Togolese lay people's and health professionals' views about the acceptability of physician-assisted suicide.

AIM: To study the views on the acceptability of physician-assisted-suicide (PAS) of lay people and health professionals in an African country, Togo. METHOD: In February-June 2012, 312 lay people and 198 health professionals (75 physicians, 60 nurses and 63 health counsellors) in Togo judged the acceptability of PAS in 36 concrete scenarios composed of all combinations of four factors: (a) the patient's age, (b) the level of incurability of the illness, (c) the type of suffering and (d) the patient's request for PAS. In all scenarios, the patients were women receiving the best possible care. The ratings were subjected to cluster analysis and analyses of variance. RESULTS: Most lay people (59%) were not systematically opposed to PAS, whereas most health professionals (80%) were systematically opposed to it. The most important factors in increasing acceptability among people not systematically opposed were advanced age of the patient and incurability of the illness. Additional acceptability was provided by the patient's request to have her life ended, although much less so than in studies in Western countries, and by suffering characterised by complete dependence rather than by extreme physical pain. CONCLUSIONS: These empirical findings--the first ones gathered in the African continent--suggest that most Togolese lay people are not categorically for or against PAS, but judge its degree of acceptability as a function of concrete circumstances.

Childhood trauma, personality disorders symptoms and current major depressive disorder in Togo.

PURPOSE: Childhood trauma (CT) has been found to be associated with major depressive disorder (MDD) and personality disorders (PD) in adulthood in Western countries, but little is known about the relationship between CT, PD and MDD in sub-Saharan Africa. The present study aims to examine: (1) the frequency of the CT, (2) the association between CT, PD symptoms and MDD and (3) the mediating role of PD between CT and MDD in Togo. METHODS: One hundred and eighty-one participants (91 individuals with current MDD and 90 healthy controls without psychiatric history) completed the 28-item CT Questionnaire (CTQ) and the Personality Diagnostic Questionnaire (PDQ-4+). RESULTS: Participants in the MDD group reported more frequently emotional, sexual and physical abuse and emotional and physical neglect than controls (p < 0.001). There was a significant positive correlation between the total abuse and the PDQ-4 + score (r = 0.48, p < 0.01) in the total sample. Emotional and sexual abuses were associated with current MDD and the number of PD criteria endorsed. Furthermore, PD symptoms mediated partially the relationship between CT and current MDD. CONCLUSIONS: Our results suggest an association between CT and current MDD in French-speaking sub-Saharan Africa, and that this relationship may be explained by PD symptoms. Prospective studies to confirm these results are warranted.

Why most Togolese people do not seek care for malaria in health care facilities: a theory-driven inventory of reasons.

Using a broad theory of human motivation, the study examined the psychological structure of the reasons evoked by Togolese people for not attending medical facilities when they think they have malaria. Five hundred and thirty-two persons living in Lome, Togo were presented with a questionnaire of motives. Through exploratory and confirmatory factor analyses, a seven-factor structure of motives was found. Participants explained their reluctance to attend medical facilities by the facts that (a) malaria is not a serious illness that deserves much investment, (b) caregivers behave in an aggressive way and try to extort extra money, (c) malaria has always been self-treated at home, and (d) attending the health care facilities is too alarming for the family. The reasons for not attending were not related to the participants' mistrust in biomedicine, their willingness to keep control over things nor a personal feeling of unease.