Flooding in Nigeria, towards prioritizing mental health and psychosocial support.

In the past decade, Nigeria has been experiencing worsening flooding. Beyond the physical injuries caused, it can impact the mental health of affected individuals. While new mental health disorders can emerge, exacerbation of preexisting mental conditions are common in the aftermath of flooding. Therefore, it is critical to integrate mental health and psychosocial support as part of the emergency response available to affected populations on both short-term and long-term basis.

Improving work and employment opportunities for women with psychosocial disabilities: an action research protocol.

In Kenya, employment rates for persons with disabilities are very low and those with psychosocial disabilities have even more dismal rates of employment. This situation has negative impact on the individual's recovery, quality of life, mental and physical health. The systemic exclusion of persons with psychosocial disabilities in work and employment disproportionately affects women. The aim of this study is to test the feasibility of disability inclusion training to improve work and employment opportunities for women with psychosocial disabilities in Tana River County, Kenya. The study will adopt a mixed methods research design using action research approach. A sample of women with psychosocial disabilities will be trained using a researcher designed disability inclusion training manual, while employers and other stakeholders will be trained on inclusive employment. Trainings will be tailored to suit different employers and for different types of psychosocial disabilities. Interactive learning and linking sessions involving the two groups and process evaluations will be conducted at different time points to measure the impact of the intervention. Findings from this pilot study will inform future research on work and employability programs for rural women with psychosocial disabilities. The study protocol was approved by Maseno University Ethics Review Committee (MUERC/00851/20). Findings from this study will be disseminated through conference presentations and scientific publications in peer reviewed journals.

Psychosocial correlates of risky sexual behaviour amongst students in Niger Delta University, Bayelsa.

INTRODUCTION: globally young people constitute one quarter of the population. They are the most vibrant and productive sector, but they are also prone to more risky sexual behaviour (RSB) with attendant negative consequences. In the Niger Delta Region of Nigeria, persistent conflicts and socioeconomic difficulty predisposes young people to risky conducts including RSB. The aim of this study is to explore the psychosocial correlates of risky sexual behaviour amongst students in the Niger Delta University, Bayelsa. METHODS: we undertook a descriptive cross-sectional survey of students in the university. A multistage random sampling technique was used to recruit 400 students who completed a self-administered questionnaire. The data collected was analyzed using SPSS version 20.0. RESULTS: out of the 400 students, 64.3% (257) engaged in RSB and 46.8% (187) were currently engaging in RSB. Rates of self-reported depression, suicidal ideation and attempt were 62.3% (249), 18.0% (72) and 14.3% (54) respectively. Independent correlates of RSB include being older than 19 years (aOR. 2.82; 95% C.I. 1.44 -5.51), male gender (aOR. 1.70; 95% C.I. 1.08-2.66), having depression (aOR. 1.83; 95% C.I. 1.15-2.92), being diagnosed with a sexually transmitted disease (STD)/HIV (aOR. 2.08; 95% C.I. 1.12-3.86), and having been taught about condoms (aOR. 1.80; 95% C.I. 1.13-2.86). CONCLUSION: risky sexual behaviours have negative psychosocial and health implications. Regular and continuous health education targeted at young people is essential to reduce the social and health effects associated with RSB.

COVID-19: an opportunity for African governments to rethink social welfare benefits and protection.

The emergence of COVID-19 in December 2019 has highlighted several lessons about Public health emergencies. One important lesson is on the role of social welfare benefits and protection in the overall management of public health emergencies. The absence of a functional and digitalized social welfare system in Africa may render ineffective public health measures to mitigate the spread of COVID-19. The social determinant of disease illustrates the nexus between poverty and health outcomes. Therefore, COVID-19 is an opportunity for African governments to rethink their stance on social welfare benefits and protection; and adopt mechanisms that protect the most vulnerable.

COVID-19: an opportunity for African governments to rethink social welfare benefits and protection

The emergence of COVID-19 in December 2019 has highlighted several lessons about Public health emergencies. One important lesson is on the role of social welfare benefits and protection in the overall management of public health emergencies. The absence of a functional and digitalized social welfare system in Africa may render ineffective public health measures to mitigate the spread of COVID-19. The social determinant of disease illustrates the nexus between poverty and health outcomes. Therefore, COVID-19 is an opportunity for African governments to rethink their stance on social welfare benefits and protection; and adopt mechanisms that protect the most vulnerable

The HIV/AIDS pandemic will not end by the year 2030 in low and middle income countries.

The recent Lancet Commission-International AIDS Society report: Advancing Global health and strengthening the HIV response in the Era of the Sustainable Development Goals; clearly highlights the fact that the world is NOT on track in ending the AIDS pandemic by 2030. Emphasis on massive and early diagnosis and placement on Combined Anti- Retroviral Therapy (cART) remain key cornerstones in reaching these goals. Effective viral load informed care remains very promising in reducing drug resistance, and improving outcomes in infected persons. The authors argue that the current funding trends, management paradigms, research agendas, data collection and information system models, as well as the overall appreciation of the evolution of the pandemic in low and middle- income countries, lead to a logical conclusion that this pandemic will not end, especially in these countries by 2030. Major action areas are proposed for policy makers and researchers for appreciation and action.

Zika Virus infection and microcephaly: anxiety burden for women.

The re-emergence of Zika virus in Brazil and other contiguous countries is a source of anxiety for pregnant women on account of its association with microcephaly. Adverse pregnancy outcome has huge mental health implications. It is essential for health providers to incorporate psychosocial care as part of pre and postnatal care for women in all countries affected by the Zika virus infection.

Prevalence of rifampicin resistance by automated Genexpert rifampicin assay in patients with pulmonary tuberculosis in Yenagoa, Nigeria.

INTRODUCTION: The diagnosis of tuberculosis and its treatment is challenging in resource - limited settings. The growth and speed of multi drug - resistant tuberculosis (MDR-TB) in high burden countries like Nigeria is a growing concern. This study is aimed at determining the prevalence of rifampicin resistance in sputum specimens of patients with pulmonary tuberculosis in Yenagoa, Nigeria. METHODS: A descriptive survey of all consecutive sputum specimens of adults greater than 15 years of age that presented to the Tuberculosis Referral Hospital Laboratory were subjected to the automated Genexpert test between January and December 2016. RESULTS: All 446 specimens were tested using the Genexpert automated system. 102 (22.9%) of the sputum specimens were positive for Mycobacterium tuberculosis, with 15 (14.7%) showing rifampicin resistance. CONCLUSION: There was significantly high prevalence of MDR-TB much higher than the World Health Organisation (WHO) prediction of 3.2 -5.4% for Nigeria.Pan African Medical Journal - ISSN: 1937- 8688 (www.panafrican-med-journal.com)Published in partnership with the African Field Epidemiology Network (AFENET). (www.afenet.net)Pan African Medical Journal - ISSN: 1937- 8688 (www.panafrican-med-journal.com)Published in partnership with the African Field Epidemiology Network (AFENET). (www.afenet.net).

Predictors of unprotected sexual intercourse among HIV-infected patients receiving antiretroviral drugs in the Niger Delta Region of Nigeria.

This study aims to evaluate the predictor of unprotected sexual intercourse among HIV-infected adults receiving antiretroviral therapy (ART) in a tertiary facility in the Niger Delta Region of Nigeria. A cross sectional study was undertaken in a 200 bed tertiary hospital in Bayelsa state, south-south Nigeria. A standardized pre-tested interviewer administered questionnaire was used to collect demographic, clinical and sexual history from consecutive HIV-1 infected adults receiving ART for at least 6 months. Independent predictors of unprotected sexual intercourse (defined as irregular condom use or unprotected sex in previous 6months) were determined using an unconditional logistic regression model. Out of 241 patients studied, 71.8% were females, 48.5% were married, and 20.7% had a sexual partner that is HIV-1 infected. Sixty (24.9%) patients engaged in unprotected sex, 86 (35.7%) used condom consistently and 95 (39.4%) abstained. Female sex, being currently married, age18-35years, partner being HIV-positive and living with sexual partner were significant associated with risky sex. Female sex, age18-35years and being currently married were the only independent predictors of unprotected sex. HIV-infected adults receiving ART in resource limited settings are potential sources of secondary transmission of HIV. Condom use in the prevention of secondary transmission of HIV in study area should target females, young adults and married couples.

LIMITED ELEVATIONS IN ANTITUBERCULOSIS DRUG-INDUCED SERUM ALANINE AMINOTRANSFERASE (ALT) LEVELS IN A COHORT OF NIGERIANS ON TREATMENT FOR PULMONARY TUBERCULOSIS AND HIV INFECTION IN YENAGOA.

BACKGROUND: This study, undertaken in a major tertiary hospital in the Niger Delta region of Nigeria was designed to examine the incidence of elevation in serum alanine aminotransference (ALT) in our patients who were on treatment for HIV/AIDS with some of them on antituberculosis drugs. METHOD: Between January and December 2014, all admission records which include HIV status, Acid fast bacilli Status, Chest radiograph, CD4 cell count, degree of hepatotoxicity during antituberculosis drugs treatment according to WHO definition using clinical findings and ALT levels at baseline (ALTI) and at 4 weeks into treatment with antituberculosis drugs (ALT2) of all the patients on HAART with some on antituberculosis drugs were retrieved and retrospectively analyzed. RESULTS: Of the total of 707 patients on HAART, 80 were on both HAART and anti-tuberculosis treatment.There was a statistically significant correlation between ALT I levels in the PTB negative and PTB positive cohort at baseline χ2 10.725,d.f4,P = 0.030. After 4 weeks of antituberculosis treatment and HAART ALT2 level in expectedly, generally showed downward trend with no statistically significant correlation between PTB status and ALT2 (χ2 = 0.789, d.f2.P = 0.674) CONCLUSION: Anti-tuberculosis drug induced elevation in alanine amino transference is unexpectedly low in our patients on treatment for pulmonary tuberculosis and HIV infection. This is a key finding that requires further studies.

Bloody semen, severe hypertension and a worried man.

Haematospermia is often associated with severe uncontrolled hypertension. The bloody semen is often very worrisome for the patient and his sexual partner(s). In addition to anti-hypertensive, counselling and lifestyle modification are essential for management of the condition.

Complex partial seizure with severe depression and conduct disorder in a 15 year old female adolescent: a case report.

Complex partial seizure complicated by psychiatric comorbidities like depression and conduct disorder presents management challenges for both the physician and parents. The etiology of such psychiatric comorbidities may be related to the seizure or to several other unrelated risk factors. The psychiatric comorbidities and the seizure affects the child's activities of daily living and are often a source of worry to parents and school authorities A high index of suspicion and a multidisciplinary approach are essential in the management of the affected adolescents.

Prevalence pattern and determinants of disclosure of HIV status in an anti retroviral therapy clinic in the Niger delta region of Nigeria

Background: In order to advance the extent of self-disclosure of HIV sero-status in Nigeria, we evaluated the prevalence, pattern and determinants of disclosure of HIV status amongst adult patients in a hospital in the Niger Delta. Materials and Methods: In a three month cross sectional study undertaken in March 2012, the demographic and clinical data as well as HIV sero-status disclosure frequency and pattern were obtained using a pre-tested questionnaire from consenting HIV infected adults attending the Anti-Retroviral Therapy Clinic in the Niger Delta. Independent determinants of HIV disclosure to current sexual partner were determined using an unconditional logistic model. P<0.05 was considered statistically significant. Results: A total of 260 patients were studied out of which 184(71%) were females. Disclosure to current sexual partner was found to be 62.0% and students had the least disclosure rate. Majority of study participants preferred to disclose to family members (57%) than past sexual partner (2.5%) or friend (4.9%). Although HIV disclosure was significantly associated with male sex, living with sexual partner, partner being HIV positive; the only independent determinants of HIV disclosure were partner being on ART (OR-12.7,95% CI 1.2-132.7)and being currently married (OR-8.8,95% CI 2.1-36.8). Conclusion: The results of our study suggest low rate of HIV status disclosure among HIV infected patients in the Niger Delta. We found that receiving ART and being currently married promoted disclosure. There is need for clinicians and policy makers to foster disclosure of HIV sero-status in Nigeria especially among HIV infected students and unmarried sexual partners