Knowledge of the coronavirus disease 2019 (COVID-19) and sleep problems among a selected sample of psychiatric hospital staff in Nigeria: a cross-sectional study

Introduction: as the coronavirus disease 2019 (COVID-19) spreads, sleep problems are expected to increase among healthcare workers. Therefore, we aimed to assess the knowledge of COVID-19, sleep problem and identify sociodemographic factors associated with sleep problems among healthcare workers in a Nigerian neuropsychiatric hospital. Methods: a cross-sectional study was conducted among 200 healthcare workers in a neuropsychiatric hospital using self-administered questionnaires to assess knowledge of COVID-19, sleep problem, social support, and sociodemographic factors that affect sleep. Chi-square test and Spearman's correlation were applied to assess the association between sociodemographic factors and sleep problems. Results: about 23.9% of the healthcare workers reported having a sleep problem. However, there was no association of sleep problems with any sociodemographic factors except age (r=0.26) and social support (r=-0.18). Conclusion: the study offered insight into the occurrence of sleep problems among healthcare workers and suggested a guide for planning interventions targeted at improving the psychological well-being of healthcare workers in the face of current global pandemics

Charles Bonnet Syndrome; Presenting as “Innocent Spirits Within’: A Case Report

Charles Bonnet syndrome (CBS) is an under-recognized and under-reported disorder that involves visual hallucinations in visually impaired individuals. These patients have intact cognition, do not have hallucinations in any other sensory modalities, and retain insight into the unreal nature of their hallucinations. In most developing countries like  Botswana where mental health and ophalmology professionals are  scarce, cases like  Charles Bonnet Syndrome are likely to be misdiagnosed for psychosis/’madness’ with consequent  inappropriate biological interventions . Our patient, a 90 year old blind widow pensioner, with no prior psychiatric history, complained to family members that she was seeing people without heads and sometimes without limbs following her. She felt tortured as these people followed her everywhere. She consulted her pastor about these visual hallucinations, and was told not to worry about them as ‘’they were harmless spirits within her’. When she was eventually brought to the Hospital she was given a diagnosis of Charles Bonnet Syndrome and showed marked improvement after being given assurance about her sanity and antidepressants.There is need to increase awareness of rare psychiatric syndromes in the elderly like the Charles Bonnet Syndrome amongst clinicians since they can be easily missed or inappropriately managed more so since the population of the elderly is increasing in Botswana and many other sub-Sahara countries Keywords: Charles Bonnet Syndrome, Hallucinations, Botswan

Assessment of Voluntary HIV Counseling and Testing Service utilization and VCT/HIV related knowledge and attitude towards VCT Among out of school youth in rural Nakuru County, Kenya: A cross sectional survey

Background: Voluntary HIV counseling and testing (VCT) is one of the key tools in the HIV/AIDS prevention and control programs in Kenya. But utilization of VCT services among out of school youth is low. The aim of this study was to assess voluntary HIV Counseling and Testing Service Utilization and VCT/HIV related knowledge and attitude towards VCT among out of school youth since though they are a risk group in Kenya they are less likely than other groups to be offered this service. A cross sectional study design was done among 369 out of school youth aged 18-35 drawn from three rural divisions of Nakuru County, Kenya, using proportionate and purposive sampling technique. Self-administered questionnaire was used to estimate the prevalence of VCT service utilization and to assess VCT/HIV related knowledge and attitude towards VCT among out of school youth. Data were entered and analyzed using SPSS version 11.5.The study sample consisted of 56.1% males and 43.9% females. The mean age for those who had utilized VCT was 24 for men and 23 for females. The majority of the out-of- school youth (62.6%) had not utilized VCT. Poor utilization of VCT services was found to be significantly associated with HIV/VCT related knowledge and negative attitude towards VCT. VCT utilization among out-of- school youth in Nakuru County was low. The major factors identified for increased VCT service utilization were high VCT/HIV related knowledge and positive   attitude towards VCT. HIV/AIDS prevention and control programs in Nakuru County should focus on the above areas. Key words: HIV testing, VCT utilization, Knowledge, Out of school youth, Nakuru Keny

Assessment of Voluntary HIV Counseling and Testing Service Utilization and Associated Health Service Related Factors Among Out of School Youth in Nakuru Kenya: A Cross Sectional Survey

Background: Voluntary HIV counseling and testing (VCT) is one of the key tools in the HIV/AIDS prevention and control programs in Kenya. But utilization of VCT services among out of school youth is low. The aim of this study was to investigate health service related factors associated with VCT utilization among out of school youth in a rural setting since though they are a risk group in Kenya they are less likely than other groups to be offered this service. A cross sectional study design was done among 369 out of school youth aged 18-35 drawn from three rural divisions of Nakuru County, Kenya, using proportionate and purposive sampling technique. Self-administered questionnaire was used to estimate the prevalence of VCT service utilization and to assess associated health service related factors. Data were entered and analyzed using SPSS version 11.5. The study sample consisted of 56.1% males and 43.9% females. The mean age for those who had utilized VCT was 24 for men and 23 for females. The majority of the out-of- school youth (62.6%) had not utilized VCT. Poor utilization of VCT services was found to be associated with perception of quality of VCT services. It was shown that VCT utilization was significantly associated with competence of VCT counselors and youth friendliness of the services. CT utilization among out-of- school youth in Nakuru County was low. The major factors identified for increased VCT service utilization were better perception of the quality of the VCT services, and more competence of the CVT counselors. Hence, HIV/AIDS prevention and control programs in Nakuru County should focus on the above areas. Keywords: HIV testing, VCT utilization, Stigma, Knowledge, Out of school youth, Nakuru, Keny

Assessment of Voluntary HIV Counseling and Testing Service Utilization and Associated Socio-demographic Factors Among Out of School Youth in Rural Nakuru County, Kenya: A Cross Sectional Survey

Voluntary HIV counseling and testing (VCT) is one of the key tools in the HIV/AIDS prevention and control programs in Kenya. But utilization of VCT services among out of school youth is low. The aim of this study was to assess Voluntary HIV Counseling and Testing Service utilization and associated socio-demographic factors among out of school youth, since though they are a risk group in Kenya; they are less likely than other groups to be offered this service. A cross sectional study design was done among 369 out of school youth, aged 18-35 years drawn from three rural divisions of Nakuru County, Kenya, using proportionate and purposive sampling technique. Self-administered questionnaire was used to estimate the prevalence of VCT service utilization and to assess associated socio-demographic factors among out of school youth. Data were entered and analyzed using SPSS version 11.5. The study sample consisted of 56.1% males and 43.9% females. The mean age for those who had utilized VCT was 24 for men and 23 for females. The majority of the out-of- school youth (62.6%) had not utilized VCT. It was shown that VCT utilization was significantly associated with the level of education, level of income and marital status. There was no significant association   between VCT utilization and age or gender. VCT utilization among out-of- school youth in Nakuru County was low. HIV/AIDS prevention and control programs in Nakuru County should focus on the above areas. Keywords: HIV testing, VCT utilization, Knowledge, Out of school youth, Nakuru Keny

Neuropsychological profile following suicide Attempt by hanging in Botswana: Three case reports

Botswana police suicide statistics reported a total of 783 cases of both attempted and completed suicide in one year. Attempted hanging usually results in severe memory disturbances but that these amnesic states usually are only temporary. While  there is a considerable amount of early German-language literature on the neurological and neuropsychological consequences of unsuccessful attempts by hanging ,by the early 1990’s , only two cases of attempted hanging had been reported In the  English language as the cause of a persistent anterograde amnestic syndrome resembling that seen in Korsakoffs syndrome. We present three cases we believe to be the first reported cases of amnesic syndromes in Botswana following unsuccessful attempts by hanging in three male adults. Key words: Attempted suicide, Amnesic states, Botswana, Korsakoff ’s syndrom

Assessment of Voluntary HIV Counseling and Testing Service Utilization and Associated Psychosocial Factors Among Secondary School Teachers in Nyando, Kisumu County Kenya: A Descriptive Cross Sectional Survey

Voluntary HIV counseling and testing (VCT) is one of the key tools in the HIV/AIDS prevention and control programs in Kenya. But utilization of VCT services among out secondary school teachers in Kenya is low. The aim of this study was to assess Voluntary HIV Counseling and Testing Service utilization and associated psychosocial factors among secondary school teachers since even though  most school-based HIV interventions in sub-Saharan Africa rely on teachers as behavior formation and behavior-change agents to deliver prevention messages to school children, their utilization of HIV VCT services has been low. The study sample consisted of 255 secondary school teachers (36% females and 64% males) out of a total of 753 teachers from 73 secondary schools in the seven divisions in Nyando district. Stratified sampling was used to select the number of schools per division to be included in the study while Simple random sampling was then used to select schools in each division. Self-administered questionnaires and focus group discussions were used to estimate the prevalence of VCT service utilization and to assess associated psychosocial factors among the secondary school teachers. Cross tabulation was used to show relationships between the independent and the dependent variables, and chi-square was used to test for existence of relationships between the variables, p<0.05 was considered statistically significant. Information from in-depth discussions was analyzed manually using qualitative methods. The data was presented descriptively and through the use of frequency tables and bar graphs. This study found that less than half (48%) of the respondents had utilized VCT services. The majority of teachers (38%), who had utilized the VCT services did so “in order to know their HIV status/plan their future”. The study also found a positive association between utilization of VCT services, and perception of the importance of VCT as an HIV/AIDS control strategy (p=0.039). Spousal approval of VCT utilization emerged as the most significant social factor affecting utilization of VCT services (p=0.019). HIV/VCT utilization among secondary school teachers in Nyando County remain low especially among male teachers. HIV/AIDS prevention and control programs among secondary school teachers in Nyando County should focus on the above areas. Keywords: HIV testing, VCT utilization, Knowledge, Secondary school teachers, Nakuru Kenya

Assessment of Voluntary HIV Counseling and Testing Service Utilization and Associated Socio-Demographic among Secondary School Teachers in Nyando, Kisumu County Kenya: A Descriptive Cross Sectional Survey

Voluntary HIV counseling and testing (VCT) is one of the key tools in the HIV/AIDS prevention and control programs in Kenya. But utilization of VCT services among out secondary school teachers in Kenya is low.  The aim of this study was to assess Voluntary HIV Counseling and Testing Service utilization and associated socio-demographic factors among secondary school teachers since most school-based HIV interventions in sub-Saharan Africa rely on teachers as behavior formation and behavior-change agents to deliver prevention messages to school children. The study sample consisted of 255 secondary school teachers (36% females and 64% males) out of a total of 753 teachers from 73 secondary schools in the seven divisions in Nyando district. Stratified sampling was used to select the number of schools per division to be included in the study while simple random sampling was used to select schools in each division.Self-administered questionnaires and focus group discussions were used to estimate the prevalence of VCT service utilization and to assess associated socio-demographic factors among the secondary school teachers.Cross tabulation was used to show relationships between the independent and the dependent variables, and chi-square was used to test for existence of relationships between the variables, p<0.05 was considered statistically significant. Information from in-depth discussions was analyzed manually using qualitative methods. The data was presented descriptively and through the use of frequency tables and bar graphs. The study found significant relationships between utilization of VCT services and gender (p=0.003) and age (p=0.004), but not level of education, marital status, religious affiliation or area of residence. Spousal approval of VCT utilization emerged as the most significant social factor affecting utilization of VCT services (p=0.019). HIV/VCT utilization among secondary school teachers in Nyando County remain low especially among male teachers. HIV/AIDS prevention and control programs among secondary school teachers in Nyando County should focus on the above areas. Key words: HIV testing, VCT utilization, Knowledge, Secondary school teachers, Nakuru Kenya

Post-traumatic stress disorder among the staff of a mental health hospital: Prevalence and risk factors

Background: Mental health service providers are frequently exposed to stress and violence in the line of duty. There is a dearth of data concerning the psychological sequelae of the frequent exposure to stress and violence, especially among those who work in resource-limited countries such as Botswana. Aim: To determine the prevalence and predictors of post-traumatic stress disorder (PTSD) among mental health workers in a tertiary mental health institute in Botswana. Setting: The study was conducted in Sbrana Psychiatric Hospital, which is the only referral psychiatric hospital in Botswana. Methods: The study used a descriptive cross-sectional design. A total of 201 mental health workers completed a researcher-designed psycho-socio-demographic questionnaire, which included one neuroticism item of the Big Five Inventory, and a PTSD Checklist-Civilian Version (PCL-C), which was used to assess symptoms of PTSD. Results: Majority of the study participants were general nurses (n = 121, 60.5%) and females (n = 122, 60.7%). Thirty-seven (18.4%) of the participants met the criteria for PTSD. Exposure to violence in the past 12 months (AOR = 3.26; 95% CI: 1.49–7.16) and high neuroticism score (AOR = 2.72; 95% CI: 1.19–6.24) were significantly associated with the diagnosis of PTSD among the participants. Conclusion: Post-traumatic stress disorder could result from stressful events encountered in the course of managing patients in mental health institutes and departments. Pre-placement personality evaluation of health workers to be assigned to work in psychiatric units and post-incident trauma counselling of those exposed to violence may be beneficial in reducing the occurrence of PTSD in mental hospital health care workers

Intimate partner violence: The need for an alternative primary preventive approach in Botswana

Intimate partner violence is a common social problem which causes considerable relationship stress and results in significant morbidity and mortality of the victims. Botswana, like many other countries in sub-Saharan Africa, has tried to address the problem of intimate partner violence with legislations prescribing punitive measures for the perpetrators and protection for the victims. The effectiveness of these measures in reducing the prevalence of intimate partner violence is doubtful. This article is to motivate for an alternative primary preventive approach to the problem as a more pragmatic option