Psychosocial consequences and reasons for illicit drug use among police officers in a northern Nigerian city: A mixed-method study

Harmful use of drugs is one of the principal risk factors affecting population health worldwide. Chronic use has been linked to medical, psychological and socioeconomic consequences. This study assessed the psychosocial consequences and reasons for illicit drug use among police officers in Kano, Nigeria. Using a mixed method of data collection, quantitative data was obtained from a cross-section of 275 officers using the Shortened Inventory of Problems-Drug Use (SIP­DU) and a pretested adapted questionnaire. In-depth interviews with 10 officers who used illicit drugs provided additional information. Almost half of the respondents (46.5%, n=128) were in their fourth decade of life with a mean age (±SD) of 35.1 ± 7.7 years. Over a quarter of the respondents (n=75) reported ever using illicit drugs, out of which 14.9% (n=41) were current users. Among the current drug users, 80.5% (n=33) attested to having money problems, 61.0% (n=25) agreed that they had spent too much money, and 56.1% (n=23) failed to do what was expected of them as a result of drug use and have hurt their family. Helping to stay awake and improving confidence were the major reasons (100%, n=41) for drug use mentioned by the respondents. The Nigerian Police Force should look into easing shifts and introducing stress-relieving activities. There is also the need to strengthen substance education and counselling and support officers with confidence issues, sleep disorders, and treat those with mood disorders.

Determinants of contraceptive use in Abidjan (Côte d'Ivoire)

In Côte d'Ivoire, contraceptive prevalence is low (21%). The search for determinants of contraceptive use could make it possible to redirect existing strategies. The objective is to identify the determinants of the use of contraception among women in Abidjan. A cross-sectional survey was conducted from May to June 2018 in the Dallas neighborhood of Adjamé municipal (Abidjan). Women of reproductive age (15 to 49 years old) were selected there. Sociodemographic, gyneco-obstetrical characteristics, educational level, attitudes and practices of women on contraception were collected. Univariate and multivariate analyzes were performed. A total of 301 women aged 29.34±8.98 years were selected. The proportion of women using modern contraception was 27.24%. In univariate analysis, the factors associated with use were: level of education (p=0.005), unwanted pregnancies (p=0.017), abortions (p<0.001), consultation of the gynecologist (p=0.003) or a family planning service (p=0.001). Hearing about contraception (p=0.043), knowing (p<0.001) and talking about it with their partner (p=0.027) was significantly associated with its use. In the multivariate analyses, the women who consulted a gynecologist and those who knew the contraceptive methods used them respectively 2 times more (OR= 2.16 [1.14-4.15], p=0.019) and 22 times more (OR= 22.38 [8.42-78.56], p<0.001). Women with primary school education used them significantly less (OR=0.15 [0.05-0.41], p<0.001). Awareness, the gynecologist's consultation, and the level of education were the main determinants of contraceptive use. Also, it is necessary to adapt awareness messages to the characteristics of women.

Drug use among youth and adults in a population-based survey in South Africa

Objective: Illicit drug use is a growing public health problem. The aim of the study was to assess the prevalence of drug use and the sociodemographic and health characteristics that influence it among young and adult South Africans. Methods: Data based on the South African national population-based survey in 2012 for 26453 individuals (52.0% women and 48.0% men) aged 15 years and older were analysed. Past 3-month drug use was assessed with the 'Alcohol, Smoking and Substance use Involvement Screening Test (ASSIST)'. Bivariate and multivariable logistic regression was conducted to assess the association between sociodemographic factors, health variables and any past 3-month drug use. Results: Overall, any past 3-month drug use was 4.4%, 7.9% among men and 1.3% among women. The proportion of past 3-month cannabis use was 4.0%, followed by sedatives or sleeping pills 0.4%, amphetamine-type stimulants 0.3%, cocaine 0.3%, opiates 0.3%, inhalants 0.2% and hallucinogens 0.1%. Among the nine South African provinces, any past 3-month drug use was the highest in the Western Cape (7.1%), followed by the Free State (6.3%) and Northern Cape (5.2%). In adjusted, multivariable, logistic regression analysis among both men and women, younger age, being mixed race and hazardous or harmful alcohol use were associated with any past 3-month drug use. In addition, having been a victim of violent crime and sexual risk behaviour among men and having psychological distress among women were associated with any past 3-month drug use. Conclusion: An increase of any past 3-month drug use from 3.7% in 2008 to 4.4% in 2012 was observed in South Africa. Prevention and intervention activities targeting drug use, in particular in identified risk groups, need to be strengthened in South Africa

Correlates of Sexual Activity Versus Non-Activity of Incoming First-Year Students at a South African University

In order to contribute to the design of more effective programmes to curb the spread of HIV at tertiary institutions; this study compares the profile of students who are sexually active versus those who are not yet sexually active when entering university. The study was conducted among three cohorts of first-year university students at the University of the Western Cape from 2007 to 2009. A range of correlates of sexual activity versus non-activity were explored using logistic regression analysis. The predicted probabilities of the logit link function depict marked differences between genders and racial groups. Males were more likely than females to be sexually active when entering university and the Black racial group was more likely than other racial groups to be sexually active. Risk-taking behaviours such as smoking; alcohol and drug use were shown to increase the likelihood of being sexually active when entering university; as did indicators of depression and suicidal ideation. The results indicate that religion plays an important role in influencing sexual behaviour; highlighting the important potential role that religious organisations can play in addressing HIV risk at tertiary institutions

Drug Use Pattern with Standard Indicators in Jos University Teaching Hospital Nigeria

Background: Drug use pattern is assessed through prescribers; dispensers; and patients.The indicators used formonitoring include; health-facility; prescribing and patient care indicators. Objectives: The study was aimed at determining the drug use pattern by measuring core indicators in Jos University Teaching Hospital (JUTH); Nigeria; from 2010 to 2011; and to compare findings with similar institutions globally.Methods: Drug-specific analysis employed research tools using nine-item questionnaires; checklists and standard patient care forms. Data was obtained from patients who visited the hospital; within the period of thisstudy.Results: The study revealed that out of the total drugs prescribed; 85.3 were dispensed and the average number of drugs per prescription was three. About 70.2 of drugs were prescribed by generic names while therest were by brand names. Drugs prescribed from the hospital formulary were 88 with antibiotics being themost prescribed (35.3) while the least prescribed were injections (9) with no significant variation (p0.05)for the indicators measured during the period. Responses to questions on drug use produced positive results(85) in six out of the nine research items. Average consultation time was 11.33 minutes and dispensing timegave 3.53 minutes.Conclusion: The drug use pattern in JUTH was satisfactory compared to national and international findings. The core indicators measured underscored the need for pharmacists to provide drug information and counseling needs to patients and could serve as basis for further studies on drug use for hospitals in resource limited settings. Conclusion: The drug use pattern in JUTH was satisfactory compared to national and international findings. Thecore indicators measured underscored the need for pharmacists to provide drug information and counseling needs to patients and could serve as basis for further studies on drug use for hospitals in resource limited settings

Rewriting the Narrative of the Epidemiology of HIV in Sub-Saharan Africa

The fight against HIV remains complicated with contracting donor resources and high burden of HIV among reproductive age adults still often limiting independent economic development. In the widespread HIV epidemics of sub-Saharan Africa (SSA); it is proposed that key populations with specific HIV acquisition and transmission risk factors; such as men who have sex with men (MSM); female sex workers (FSW); and people who use drugs (PUD); are less relevant because HIV transmission is sustained in the general population with average HIV acquisition and transmission risks. However; the understanding that key populations are less relevant in the epidemics of Africa is based on the surveillance system from which these populations are mostly excluded. Outside of SSA; the epidemics of HIV are generally concentrated in the same populations that are excluded from the primary HIV surveillance systems in SSA. The manuscripts included in this special issue present convincing data that FSW; MSM; and PUD carry disproportionate burdens of HIV wherever studied in SSA; are underrepresented in HIV programs and research; and require specific HIV prevention services. These manuscripts collectively suggest that the only effective path forward is one that transcends denial and stigma and focuses on systematically collecting data on all populations at risk for HIV. In addition; there is a need to move to a third generation of HIV surveillance as the current one inadvertently devalues HIV surveillance among key populations in the context of widespread HIV epidemics. Overall; the data reviewed here demonstrate that the dynamics of HIV in Africa are complex and achieving an AIDS-free generation necessitates acceptance of that complexity in all HIV surveillance; research; and prevention; treatment; and care programs

Demand for Programs for Key Populations in Africa from Countries Receiving International Donor Assistance

There has been increasing attention in recent years to the HIV prevention; treatment; and care needs of key populations in Africa; in particular men who have sex with men (MSM); injection drug users (IDU); and female sex workers (FSW). While several major donors have undertaken efforts to prioritize these groups; it remains unclear which African countries are actively seeking donor support for these programs. For this analysis; we reviewed publicly available proposal and budget documentation from the US PEPFAR for fiscal years 2007 through 2010 and Rounds 1 through 10 of the Global Fund to Fight AIDS; Tuberculosis and Malaria for 40 countries in sub-Saharan Africa. Of the 164 searchable documents retrieved; nearly two-thirds contained at least one program serving FSW (65; 107 proposals); less than one-third contained at least one program serving MSM (29; 47 proposals); and a minority proposed programming for IDU (13; 21 proposals). Demand for these programs was highly concentrated in a subset of countries. Epidemiological data for at least one key population was included in a majority of these proposals (63; 67 proposals); but in many cases these data were not linked to programs

Drug Trafficking; Use; and HIV Risk: The Need for Comprehensive Interventions

The rapid increase in communication and transportation between Africa and other continents as well as the erosion of social fabric attended by poverty; ethnic conflicts; and civil wars has led to increased trafficking and consumption of illicit drugs. Cannabis dominates illicit trade and accounts for as much as 40 of global interdiction. Due to escalating seizures in recent years; the illicit trade in heroin and cocaine has become a concern that has quickly spread from West Africa to include Eastern and Southern Africa in the past 10 years. All regions of Africa are characterized by the use of cannabis; reflecting its entrenched status all over Africa. Most alarming though is the use of heroin; which is now being injected frequently and threatens to reverse the gain made in the prevention of HIV/AIDS. The prevalence of HIV infection and other blood-borne diseases among injection drug users is five to six times that among the general population; calling for urgent intervention among this group. Programs that aim to reduce the drug trafficking in Africa and needle syringe programs as well as medication-assisted treatment (MAT) of heroin dependence while still in their infancy in Africa show promise and need to be scaled up

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; 73.8and 65.7respectively. 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."

Cannabis publication analysis using density-equalising mapping and research output benchmarking

Background. Cannabis has been a topic of political and medical controversy in many countries over the past century. Although many publications on this topic are available, there is currently no comprehensive evaluation of global research activities in the field. Objective. This study was conducted in order to provide a quantitative and qualitative analysis of the worldwide research output on cannabis. Methods. In a quantitative approach, items concerning cannabis published between 1900 and 2008 were retrieved from the ISI Web of Science databases developed by the Thompson Institute of Scientific Information and analysed using scientometric methods. In a second step, research fields of growing interest were identified. Results. We found that publications on this topic increased during the late 1960s, as well as during the period 1990 - 2008. We noted that South Africa was one of the countries with a high research output; having published numerous articles on cannabis. A comparison of cannabis with other drugs (e.g. alcohol, tobacco, cocaine and heroin) showed that in relation to the proportion of respective drug users, cocaine and heroin are overly represented in terms of research output. When analysing the main subjects of the publications; psychiatry was prominent, especially with regard to research on psychosis. Conclusion. There is increasing interest in research on cannabis. The research only partially reflects the drug's importance with regard to number of users