associated with B phenotype, while mild and moderate asthma is associated with O and A phenotypes. Third, O phenotype has been linked to allergic rhinitis but only in males. Furthermore, asthma risk is related to O/Lewis negative/secretor phenotypes, while a significant relationship has also been established with B phenotype but not with A and O phenotypes. However, one study failed to establish a significant relationship with any of the ABO blood group antigens. In conclusion, there is no unanimity on the specific histo-blood groups linked to respiratory atopy risk, although asthma phenotypes are associated with specific blood groups. Despite the prospect that this relationship holds for the use of blood-group typing in evaluating respiratory atopy risk in children, more evidence-based studies are still required for its validation. Keywords: blood-group phenotypes, asthma phenotypes, B phenotype, von Willebrand factor, asthma risk, blood-group typin

ANTI-DIARRHOEAL AND ANTISPASMODIC EFFECTS OF LEAF EXTRACT OF PTEROCARPUS SANTALINOIDES

Diarrhoea is one of the popular gastrointestinal disorders with high mortality especially in children. Certain medicinal plants are being used in traditional medicine practice to treat and control diarrhoea. One of such plants is the leaves of Pterocarpus santalinoides. The need to scientifically ascertain this folkloric claim and the possible identification of the active constituents therein motivated this study. The methanol leaf extract of P. santalinoides was prepared and screened for activity using castor-oil induced diarrhoea, gastrointestinal motility tests (charcoal transit test) and inhibition of contraction induced by histamine (H) and acetylcholine (Ach) on isolated rabbit jejunum. The results indicated that the extract at 200 mg/kg dose exhibited a significant inhibition (P < 0.05) of castor-oil induced diarrhoea when compared with a standard antidiarrhoeal agent, diphenoxylate hydrochloride (5 mg/kg). The extract also at 200 mg/kg dose level showed a significant inhibition (P<0.05) on gastrointestinal motility when compared with the vehicle (3 % Tween 80). The extract also exhibited a dose dependent inhibition on the contraction induced by acetylcholine and histamine on rabbit jejunum as well as the abolition of spontaneous pendular movements of the smooth muscles of the rabbit jejunum. The acute toxicity study exhibited an LD50 greater than 5000 mg/kg. The phytochemical screening revealed the presence of carbohydrates, resins, terpenoids, steroids, saponins. The extract exhibited both antidiarrhoeal and antispasmodic effects which could be through inhibition of histaminergic and cholinergic mechanisms via their respective receptors abundant in the GIT. The antidiarrhoeal effect of this plant can be explored for therapeutic advantages as an alternative for treatment of diarrhoea and further research is expected to confirm the active phytochemical constituent(s) responsible for the activity. Keywords: P. santalinoides, antidiarrhoeal, antispasmodic and rabbit jejunumNigerian Journal of Pharmaceutical Research, Vol. 8 No 1 pp. 138 - 144 (September 2010

Association between caregivers' knowledge and care seeking behaviour for children with symptoms of pneumonia in six sub-Saharan African Countries

BACKGROUND: Pneumonia is the main cause of child mortality world-wide and most of these deaths occur in sub-Saharan Africa (SSA). Treatment with effective antibiotics is crucial to prevent these deaths; nevertheless only 2 out of 5 children with symptoms of pneumonia are taken to an appropriate care provider in SSA. While various factors associated with care seeking have been identified, the relationship between caregivers’ knowledge of pneumonia symptoms and actual care seeking for their child with symptoms of pneumonia is not well researched. METHODS: Based on data from Multiple Indicator Cluster Surveys, we assessed the association between caregivers’ knowledge of symptoms related to pneumonia – namely fast or difficulty breathing – and care seeking behaviour for these symptoms. We analysed data of 4,163 children with symptoms of pneumonia and their caregivers. A Chi-square tests and multivariable logistic regression was performed to assess the association between care seeking and knowledge of at least one symptom (i.e., fast or difficulty breathing). RESULTS: Across all 6 countries only around 30% of caregivers were aware of at least one of the two symptoms of pneumonia (i.e., fast or difficulty breathing). Our study shows that in the Democratic Republic of the Congo and Nigeria there was a positive association between knowledge and care seeking (P ≤ 0.01), even after adjusting for key variables (including wealth, residence, education). We found no association between caregivers’ knowledge of pneumonia symptoms and actual care seeking for their child with symptoms of pneumonia in Central African Republic, Chad, Malawi, and Sierra Leone. CONCLUSIONS: These findings reveal an urgent need to increase community awareness of pneumonia symptoms, while simultaneously designing context specific strategies to address the fundamental challenges associated with timely care seeking