War in the midst of a pandemic: the synergy accelerating mental health disorders

War and displacement can have long-term and disastrous repercussions on people's mental, emotional, and physical health. Bombardments, invasions, occupation desertion, and being forced to flee diminish people's sense of security. The risk of being hurt or maimed as a result of conflict causes acute dread, which sets in motion other cascades of mental illnesses such as depression, anxiety, and post-traumatic stress disorder. These mental and emotional impacts are exacerbated by a co-existing pandemic, as migration and populations forced into cramped, dangerous situations are likely to contribute significantly to disease spread, particularly given the current surge of the highly transmissible omicron variant of COVID-19. This threat to life and livelihood eventually leaves some survivors with mental health disorders.

Antidiabetics and antihypertensive medications use in Morocco: a pharmacoepidemiological descriptive study

Background: In Morocco, and many other African countries, there is a paucity of antihypertensive and antidiabetics use amongst the general population. Aim: To investigate the epidemiological profile of antihypertensive and antidiabetics use and analysis their adverse reactions. Setting: This study was conducted in the prefecture of Figuig, Morocco. Methods: A cross-sectional descriptive study. Data was collected using semi-structured questionnaire about their pharmacological treatment and presented using descriptive statistical analysis. Results: Sample of 244 subjects, predominantly women 58.15% (p < 0.03) composed of diabetic patients 56.96% (n = 139) and hypertensive patients 43.03% (n = 105). After adjustments, 60.24% of all patients were under monotherapy. The diabetics were being treated using the Biguanide class (26.92%), insulin (20.0%) and sulfonylureas (10.0%) while hypertensive patients were treated by Calcium Channel Blockers (27.36%), Angiotensin Converting Enzyme Inhibitors (21.05%), Angiotensin T-Blockers (16.84%), Diuretics (7.36%) and ß-adrenergic receptors blockers (3.15%). In total, 23.00% of all subjects have experienced negative side-effects, mostly, reported (90.38%) to health professionals and 23.52% of them have interrupted temporarily or try to change their treatment. Gastro-intestinal problems were the most adverse reactions reported (11.11%) followed by headache, dizziness and tinnitus (6.66%) and asthenia, feeling sick and feeling of faintness (5.33%). Conclusion: Managing diabetes and hypertension entails a lot of public challenges and requires more focus and interest, especially amongst the illiterate population in remote areas. Some of the suggested ways to help face the problem include the introduction of new innovative measures, systems of fellow-up and adverse reactions

Déshydratation sub-clinique dans une population d'élèves âgés de 8 à 11 ans à Yaoundé

Introduction : La déshydratation sub-clinique se définit par une perte de 1% à 3% du poids corporel en eau. Elle touche un à deux tiers des élèves en Europe. Peu de données sont disponibles dans notre contexte (climat tropical), justifiant le présent travail. Objectif : Evaluer l'état d'hydratation d'enfants scolarisés au cours de la saison sèche à Yaoundé.Patients et Méthodes : Nous avons mené une étude transversale en février 2017, sur une population d'enfants âgés de 7 à11 ans. L'état d'hydratation était évalué en début et fin de journée par bioimpédancemétrie et analyse d'urine. Par ailleurs les données sur les habitudes d'hydratation ont été recueillies grâce à un questionnaire.Résultats : Nous avons inclus 167 enfants dont 55,1% de filles. Les enfants déclaraient des 86,2% des cas boire de l'eau mais de manière spontanée dans 67,7% de cas. La consommation moyenne d'eau par les enfants au cours de 8 heures passées à l'école était de 527 ± 301 ml. A la bioimpédancemétrie, la masse hydrique était faible chez 52,3% d'élèves. La densité urinaire quant à elle était élevée chez 76% des élèves à l'arrivée à l'école et cette proportion atteignait 81,4% en fin de journée.Conclusion : La consommation d'eau semble faible dans notre population. Plus de la moitié de notre population d'étude est en déshydratation sub-clinique à l'arrivée à l'école. Cette proportion varie selon la méthode utilisée

Gender perspectives and health literacy proficiencies of In-school adolescents in Osun State, Nigeria

Health literacy proficiency has been linked with positive adolescent health outcomes. Strategies aimed towards improving health literacy have been suggested as a major way of achieving adolescent health and wellbeing. Previous research has identified a nexus between socio-demographics, education and health literacy proficiency. This study therefore, explores existing relationships between gender, socio-economic class and the health literacy proficiency levels of in-school adolescents in Osun State.Mixed method involving questionnaire survey and Focus group discussion were used to obtain data from 1,200 randomly selected in-school adolescents from 12 high schools in Osun State, Nigeria. The survey instrument was an adaptation of the electronic health literacy scale (eHEALS). Results show only 1,186 (98.8%) questionnaire were found analysable. Mean age of respondents was 15 + 0.6 with 616(51.1%) being female. Overall health literacy proficiency was low with only 447(37.7%) having a high level of health literacy proficiency. Quantitative survey shows that both gender and socio-economic background have negative statistically significant relationship with health literacy proficiency. Similarly, FGD revealed that females generally have lower health literacy proficiency when compared with males. The study concludes that gender based interventions for female adolescents could reduce health and educational disparities which will contribute to the achievement of Sustainable Development Goals 3, 4 and 5.

The normal range of maximal incisal opening in pediatric population and its association with physical variables

Background: Restricted mouth opening is a common complaint in patients suffering from temporomandibular joint disorders, ankylosis, impaired masticatory muscle function, rheumatic disease, infection, or malignancy. As with any disease, the aim of treatment of disorders affecting mouth opening is to restore the mouth opening to its normal value. It is thus of paramount importance to determine the normal value. Objective: To establish the normal range of maximal incisal opening (MIO) in children aged 4 to 15 years and to investigate the correlation between MIO and age, gender, height, and body weight. Materials and Methods: Six hundred and two children from various schools in Bengaluru, India, participated in the study. The children were divided into the following age groups: 4­5, 6­7, 8­9, 10­11, 12­13, and 14­15 years. MIO for the children was recorded using Therabite® scale. The measurements of MIO were then correlated with gender, body weight, and height of the children in different age groups. Results: It was observed that MIO gradually increased with age with a mean MIO of 41.34 mm at 4­5 years to a mean MIO of 51.73 mm at 14­15 years. The mean MIO value for males (48.90 ± 6.49 mm) was found to be higher when compared to that of females (46.17 ± 5.58 mm). The results indicated a strong positive correlation of MIO with height and weight. Conclusion: MIO gradually increased with age in both the genders, and a strong positive correlation of MIO with height and weight was observed

Snakebites in a Nigerian children population: A 5-year review

Background: Snakebite envenomation is a worldwide problem, which is an important cause of death in the developing countries and still remains a neglected public health problem. Children sustain more severe toxicity from envenomation compared to adults and thus have different outcomes.Objectives: This study was carried out to review the demographics, risk factors, interventions,outcomes of snakebite victims in the pediatric age group in Enugu, Southeast Nigeria, to improve the existing database.Materials and Methods: This was a descriptive, retrospective study conducted at the children emergency room (CHER) of Enugu State University Teaching Hospital (ESUTH), Enugu. The admission records of all the children that were admitted into CHER of ESUTH over a 5­year period (January 2012 to December 2016) were reviewed. Analysis was mainly descriptive. Frequency distributions of all relevant variables were reported as tables and prose. Test of significance for discrete variables was done using the Chi­square test. P <0.05 was regarded as statistically significant. Results: There were 5182 admissions with 13 cases of snakebite, giving a prevalence rate of 0.25%. Late presentation was significantly associated with longer duration of hospitalization (P = 0.026, χ2 = 4.952).Five (30.8%) patients had complications distributed as follows: one gangrenous limb (7.7%), one necrotic ulcer (7.7%), and three compartment syndromes (23.1%). Prehospital visit interventions included visit to the native doctor, local incision, application of herbs, tourniquet, and black stone application. One of the patients died, giving a case fatality rate of 7.7%. Conclusions: The prehospital emergency interventions given to snakebite victims still reflect practices that are harmful. It is possible that the majority of snakebite cases in our environment do not present to the health facilities. More efforts are required to improve the health­seeking behavior and emergency interventions for snakebite victims

Acceptance of sugar reduction in yoghurt among Moroccan population

Introduction: Morocco has recently developed a plan of reducing sugar consumption to reinforce prevention of non-communicable diseases and to contribute to the achievement of global voluntary targets for non-communicable diseases set by ICN2 by 2025. The objective of the present study was to assess acceptance of yogurts with different percentage reduction of sugar by the Moroccan population.Methods: a total of 201 participants (age > 15 y.) were recruited to determine the level of sugar reduction in yogurt. Sucrose was added to a plain yoghurt in the following different concentrations 166.5; 149.8; 133.2; 116.5; 99; 83.2 mM/l, corresponding to the reduction of sugar of 0%, -10%, -20%, -30%, -40% and -50%, respectively, compared available yogurt in local market. Overall, the acceptability scores of the different yoghurts were based on liking, "Just About Right" (JAR) and purchase intent scales was used to score the different yoghurts.Results: yogurts containing -20% and -30% added sugar were highly accepted by 81% and 74% of respondents. Based on JAR score, yoghurt with 20% (133.2mM/l) and 30% (116.5 mM/l) reduction were considered as "just about right" by 42.7% and 44.3% respectively. Best average score of purchase intent was obtained for sucrose concentration of 149.8 mM/l. 35.8% and 40.3% for yoghurt with sucrose concentration of 133.2 mM/l and 116.5 mM/l respectively.Conclusion: the finding from this study indicated that yogurts containing -20% and -30% added sugar were most accepted by respondents. Advocacy before dairy industry to have them commit towards sugar reduction in yogurt is needed, in order to help achieving the national sugar reduction strategy in Morocco

Les changements climatiques et leurs conséquences sur la santé

Le changement climatique est une réalité inéluctable pour les décennies à venir, compte tenu de l'inertie du système climatique. L'ampleur du changement est à ce stade incertaine au niveau planétaire, et plus encore localement. Cependant, des conséquences sont à prévoir dans tous les cas sur la santé humaine, considérée à l'échelle de la planète, avec des retentissements sanitaires directs (vagues de chaleur, inondations, pollution de l'air…) et surtout indirects sur la disponibilité de l'eau potable et des ressources alimentaires, la destruction de l'habitat. Ces impacts sont source potentielle de déplacement de populations, de violences, de conflits. Il est non seulement possible mais nécessaire de se préparer à répondre à l'incertitude et à l'inconnu par des politiques publiques volontaristes d'atténuation des émissions de gaz à effet de serre et d'adaptation aux impacts déjà en développement et à venir. Ces politiques doivent s'appuyer sur une interdisciplinarité scientifique mais aussi sur l'implication des populations

Déterminisme génétique de l'anosmie : Cas des populations Hadjaraï au Tchad

Introduction :L'anosmie a des causes diverses. Cette affection a été observée chez les «Hadjaraï», originaires de la région du Guéra au centre du Tchad. Le but de cette étude est de montrer l'origine génétique de l'anosmie et de déterminer son mode de transmission chez ces populations.Patients et Méthodes : C'était une étude prospective et descriptive menée dans la ville de N'Djaménaau Tchad. L'étude a concerné 146 personnes anosmiques, toutes des Hadjaraï d'au moins 15 ans. Pour chaque patient, un pedigree a été réalisé. Nous avons tiré au hasard 30 pedigrees pour l'étude.Résultats : L'ensemble de 30 pedigrees était composé de 485 personnes dont 161 anosmiques (93 hommes et 68 femmes).Dans tous les pedigrees, une personne anosmique de la deuxième ou troisième génération avait toujours un des parents anosmique excepté deux individus. La transmission de l'anosmie était verticale dans presque tous les pedigrees. Trois cas probables d'anosmie à pénétrance incomplète avaient été notés, donnant la pénétrance de la maladie à 0,98. La quasi-totalité des enfants issus des couples sains étaient indemnes. Dans trois quart des cas, les hommes malades mariés à des femmes sainesle transmettaient à leurs fils. Dans tous les pedigrees, une transmission de la maladie de père à enfants avait été notée.Conclusion : L'anosmie observée chez les « Hadjaraï » est d'origine génétique et se transmettrait selon le mode autosomique dominant, à pénétrance presque complète et à expressivité peu variable

Nasal Carriage of Multi-Drug Resistant Staphylococcus Aureus in Healthy Inhabitants of Amassoma in Niger Delta Region of Nigeria

Background: Nasal Staphylococcus aureus is a major source of community and hospital associated staphylococcal infections. This study determined the prevalence of nasal S. aureus isolates and investigated their antimicrobial resistance profile in healthy volunteers. Methods: Nasal specimens of healthy volunteers in Amassoma were cultured and screened for S. aureus using standard microbiological protocols and their antibiotic profile susceptibility was investigated using disc diffusion and agar dilution techniques. Results: A total of 40 (33.3) S. aureus isolates were obtained from 120 nares specimens screened. Twenty three (57.5) and 17 (42.5) of the isolates were from university students and villagers respectively. The isolates showed an overall 75resistance to ampicillin; 52.5to doxycycline; 47.5to chloramphenicol; 35to erythromycin and 32.5to cotrimoxazole; with 27.5methicillin resistant. No isolate was resistant to gentamicin while few isolates were resistant to cefuroxime (2.5); augmentin (5.0); ciprofloxacin (10.0); ofloxacin (10.0) and vancomycin (7.5). Twenty one (52.5) of all the isolates were multi-drug resistant; ten (47.6) of which were methicillin resistant Staphylococcus aureus (MRSA) and only 3 (7.5) were fully susceptible to all the tested antimicrobial drugs. Conclusions: The observation calls for strategies to prevent their spread to more vulnerable populations where the consequences of their infections can be severe

Population and reproductive health in national adaptation programmes of action (NAPAs) for climate change in Africa

This paper reviews 44 National Adaptation Programmes of Action (NAPAs) to assess the NAPA process and identify the range of interventions included in countries' priority adaptation actions and highlight how population issues and reproductive health/family planning (RH/FP) are addressed as part of the adaptation agenda. A majority of the 44 NAPAs identify rapid population growth as a key component of vulnerability to climate change impacts. However, few chose to prioritise NAPA funds for family planning/reproductive health programmes. The paper emphasizes the need to translate the recognition of population pressure as a factor related to countries' ability to adapt to climate change into relevant project activities. Such projects should include access to RH/FP, in addition to other strategies such as girls education and women's empowerment that lead to lower fertility. Attention to population and integrated strategies should be central and aligned to longer-term national adaptation plans and strategies (Afr J Reprod Health 2010; 14[4]: 133-145)

Stigmatising attitudes towards the mentally ill: a survey in a Nigerian university teaching hospital

Background. The burden of mental illness is particularly severe for people living in low-income countries. Negative attitudes towards the mentally ill; stigma experiences and discrimination constitute part of this disease burden.Objective. The aim of this study was to investigate knowledge of possible causes of mental illness and attitudes towards the mentally ill in a Nigerian university teaching hospital population.Method. A cross-sectional descriptive study of a convenience sample of 208 participants from the University of Uyo Teaching Hospital; Uyo; Nigeria; using the Community Attitudes towards the Mentally Ill (CAMI) scale. Information was also obtained on beliefs about possible causes of mental illness.Results. The respondents held strongly negative views about the mentally ill; mostly being authoritarian and restrictive in their attitudes and placing emphasis on custodial care. Even though the respondents appeared to be knowledgeable about the possible role of psychosocial and genetic factors in the causation of mental illness; 52.0 of them believed that witches could be responsible; 44.2 thought mental illness could be due to possession by demons; and close to one-third (30) felt that it could be a consequence of divine punishment.Conclusions. Stigma and discrimination against the mentally ill are widespread even in a population that is expected to be enlightened. The widespread belief in supernatural causation is likely to add to the difficulties of designing an effective antistigma psycho-educational programme. There is a need in Nigeria to develop strategies to change stigma attached to mental illness at both institutional and community levels

Anxiety among Residents Living near Poultry Farms during Avian Influenza H5NI -Outbreak in Nigeria

Avian influenza (AI) H5NI arrived Nigeria in the year 2006 with apathy towards poultry and poultry products. Our study was conducted among residents living near poultry farms (RLNPF); who were daily exposed to emissions from poultry farms; during the AI H5NI outbreak in the year 2006 and a year later. The physical and mental health statuses were assessed via structured questionnaire. The RLNPF experienced similar physical ill-health symptoms during the study period; 2006 and 2007; but were significantly higher than those reported by the control populace. Depression indices were similar in the two years running with no significant difference in all the groups studied. Anxiety symptoms were significantly higher in 2006 during outbreak of AI than in the year 2007 among RLNPF; as well as than control. There was no significant difference in anxiety symptoms between the RLNPF in 2007 and the control populace. The result indicated that there was anxiety among the RLNPF in the year 2006 when there was outbreak of AI H5NI in Nigeria

Prevalence of Schistosoma haematobium Infection in a Neglected Community, South Western Nigeria

Purpose: Schistosomiasis ranks second to malaria among parasitic diseases of socio-economic and public health importance. In Nigeria; urinary schistosomiasis caused by Schistosoma haematobium is endemic. This study aimed at producing an accurate data on the prevalence of urinary schistosomiasis in Apojula; a neglected community located around Oyan Dam; southwest Nigeria; using parasitological and molecular techniques. Methods: Parasitological examinations were carried out on urine samples from 63 participants whose ages ranged between 7 and 63 years. Matched blood and urine samples were also screened for S. hematobium infection by polymerase chain reaction (PCR) amplification of the schistosome Dra1 repeat. Results: of the 63 participants; 33 (52.4) were positive for heamaturia while 6 (9.5) had S. haematobium ova in their urine. PCR amplification of S. haematobium Dra1 repeat from their urine and blood samples showed that 59 (93.65) and 62 (98.4) were infected respectively. Conclusion: There was a high prevalence of S. haematobium infection as detected by PCR amplification of schistosome Dra1 repeat from the urine and blood samples of the study participants. In addition; the PCR was able to detect schistosome infection in cases otherwise shown to be negative by parasitological examinations thereby making them also to receive chemotherapy

Uterine Roundness Index: Model Formulation and Nomogram for a Nigerian Population

This study was aimed to establish a nomogram for uterine roundness index (UTRI) for a Nigerian population. Seven hundred Nigerian girls and women in the premenarche; nulliparous; multiparous and postmenopausal groups with normal uteri were evaluated by pelvic ultrasound. The length; anteroposterior and transverse diameters of the uterus were measured and the UTRI calculated as the ratio of anteroposterior diameter to the length. The age; height; and parity of the subject were recorded. The mean UTRI +SD were 0.44457+0.0629 for premenarche; 0.5880+0.1118 for nulliparous; 0.6005+0.1046 for multiparous and 0.5269+0.1037 for postmenopausal. Pearson's correlation analysis showed significant correlation between UTRI and age; height and weight in premenarche group and weight in the nulliparous; multiparous and postmenopausal groups (p 0.05). Significant negative correlation between UTRI and age occurred only in the postmenopausal group (p 0.05). The study has established a nomogram for UTRI in a Nigeria population which will be of gynaecological importance to sonographers and referring clinicians in assessing the normality of uterine shapes and contour

Has the HIV Epidemic in Rural Mwanza; Tanzania Reached a Plateau?

Data from studies in Mwanza Region in Tanzania suggest stabilising HIV prevalence. The objective was to determine the factors that may have contributed to the relatively stable pattern of the HIV prevalence observed in the comparison communities of the Mwanza STD treatment trial in rural Mwanza Region; Tanzania between 1991 and 2001. Socio-demographic; sexual behaviour and HIV prevalence data in two surveys conducted 10 years apart in the same communities using similar sampling schemes were compared. The age standardised HIV prevalence was 3.8(95CI: 3.2-4.6) in 1991 and 4.3(95CI: 2.8-6.4) in 2001 for males (Z= - 0.56; P= 0.58); and 4.5(95CI: 3.8-5.3) in 1991 and 3.9(95CI: 2.6-5.6) in 2001 for females (Z= 0.64; P= 0.52). Participants in the 2001 survey reported significantly fewer lifetime and recent sexual partners (12 months); Sexually Transmitted disease syndromes (12 months) and significantly more condom use at last sex with casual partners than those in the 1991 behaviour survey. We conclude that STD/ HIV infection prevention activities in rural Mwanza may be responsible for changes in risky sexual behaviour and have successfully impeded the spread of HIV infection. These activities should therefore be enhanced to reduce HIV incidence even further. In addition; modelling studies are needed to assess whether mobility of HIV infected people out of rural communities may stabilise the prevalence of the HIV infection in the general populations