Psychological impact of the COVID-19 pandemic on anaesthetists in an academic institution in South Africa

Background: Anaesthesiology is considered to be a medical speciality that can result in high levels of stress. The COVID-19 pandemic required anaesthetists to rapidly adopt additional challenging roles. This study describes the psychological impact of the pandemic on anaesthetists and identified and compared factors associated with depression, anxiety, stress, and post-traumatic stress disorder (PTSD). Methods: A cross-sectional study design was used. An anonymous questionnaire was used to collect data utilising convenience sampling and results were reported using descriptive statistics and logistic regression analysis. The order of importance for the sources of stress and organisational support was determined by calculating the median rank. Results: The majority of the participants were between ages 31­40 (62.6%), male (59.8%), registrars (47.6%), had no comorbidities (73.8%), and had no known mental illness (79.9%). Having a previous diagnosis of a mental health illness was linked with greater levels of depression (OR [95% CI] = 4.50 [2.02­10.24], p < 0.001), anxiety(OR [95% CI] = 3.9 [1.7­9.0], p = 0.001), stress (OR [95% CI] = 3.8 [1.6­9.2], p = 0.002), and PTSD (OR [95% CI] = 5.4 [2.2­13.5], p < 0.001). Sources of stress identified included: insecure access to appropriate personal protective equipment, being exposed to COVID-19 at work, and taking the infection home to family. Conclusion: Participants with a history of mental illness were predisposed to developing negative psychological symptoms as a result of the pandemic. The main source of stress identified was insecure access to appropriate personal protective equipment.

Psychosocial factors associated with psychiatric morbidity in higher institution students in Nigeria

Introduction: Mental health disorders in undergraduates are often undetected and may predispose to other academic and social complications. The objective of the study is to determine the prevalence of probable psychiatric morbidity among students of University of Ilorin, Nigeria and the psycho-social factors that are associated with psychiatric morbidity in them. Methods: Socio-demographic questionnaire and the 12-item General health questionnaire (GHQ-12) were administered to 3,300 undergraduate students to assess psychosocial variables and psychiatric morbidity respectively. Results: About 23.5% of respondents scored >3 using the GHQ-12 questionnaire, signifying a likehood of psychiatric morbidity. Students from polygamous families were 1.3 times more likely to have GHQ scores of >3 than those from monogamous (OR=1.276, P=0.026). Those who had unemployed fathers were twice more likely to have a GHQ > 3 than those with employed fathers. (OR=2.084, P=0.005).Those who lived in houses with shared toilet facilities were 1.3 times more likely to have GHQ >3 (OR=1.310, P=0.028) Conclusion: This study calls for a careful consideration and modification of the various psychosocial factors associated with pschiatric morbidity in order to ensure a mentally healthy and vibrant student community

Quality of life among cancer patients at Queen Elizabeth and Kamuzu Central Hospitals in Malawi: a cross-sectional double-center study

Introduction: Many cancer patients experience psychosocial challenges that affect quality of life during the trajectory of their disease process. We aimed at estimating quality of life among cancer patients at two major tertiary hospitals in Malawi. Methods: The study was conducted among 398 cancer patients using semi-structured questionnaire. Quality of life was measured using EQ-5D-3L instrument. Results: Mean age was 45 years ± 12.77. Pain (44%) was the most prevalent problem experienced by cancer patients. About 23% had worst imaginable health status on the subjective visual analogues scale. Attending cancer services at QECH (AOR= 0.29, 95% CI: 0.17-0.54, p<0.001) and having normal weight (AOR=0.25, 95% CI: 0.08-0.74, p = 0.012), were associated with improved quality of life. A history of ever taken alcohol (AOR= 2.36, 95% CI: 1.02-5.44, p = 0.045) and multiple disease comorbidities (AOR= 3.78, 95% CI: 1.08-13.12, p = 0.037) were associated with poor quality of life. Conclusion: Loss of earning, pain, marital strife, sexual dysfunction, were among the common psychosocial challenges experienced. History of ever taken alcohol and multiple comorbidities were associated with poor quality of life. There is need to integrate psychosocial solutions for cancer patients to improve their quality of life and outcomes

Oculocutaneous albinism in southern Africa: Historical background, genetic, clinical and psychosocial issues

Albinism is an inherited condition associated with significant depigmentation of the skin, hair and eyes. It occurs in every population with varying frequency, and narratives of people with albinism have been recorded since 200 BC. In southern Africa albinism is common, about 1 in 4000 people are affected, but it remains a poorly understood condition surrounded by myths and superstition. This article provides a historical background on oculocutaneous albinism (OCA) in southern Africa and presents relevant information from the literature regarding epidemiology, genetics and genetic counselling, health, psychosocial and cultural issues, and medical care. There are several recessively inherited types of OCA and a mutation, responsible for about 80%of South African variants, has been identified in OCA type 2. The physical characteristics associated with albinism, that is, sun-sensitive skin and low vision, can be managed. However, people with OCA in Africa also experience psychosocial issues, such as discrimination, because of the various superstitious beliefs and attitudes held in the community. Management should include medical care for health problems, appropriate adjustment of the schooling context and genetic counseling. In addition, widespread public awareness programs are required to increase the knowledge of the genetic causes of OCA and of the nature of genetic counselling, to address the negative attitudes in the community, to reduce the marginalization and stigmatization of people with albinism and to improve their quality of life.

Oculocutaneous albinism in southern Africa: Historical background, genetic, clinical and psychosocial issues

Albinism is an inherited condition associated with significant depigmentation of the skin, hair and eyes. It occurs in every population with varying frequency, and narratives of people with albinism have been recorded since 200 BC. In southern Africa albinism is common, about 1 in 4000 people are affected, but it remains a poorly understood condition surrounded by myths and superstition. This article provides a historical background on oculocutaneous albinism (OCA) in southern Africa and presents relevant information from the literature regarding epidemiology, genetics and genetic counselling, health, psychosocial and cultural issues, and medical care. There are several recessively inherited types of OCA and a mutation, responsible for about 80%of South African variants, has been identified in OCA type 2. The physical characteristics associated with albinism, that is, sun-sensitive skin and low vision, can be managed. However, people with OCA in Africa also experience psychosocial issues, such as discrimination, because of the various superstitious beliefs and attitudes held in the community. Management should include medical care for health problems, appropriate adjustment of the schooling context and genetic counseling. In addition, widespread public awareness programmes are required to increase the knowledge of the genetic causes of OCA and of the nature of genetic counselling, to address the negative attitudes in the community, to reduce the marginalisation and stigmatization of people with albinism and to improve their quality of life

Comparative assessment of young people's psychosocial, economic state and reproductive health needs between total and partial lockdown states of Nigeria

Introduction: In Nigeria, adolescents and young adults, age 10-24 years constitute 32% of the entire population. They are particularly vulnerable when disasters occur, such as in the current pandemic. Existing events and circumstances including the various pandemic-related movement restrictions (lock-down) influences behavioural attitudes and predisposes to risky sexual behaviours.Methodology: This is a comparative cross-sectional study conducted between a total lockdown (Osun) state and partial lockdown (Oyo) state in South-Western Nigeria. A convenience sampling technique was adopted using a self-administered closed-ended questionnaire designed using Google form and data were then analysed using SPSS version 22. Bivariate analysis and Logistic regression were performed with the level of significance set at p < 0.05. Results: A higher proportion of those in Osun (total lockdown) state have their needs extremely difficult to meet during the pandemic period compared to Oyo (partial lockdown) had their needs only a little difficult to meet. Different factors were found to influence the social, economic effect and reproductive health needs but age and educational level attained were found to be common factors that affected young people needs during the lockdown period. Conclusion: Access to contraceptive drastically reduced during this pandemic, especially among those under total lockdown, this may consequently lead to the increase incidence of unwanted pregnancies among the youths, which if not well managed could lead to unsafe abortion and invariably, death. As new COVID-19 cases continue to emerge, staying at home for prolonged periods of time can pose a significant challenge on the health of young people.

Ethical Dilemma involving autonomy and COVID-19 testing

Background: In December 2019, an atypical form of pneumonia was discovered in Wuhan, China and it has spread to different parts of the world including Nigeria. Testing for the causative agent which is the severe acute respiratory distress syndrome coronavirus-2 is one of the strategies to contain the pandemic. For some reason, some patients with clinical symptoms suggestive of COVID-19 may refuse to be tested for the disease. Methodology: A review of studies conducted on COVID-19 testing and ethical dilemma associated with it was done using Google Scholar, PubMed and Cochrane reviews. Conclusion: Ethical dilemma exists in testing for COVID-19 as some patients may refuse testing even when it is necessary and they present with symptoms suggestive of COVID-19. The right to autonomy according to the principles of medical ethics is necessary for every medical consultation but may not be important in pandemics as the person becomes a health threat and harmful to the public.

Teaching Biopsychosocial Competence and the Principles of the Primary Health Care (PHC) at the Patient's Bedside

The importance of behavioural and social determinants in health was recognised long ago; yet we still grapple with the challenges of developing appropriate teaching pedagogies to bring these principles into routine clinical practice. A teaching pedagogy blending the biopsychosocialapproach and the principles of primary health care (PHC); as expressed in the Alma-Ata Declaration of 1978; is lacking in the literature. This report hopes to address this need.In 1994 the University of Cape Town (UCT); South Africa; adopted a PHC-based approach to health sciences education to equip its graduates with the necessary knowledge; skills and attributes required to meet the challenges of providing health care in a country with vast socio-political inequalities. This paper describes an educational pedagogy which weaves these principles into clinical practice in an undergraduate medical clerkship. The methodology uses real patient encounters linked to an interactive seminar and a portfolio of case studies. Students described the teaching pedagogy as interesting and informative. They recognised the importance of holistic; patient-centeredcare based on a biopsychosocial approach and the importance of the PHC principles. Barriers to implementing this approach were also highlighted. The pedagogy; in use for four years; is being adopted by another department; indicating the sustainability and success of the course

Tabagisme en milieu scolaire dans la commune de Marcory

Une etude transversale prospective portant sur le tabagisme en milieu scolaire dans la commune de Marcory a Abidjan a ete menee dans l'objectif de determiner : la prevalence tabagique; les facteurs favorisant le tabagisme et les connaissances des eleves sur le tabac et ses mefaits. Ainsi; nous avons a l'aide d'un questionnaire individuel anonyme; enquete sur un echantillon de 509 eleves. Cette enquete s'est deroulee sur une periode de 2 mois allant du 4 avril au 8 juin 2005. Au terme de cette etude; les resultats suivants ont pu etre releves: *La prevalence tabagique etait de l'ordre de 19;06Pour cent avec une nette predominance masculine (25;65Pour cent de fumeurs contre 8;96Pour cent de fumeuses). *Le tabagisme augmentait avec l'age et le niveau d'etude; les fumeurs ayant une moyenne d'age de 17;83 ans et etant dans 55;67 pour cent des cas au second cycle. *La majorite des fumeurs vivait dans des conditions socio-economiques modestes. Ils residaient dans 69;07Pour cent des cas dans des habitats de type cadre (villas et appartements). Leurs peres etaient surtout des cadres moyens (34 Pour cent) et leurs meres de la classe ouvriere (35 Pour cent) ou menageres (25;77 Pour cent). *L'initiation tabagique s'est operee en moyenne a 15;01 ans et a ete principalement motivee par le mimetisme (33Pour cent) et par la curiosite (23;71Pour cent). Le tabagisme des pairs a influence dans 58;33Pour cent des cas cette initiation. *La consommation tabagique moyenne etait de 4;96 cigarettes par jour. Ce qui correspond a une depense moyenne quotidienne de 185;86 FCFA. *Les maquis et boites de nuit (73;63Pour cent) etaient les lieux de predilection de l'intoxication tabagique. L'association alcoolo tabagique a concerne 66;67Pour cent des fumeurs. *71;13Pour cent des eleves qui fumaient ont essaye d'arreter de fumer sans succes. *97;05Pour cent des eleves estimaient que le tabac represente un danger pour la sante. *De toutes les affections induites par le tabagisme; les pathologies respiratoires; avec une frequence de 56;97Pour cent; etaient les plus connues des eleves. Le cancer broncho-pulmonaire (47;18Pour cent) etait la pathologie respiratoire la plus citee. Ces resultats mettent en relief la gravite du tabagisme en milieu scolaire. L'elaboration et l'application de moyens de lutte anti-tabac efficaces s'averent plus qu'urgentes pour estomper l'expansion galopante de ce fleau au sein de la jeunesse

Place des pathologies mentales au conseil de sante de la Cote d'Ivoire. Bilan de 10 annees d'activite : de janvier 1989 a decembre 1998

Le Conseil de Sante de la Cote d'Ivoire a ete mis en place le 1er avril 1965 arrete no12 SP. CAB et est charge d'examiner et d'emettre son avis sur : -Les demandes presentees par les fonctionnaires et agents de l'etat au sujet des Conges de maladie; conges de convalescence; conges de longue duree; changements de position administrative pour raison de maladie. -Les demandes d'evacuation sanitaire hors de la Cote d'Ivoire; -Les demandes de cure thermale. Cette etude a pour objet d'apprecier la place qu'occupent les sujets consultant pour des motifs d'ordre psychiatrique. En effet la frequence des pathologies mentales est elevee; c'est ainsi que sur 10 ans (de janvier 1989 a decembre 1998); les services de psychiatrie ont adresse 1342 sur les 5629 demandes repertoriees au Conseil de Sante soit 23;8 pour cent ;les services de Pneumophtisiologie et de Neurologie ayant respectivement 20;2 pour cent et 12;4 pour cent. Les sujets de sexe masculin representent 70;9 pour cent des consultants et les professions d'enseignants (instituteurs; professeurs du secondaire et du superieur) 56;6 pour cent avec un taux de 41;6 pour cent (sur les 5629 demandes) pour les seuls instituteurs. Les sujets de sexe masculin represente 70;9 pour cent des consultants et les professions d'enseignants (instituteur; professeurs du secondaire et du superieur) 56;6 pour cent avec un taux de 41;6 pour cent(sur les 5629 demandes) pour les seuls instituteurs. Les diagnostics de psychiatrie les plus frequents sont les Etats psychotiques chroniques a savoir schizophrenie; paranoia; psychose hallucinatoire chronique avec 37 pour cent suivi de la depression avec 36;5 pour cent. Les decisions finales du conseil de Sante a savoir maintien ou non de l'activite professionnelle sont en faveur du maintien avec 89;7 pour cent des 5629 demandes avec cependant 13;3 pour cent des dossiers non traites. Les sujets de sexe feminin representent les taux les plus eleves de demandes de conge de maladie courte duree(grossesse a risque)et aussi un taux important des patients adresses par les services de cancerologie 96;2 pour cent (contre 30;8) d'hommes sur les 65 cas .Ce travail revele la meconnaissance du statut et des objectifs du Conseil de Sante par les fonctionnaires et aussi leurs superieurs hierarchiques ses limites sont imprecises et ses decisions vont permettre d'eviter des sanctions disciplinaires

Medical education for a primary care : teaching psychology to health students at Makerere University

Introduction: Psychology was introduced in the medical curriculum at Makerere University in 1989 in order to enable Ugandan health workers to be able to work with communities in the promotion of health and the prevention of ill health. Originally; a series of lectures were delivered on topics relevant to health care. Teaching was re-designed in 1992 for second year students; and this comprised of case-study; case write-up; and presentations. Objectives : To evaluate the method of teaching psychology at Makerere University Faculty of Medicine. Methods: a questionnaire comprising of two statements concerning (a) the choice of methods of teaching preferred by students (b) students' opinion on type of work they would choose in the future; was administered to first and second year medical; dental; and students. Results: Second year students preferred being taught using case study and presentations while first year students preferred lectures and handouts. In addition; 58.1of second year students believed that they would prefer to work as all round medical doctors while only 4.8 believed they would as psychiatrists. However; 44.1of first year students indicated that they would be general duty medical officers; and none indicated interest in psychiatry at this level of training. Conclusion: The findings have important implications for the training of general duty medical officers for the future provision of mental health care at primary care settings in Uganda

Assistance aux victimes de violences sexuelles dans les camps de refugies. Lecture ethnologique des recommendations des agences internationales de soutien psycho-social

"Une politique d'assistance definit dorenavant l'approche et les pratiques considerees comme legitimes en matiere de ""sante de la reproduction"" dont ses procedures concernent l'assistance psycho-sociale aux victimes de violences sexuelles. D'apres l'analyse de l'auteur; avant meme sa mise en pratique; elle semble vouloir appliquer des techiques therapeutiques contigentes a un contexte socioculturel souvent etranger a la victime refugiee. De plus; bien que voulant prendre en compte les ""conceptions traditionnelles"" dont les victimes refugiees seraient porteuses; elle nie l'aspect dynamique de la construction individuelle et collective du sens."