Post-stroke depression: Prevalence, associated factors and impact on quality of life among outpatients in a Nigerian hospital

Objectives: To investigate the prevalence of post-stroke depression (PSD), its associated factors and impact on quality of life (QoL) among outpatients in a Nigerian hospital. Methods: This cross-sectional study was carried out among 140 adults made up of 70 stroke survivors and matched controls with s table hypertension. Participants were administered questionnaires to profile their socio-demographic and clinical characteristics. Subsequently, they were assessed with the modified mini-mental state examination (MMSE), modified Rankin Scale (mRS), schedule for clinical assessment in neuropsychiatry (SCAN) and World Health Organization Quality of Life-BREF (WHOQoL-BREF). Results: The mean ages (± s.d.) of stroke survivors and controls were 57.43 (± 9.67) years and 57.33 (± 9.33) years, respectively. Majority of stroke survivors (n = 55 [78.6%]) had infarctive stroke, and 37 (52.9%) had right hemispheric lesion. Sixteen (22.9%) stroke survivors had PSD, with moderate to severe depression (F32.1) being the most prevalent, while none of the controls was clinically depressed. PSD correlated positively with monthly health bill above 10000 naira ($61), significant post-stroke disability and poorer scores on all QoL domains (p < 0.05). Conclusion: Depression was 20-fold prevalent in stroke survivors compared to controls with s table hypertension, and sevenfold the life-time prevalence reported among adult general population in Nigeria. Furthermore, increased health care bills per month, significant post-stroke disability and poorer QoL indicated survivors more likely to have depression. Findings in this study support the need to pay closer attention to psychosocial needs of stroke survivors to improve well-being. Future longitudinal study on psychosocial burden of stroke is warranted

Survey of Medical Officers Attitudes and Knowledge of Eye Conditions in Older Patients.

Aim: To assess medical officers’ attitude and knowledge of eye conditions in the elderly. Study Design: Convenient sampling technique. Place and Duration of Study: Department of Ophthalmology, Federal Medical Centre, Birnin Kebbi, Nigeria, November 2012. Methodology: Thirty four medical officers were shown 10 slides of common external eye conditions in the elderly and were asked to give the diagnosis of each slide and complete a selfadministered questionnaire during a hospital clinical presentation. The questionnaire and the answers to the 10 slides were collected immediately after the presentation. Results: All the medical officers agreed that eye examination is an important part of the general medical examination. However, only 16 (47.1%) routinely examined the eye of the elderly patient as part of the general medical examination. Fourteen medical officers (41.2%) were comfortably examining the eye of the elderly. Though 6 (17.6%) medical officers reported being sufficiently trained in the ocular examination but only 1 (2.9%) admitted being proficient in the ocular examination. The entire medical officers agreed that ageing is a risk factor for some ocular conditions, but only 18 (52.9%) ever inquired from the older patients if they had any specific eye conditions. Many of the medical officers wrongly diagnosed the presented slides. There were associations between duration of the medical practice and attitude with the medical officers of less years of practice not bothering about the eye examination in the elderly during the general medical examination (P<.05). Conclusion: Most studied medical officers were not routinely examining the eyes of the older patients and many were unable to diagnose common eye conditions in the elderly. Medical training should emphasize the ocular examination and diagnosis. The continuing eye medical education for medical officers can bridge the knowledge gaps in eye care and enhance early detection of the eye conditions.

Causes and Prevalence of Ocular Morbidity among Primary School Children in Ilorin; Nigeria

Objective: To determine the causes and prevalence of ocular morbidity among primary school children in Ilorin; Nigeria. Materials and Methods: A cross sectional survey of primary school children in 10 randomly selected primary schools within Ilorin; Nigeria was carried out between July 2005 and January 2006. Relevant ocular history and basic ocular examinations were carried out on the children that were selected from a multi-stage sampling process. Results: One thousand three hundred and ninety three pupils were surveyed. There were 689 (49.4) boys and 704 (50.6) girls. The age range was between 4 and 15 years. The mean and modal ages were 10.16 SD 2.5 and 10 respectively. Two hundred and seventy seven pupils had ocular pathology giving a prevalence of 19.9. The two most common ocular disorders found among the pupils were refractive errors and vernal conjunctivitis with prevalence of 6.9and 6.7respectively. Others included genetic / congenital / developmental ocular disorders 39 (2.8); glaucoma / glaucoma suspect 20 (1.4); ocular infections 18 (1.3); and ocular trauma 11 (0.8). More than three-quarters (86.7) of the causes of visual impairment and blindness among the pupils were avoidable (preventable or treatable). Conclusion: The sheer magnitude of avoidable causes of visual impairment and blindness in the study underscores the need for effective school eye-health programmes in developing countries