Substance use among secondary school students in an urban setting in Nigeria: prevalence and associated factors

Objective: Substance use continues to be major risk behaviour among youth, with consequent physical and /or mental health complications. The current study aimed to establish the prevalence and associated factors of substance use among selected secondary school students in Lagos. Method: This was a cross-sectional and descriptive study among selected secondary school students in Lagos. Permission was obtained from appropriate school authorities; as well as consent from each participant. The WHO Students’ Drug Use Questionnaire which had been previously validated in the country was used to obtain the drug use information from the subjects. Analysis of the data was conducted using Epi-info version 5. Results: A total of 402 students were studied - of whom 43.5% (n=175)were males and 56.5% (n=227) females. The mean age was 15.9 years. 83.1% (n=334) lived with their parents, 7.6% (n=31) with their relatives and 7.2% (n=29) with friends. The commonest substances used by the subjects were caffeine (kolanut and coffee), mild analgesics (paracetamol and aspirin) and the antimalarials, most especially chloroquine with lifetime use prevalence rates of 85.7%, 73.8% and 65.7% respectively. Generally, the prevalence rates for lifetime use of the substances varied from 3.8% (n=14) for Heroin and Cocaine to 85.7% (n=344) for psychostimulants; and for current use varying from 2% (n=8)to 56.5% (n= 213). For the so called “gateway drugs”: alcohol and tobacco, their lifetime use prevalence rates were 9.2% (n=34) and 5.2% (n=19) while the lifetime use prevalence rate for cannabis was 4.4% (n=16). In terms of gender, the prevalence rates for males were generally higher than for their female counterparts except for antibiotics, analgesics, heroin and cocaine. Reasons for using substances included relief from stress, 43.5% (n=175), self medication to treat illness, 23.8% (n=96), and to stay awake at night to study, 14.9% (n=60). Conclusion: Substance use was found to be prevalent among students in this study involving over-the-counter and socially acceptable substances as well as the abuse of illicit substances. It is advocated that there is a need to review existing health educational programmes.Key words: Substance use; School; Prevalence; Nigeri

Advocacy and Its Role in Improving Mental Health Care: The Nigerian Context

Worldwide persons that suffer from mental health problems continue to face considerable stigma, abuse, inequity and discrimination. This has direct implications on the kind of care, access to care, and service integration, thus further maintaining the mental health gap that exist in low and middle income countries like Nigeria. Advocacy is one of the main tools targeted at addressing the gap and achieving fairness in distribution and access to mental health. This discourse highlights mental health advocacy and the relevance in Nigeria. Mental health advocacy still remains a relevant tool in the development of mental healthcare service delivery and public enlightenment. Locally based advocacy bodies in this field are to be encouraged and collaboration between stakeholders on advocacy projects are recommended.Key Words: Mental Health, Advocacy, Nigeria

Presentation and Follow-up Patterns of Child and Adolescent Patients attending a Teaching Hospital Psychiatric Clinic in Lagos, Nigeria.

Background: Child and Adolescent Mental Health is a fast developing subspeciality of psychiatry in low income countries. Units in tertiary hospital settings are well positioned to be useful referral centres for young patients from other areas of medicine in such hospitals. Aim: The authors aimed at describing the ways in which the children/ adolescents presented at the psychiatric out patient clinics and their follow up attendance patterns. Method: The study was retrospective in nature, with data gathered basically from the case file records. All the records of patients that were aged below 16 years old at first presentation and were registered between January 1993 and December 2008 were included. Results: A total of 106 cases were included in the study. Mean age was 8.84 + / - 3.5) years and 60.4% were male and 39.6 female. For majority of them, the key informant at presentation was the mother (55.3%), followed by the father (19.4%) and in some cases both parents (15.1)%. It was seen from this study that more than half (55.6%)of the patients seen in the unit were referred from the paediatric neurology clinic within the teaching hospital, while another quarter (25.5%) were from child guidance centres in the community; only 15.1% walked in from the community on their own initiative. Abnormal behaviours , seizures and restlessness were the commonest reasons for presenting. Over 88% had stopped attending the clinic over the years while about 11% were still attending regularly. The average total number of clinic visits was 7.65 + - total 8.5). Conclusion: Child and Adolescent units are relevant referral units for patients with developmental or neurological problems identified from other hospital units and community child service providers. Default rates in clinic attendance is however high.Key Words: Child, Adolescent, Psychiatry, Africa, Hospita

Problematic Internet Usage Among Students In a Medical School In Lagos, Nigeria.

Background: The increasing use of the World Wide Web, also known as the internet, presents as many opportunities as challenges. Challenges such as addictive use are prevalent among all age groups, but young persons are particularly at risk of being dependent upon its use. Problematic use of the internet is a growing problem of public health significance globally and the prevalence of this health challenge is particularly important in developing nations. Aims: To determine the prevalence of problematic internet use, and the relationship with probable psychiatric morbidity among a sample of students in a medical College in Lagos Nigeria.Methods: A cross-sectional descriptive study among undergraduate students of a medical school in Lagos, Nigeria. The students were selected from the second, third and fourth years of medical training. Using convenience sampling a total of 192 students participated and completed the distributed questionnaires. The Internet Addiction Scale (IAS) designed by Kimberly Young was used in assessing for problematic use. On this scale a total score of 20- 49 suggests the user has complete control over usage of the internet, 50-70 suggests occasional problematic internet use and above 70 suggests significant problematic use or internet addiction. The General health questionnaire (version 12) served to screen for probable Psychiatric Results: The mean age of respondents was 23.8 years (± 6.3 SD). Majority (89.6%) of the students were studying Medicine and Surgery while others were studying Pharmacy (5.6%), Physiology (1.40%) and Dentistry (3.5%). Fifty six (29.2%) of the students had occasional problematic internet use, while 9(4.7%) had significant  problematic internet use symptoms. Eighty one (42.2%) had scores on the GHQ suggestive of probable psychiatric morbidity. Among those with occasional problematic internet use and significant problematic internet use, scores suggestive of probable psychiatric morbidity was found in 27 (49.1%) and 1 (11.1%) respectively. Overall mean score on the IAS was 43.4 (SD ± 19.3).Conclusion: Occasional problematic Internet use and probable psychiatric morbidity exists among this population group. Enlightenment about the potential problems associated with internet use and options for support or professional care should be made available to young internet users via institutions of learning

Major Placenta Previa with Assisted Vaginal Delivery and Primary Postpartum Hemorrhage

An unbooked 20 year-old primigravida presented at 36 weeks gestation with severe antepartum hemorrhage due to major placenta previa in shock. She fell into labour during resuscitation prior to emergency caesarian section. She had outlet forceps delivery of a fresh still birth and developed primary postpartum hemorrhage. She was managed with uterotonics, anti-shock garment and uterine packing with blood transfusion and antibiotics

Taking alcohol by deception II: Paraga (alcoholic herbal mixture) use among commercial motor drivers in a south-western Nigerian city

<p>Abstract</p> <p>Background</p> <p>Paraga, an alcoholic herbal preparation that comes in different varieties had been shown to be commonly available to commercial drivers in southern Nigeria. This study aims to determine the prevalence and pattern of paraga use, and to evaluate the level of awareness of the risks entailed in taking paraga among intercity commercial drivers operating out of motor parks in Osogbo, southwest Nigeria. We administered a locally validated version of the WHO drug and alcohol survey questionnaire to 350 commercial drivers.</p> <p>Results</p> <p>Of the 350 questionnaires administered, 332 were used for the data analysis; the remaining 18 were rejected because they had too many missing data. The prevalence rate in the past one year was 53.6% and 43.2% for the past one month (current). Three-quarters were moderate to heavy users, and many take the drug while working. A total of 25.6% had been involved in road crashes after taking paraga and 36.7% had actually seen people getting drunk from taking paraga. Only 40% of the drivers thought paraga use was harmful to their health, the others believing it to have therapeutic values (25%) or undecided (35.0%). Only 43.8% of the drivers would be willing to stop taking paraga.</p> <p>Conclusions</p> <p>Paraga use is popular among commercial drivers. Because of its alcoholic nature, drivers’ access to the concoction should be controlled and appropriate enforcement put in place.</p

Prevalence of Lifetime Tobacco, Alcohol and Drug Use Among 10 th

yaşam boyu tütün, alkol ve madde kullanım yaygınlığı Amaç: Bu çalışmanın amacı İstanbul/Türkiye’de 10. sınıf öğrencileri arasında yaşam boyu tütün, alkol ve madde kullanma yaygınlığını belirlemektir. Yöntem: İstanbul’un 15 farklı ilçesinde 45 okulda kesitsel yapılan online kendi-bildirimli anket çalışmasıdır. Soru formu demografik verileri, ailede ya da çevrede madde kullanımı, okul yaşamı, sosyal iletişim ve tütün, nargile, alkol, esrar, uçucular, eroin, kokain, reçete edilmemiş yasal sakinleştiriciler (benzodiazepinler, alprazolam vs.) ve yasal olmayan sakinleştiricileri (flunitrazepam) de içeren madde kullanımı bölümlerini içermekteydi. Analiz 4957 olguyu temel alarak yürütülmüştür. Bulgular: Yaşam boyu en az bir kez deneme oranı en yüksek nargile kullanımındaydı (%45.4). Onu sırasıyla alkol (%34.2), sigara (%24.4), uçucu maddeler (%4.9), benzodiazepin (%3.8), esrar (%2.9), kokain (%0.6) ve eroin (%0.4) takip etmekteydi. Eroin, ecstasy ve esrar kullanım riski erkek öğrencilerde daha yüksekti. Ayrıca verilerimiz tütün kullanımının diğer tüm maddelerin kullanım riskini arttırdığını göstermiştir. Sonuç: Onbeş milyon nüfusu ve heterojen yapısı ile İstanbul’da halihazırdaki madde kullanım verilerini belirlemenin önemli olduğuna inanıyoruz. Bununla birlikte Türkiye’nin farklı coğrafi bölgelerini kapsayan bir çalışmanın gerekliliği de ortadadır. Anahtar sözcükler: alkol, ergen, online anket, madde, tütü