Prevalence and predictors of delirium among medical inpatients admitted through accident and emergency unit of Jos University Teaching Hospital

Background: Delirium is a complex neuropsychiatric syndrome, commonly encountered across all healthcare settings. However, little is known about its magnitude and determining factors in medical inpatients especially at the Accident and Emergency (A&E) setting of tertiary institutions in low income countries.Objectives: This study was conducted to evaluate the prevalence of delirium among medical inpatients admitted through the A&E unit as well as to assess its predictors.Method: This was a cross-sectional study that employed a consecutive sampling technique to select 290 eligible subjects from medical inpatients that presented to A&E unit of Jos University Teaching Hospital (JUTH). Confusion Assessment Method (CAM) was used to assess for delirium.Results: The results showed that 35.9% of the respondents had delirium. The predictive variables for delirium were: Age groups 18-34 years and 35-64 years (P=0.014 and P = 0.003), prior cognitive impairment (P = 0.020), having estimated monthly income belowN50,000 (P<0.001 and P=0.008) , use of alcohol (P=0.026) and having rare/other medical diagnosis (P = 0.0016).Conclusion: Delirium is very common in medical inpatients and highly predictable especially in high risk patients. Consultation-Liaison Psychiatry services need to be integrated into the A&E unit management team particularly in the areas of prevention and management of identified cases.Keywords: Delirium, Medical Inpatients, Prevalence, Predictors, Accident and Emergency Uni

The negative impact of global health worker migration, and how it can be addressed

International migration of healthcare workers is well established and has become a means of maintaining service quality in many high income countries. In recent years, there has been a dramatic increase in recruitment of health personnel who have been trained abroad, including from the poorest countries in the world. In this article, using General Medical Council (GMC) data, we chart the growth in numbers of international staff working in the United Kingdom, where since 2018, over half of all new GMC registrations have been of doctors trained abroad. There is evidence that this migration of health staff results in poorer health service provision in low and middle income countries, as well as substantial economic impacts in these countries that have invested in training their health workforce. Recruiting governments have argued that remittances compensate for the loss of personnel, and that training opportunities can enable skills transfer to countries with weaker health systems. However, we found that the costs to the source countries dwarfed remittances, and that only a tiny fraction of people who move to take up posts in wealthier countries ever return to their countries of origin to work. We conclude that in addition to the investment in health systems (and workforce development) in low and middle income countries as part of Official Development Assistance for Health, there is an urgent need to increase training of nurses and doctors so that damaging migration is no longer relied upon to fill gaps in healthcare personnel

Terrorism catastrophising and hazardous alcohol use among students of a tertiary institution in Jos, Nigeria

Background: Being a maladaptive means of coping with stress, alcohol abuse may be associated with level of terrorism in a community. Jos has had a number of terrorists’ attacks which have had devastating effects on the city and its environs. This study aimed to determine the prevalence of terrorism catastrophizing, hazardous alcohol use as well as the relationship between terrorism catastrophizing and hazardous alcohol use among students of the Plateau State Polytechnic, Jos Campus.Methods: A cross sectional study of 230 students in the departments of accountancy, business administration and management who completed self-administered questionnaires during one of their classes following a random cluster sampling of departments.Results: The TCS showed that 43.5% of the participants had terrorism catastrophizing. Pearson correlation showed a high significant positive correlation (p<0.05) across the three dimensions of terrorism catastrophizing: rumination, r=0.807; magnification, r=0.726; and helplessness, r=0.754. However, no significant correlation exists between terrorism catastrophising (rumination, magnification and helplessness), alcohol use disorder, r = -0.016, p = 0.817 (AUDITc), and problem drinking behavior, r= -0.157, p=0.06.Conclusions: There was no positive correlation between terrorism catastrophizing and hazardous alcohol drinking

Tinnitus and the prevalence of co-morbid psychological stress

Background: Tinnitus is a symptom of unknown pathophysiology with few therapeutic measures and may present with co-morbid psychological stresses necessitating psychiatric treatment. This study aims at determining the prevalence of depression and anxiety in tinnitus sufferers in our environment. Method: This is a one year (April 2006 – March 2007) prospective study of out-patients presenting with tinnitus to our Ear, Nose and Throat clinic who were administered the Hospital Anxiety and Depression Scale (HADS) questionnaire until the sample size was reached. Results: Questionnaires were administered to one hundred and four patients with tinnitus, 92 patients filled theirs correctly and these were analyzed. There were 42(45.7%) males and 50(54.3%) females (Table 1) with an age range of 20 to 78years. Six hundred and eighty seven patients presented with various otologic ailments in the study period, of which 104 (15.1%) patients had tinnitus. The overall prevalence of depression was 17.4%, higher in females (9.8%) than males (7.6%).The overall prevalence of anxiety was 22.8% with males having a higher prevalence (11.9%) than females (10.9%). Three (3.2) patients had both depression and anxiety. Eighty three (90.2%) patients were in the active and productive age group with 13 patients (prevalence of 14.1%) having depression and 20 patients (prevalence of 21.7%) with anxiety. Conclusion: We recommend the screening or assessment for psychological distress in tinnitus sufferers so that patients can be adequately treated. Nigerian Journal of Medicine Vol. 17 (1) 2008 pp. 95-9

The negative impact of global health worker migration, and how it can be addressed.

International migration of healthcare workers is well established and has become a means of maintaining service quality in many high income countries. In recent years, there has been a dramatic increase in recruitment of health personnel who have been trained abroad, including from the poorest countries in the world. In this article, using General Medical Council (GMC) data, we chart the growth in numbers of international staff working in the United Kingdom, where since 2018, over half of all new GMC registrations have been of doctors trained abroad. There is evidence that this migration of health staff results in poorer health service provision in low and middle income countries, as well as substantial economic impacts in these countries that have invested in training their health workforce. Recruiting governments have argued that remittances compensate for the loss of personnel, and that training opportunities can enable skills transfer to countries with weaker health systems. However, we found that the costs to the source countries dwarfed remittances, and that only a tiny fraction of people who move to take up posts in wealthier countries ever return to their countries of origin to work. We conclude that in addition to the investment in health systems (and workforce development) in low and middle income countries as part of Official Development Assistance for Health, there is an urgent need to increase training of nurses and doctors so that damaging migration is no longer relied upon to fill gaps in healthcare personnel

Relationship between quality of life and postpartum depression among women in North-Central, Nigeria

Background: Postpartum depression is a problem of public health interest and impacts negatively on the perception of quality of lifer of sufferers. Quality of life' (QoL) as an outcome measure, is scantly used on women with postpartum depression in Nigeria. The current study was designed to assess the QoL of women with postpartum depression (PPD) in a tertiary hospital in North-Central, Nigeria.Method: A two-stage cross sectional procedure was used to recruit 550 participants 6 to 8 weeks postpartum in Jos, Northcentral, Nigeria. The Edinburgh Postnatal Depression Scale (EPDS), the World Health Organization Quality of Life-BREF-26 (WHOQoL-BREF-26) questionnaire and the Depression Module of the Structured Clinical Interview for DSM-IV axis I Diagnosis (SCID) were used.Results: The studied participants were 531 out which 21.8% with postpartum depression had significantly poor perception in all the four domains of the WHOQoL-BREF-26 i.e., in the physical health (p&lt;0.001), psychological (p&lt;0.001), social relationships (p&lt;0.001) and environmental (p&lt;0.001) domains. On the whole, the overall rating of quality of life (p=0.002) and satisfaction with general health (p&lt;0.001) were also perceived to be poor when compared to those without depression. However, regression model analysis showed that the presence of postpartum depression in a participant predicts a significant negative perception on physical and environmental domains of quality of life, but a positive prediction on the general satisfaction with health.Conclusion: Postpartum depression as a disorder of public health importance impacts on the perception of quality of life of women who suffer from it. Early detection and treatment will improve the quality of life of women with postpartum depression.Keywords: Quality of life, WHOQoL-BREF-26, Postpartum Depression, prevalence, North-Central, Nigeri

Recognition of Autism Spectrum Disorder (ASD) symptoms and knowledge about some other aspects of ASD among final year medical students in Nigeria, Sub-Saharan Africa

Background: Earlier studies suggest that knowledge about Autism Spectrum Disorder (ASD) among healthcare workers in Nigeria is low. This present study assessed the knowledge of Nigerian final year medical students about symptoms of ASD and some other aspects of ASD. This is a cross sectional descriptive study that drew a total of seven hundred and fifty-seven (757) final year medical students from ten (10) randomly selected fully accredited medical schools out of a total of twenty-seven (27) fully accredited medical schools in Nigeria. Sociodemographic and Knowledge about Childhood Autism among Health Workers (KCAHW) questionnaires were used to assess knowledge of final year medical students about ASD and obtain demographic information. Results: Only few, 218 (28.8 %) of the 757 final year medical students had seen and participated in evaluation and management of at least a child with ASD during their clinical postings in pediatrics and psychiatry. Knowledge and recognition of symptoms of ASD is observed to be better among this group of final year medical students as shown by higher mean scores in the four domains of KCAHW questionnaire. Knowledge about ASD varies across gender and regions. Misconceptions about ASD were also observed among the final year medical students. Conclusions: More focus needs to be given to ASD in the curriculum of Nigerian undergraduate medical students, especially during their psychiatry and pediatric clinical postings. Electronic supplementary material The online version of this article (doi:10.1186/s13104-015-1433-0) contains supplementary material, which is available to authorized users