Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) among Rural Primary School Children in Southeastern Nigeria: Comparison of School and Home Settings

Background: Diagnosis of ADHD depends on manifestation of symptoms in at least two different settings. This therefore emphasizes the importance of multiple informants; parents and teachers. However perception could differ because of differences and inconsistencies across different settings. This is particularly important in rural settings in Africa where the educational attainment and outlook of teachers are very different from those of the parents. The study is aimed at comparing the presentations of children with ADHD in the rural area; across two different settings: home and school. Methods: The teachers of 181 rural primary school children in Ogberuru in Imo state; south eastern; Nigeria completed the school version of ADHD rating scale-IV; and their parents completed a Socio demographic questionnaire and the home versions of the ADHD rating scale IV. Results: Of the 18 symptoms of the condition; there were significant differences in the rate of identification in eight symptoms. These symptoms include 'being easily distracted' (p=0.0427); 'difficulty following through on instruction' (p=0.0026); 'fails to give close attention to details (p=0.0001); 'avoids tasks necessary for tasks' (p=0.0013); 'difficulty playing quietly (p=0.0059 ) ; 'talks excessively' (p=0.0023); 'intrudes on others' (p=0.0004); and 'seems not to listen when spoken to directly' (p=0.0002). They were all consistently more manifest in school settings than in their homes. Conclusion: Teachers identified ADHD symptoms more commonly than parents. They could therefore play critical roles in programs aimed at improving early identification and management of children with ADHD especially in rural Africa where healthcare facilities are scarce

Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) among Rural Primary School Children in Southeastern Nigeria: Comparison of School and Home Settings

Background: Diagnosis of ADHD depends on manifestation of symptoms in at least two different settings. This therefore emphasizes the importance of multiple informants; parents and teachers. However perception could differ because of differences and inconsistencies across different settings. This is particularly important in rural settings in Africa where the educational attainment and outlook of teachers are very different from those of the parents. The study is aimed at comparing the presentations of children with ADHD in the rural area; across two different settings: home and school.Methods: The teachers of 181 rural primary school children in Ogberuru in Imo state; south eastern; Nigeria completed the school version of ADHD rating scale-IV; and their parents completed a Socio demographic questionnaire and the home versions of the ADHD rating scale IV. Results: Of the 18 symptoms of the condition; there were significant differences in the rate of identification in eight symptoms. These symptoms include 'being easily distracted' (p=0.0427); 'difficulty following through on instruction' (p=0.0026); 'fails to give close attention to details (p=0.0001); 'avoids tasks necessary for tasks' (p=0.0013); 'difficulty playing quietly (p=0.0059 ) ; 'talks excessively' (p=0.0023); 'intrudes on others' (p=0.0004); and 'seems not to listen when spoken to directly' (p=0.0002). They were all consistently more manifest in school settings than in their homes. Conclusion: Teachers identified ADHD symptoms more commonly than parents. They could therefore play critical roles in programs aimed at improving early identification and management of children with ADHD especially in rural Africa where healthcare facilities are scarce

Recognition of Autism Spectrum Disorder (ASD) symptoms and knowledge about some other aspects of ASD among final year medical students in Nigeria, Sub-Saharan Africa.

BACKGROUND: Earlier studies suggest that knowledge about Autism Spectrum Disorder (ASD) among healthcare workers in Nigeria is low. This present study assessed the knowledge of Nigerian final year medical students about symptoms of ASD and some other aspects of ASD. This is a cross sectional descriptive study that drew a total of seven hundred and fifty-seven (757) final year medical students from ten (10) randomly selected fully accredited medical schools out of a total of twenty-seven (27) fully accredited medical schools in Nigeria. Sociodemographic and Knowledge about Childhood Autism among Health Workers (KCAHW) questionnaires were used to assess knowledge of final year medical students about ASD and obtain demographic information. RESULTS: Only few, 218 (28.8 %) of the 757 final year medical students had seen and participated in evaluation and management of at least a child with ASD during their clinical postings in pediatrics and psychiatry. Knowledge and recognition of symptoms of ASD is observed to be better among this group of final year medical students as shown by higher mean scores in the four domains of KCAHW questionnaire. Knowledge about ASD varies across gender and regions. Misconceptions about ASD were also observed among the final year medical students. CONCLUSIONS: More focus needs to be given to ASD in the curriculum of Nigerian undergraduate medical students, especially during their psychiatry and pediatric clinical postings.

Psychiatric Morbidity among Subjects with Leprosy and Albinism in South East Nigeria: A Comparative Study.

BACKGROUND: Skin, which is the largest organ in the body, carries immense psychological significance. Disfiguring skin disorders may impact negatively on the mental health of individuals. AIM: This study compared the psychiatric morbidity of subjects with leprosy and albinism. SUBJECTS AND METHODS: One hundred subjects with leprosy and 100 with albinism were interviewed. Sociodemographic questionnaire and General Health Questionnaire (GHQ-28) assessed the sociodemographic characteristics and psychiatric morbidity, respectively. GHQ positive cases and 10% of noncases for each group were interviewed with Mini International Neuropsychiatric Inventory for specific ICD-10 diagnoses. RESULTS: Fifty-five percent (55/100) subjects with leprosy were GHQ positive cases while 41% (41/100) with albinism were GHQ positive cases. The risk of developing psychiatric morbidity was significantly higher in subjects with leprosy than in subjects with albinism (OR = 1.76, CI = 1.00 - 3.08, P = 0.04). The prevalence of specific psychiatric disorders among subjects with leprosy were depression 49% (49/100), generalized anxiety disorder (GAD) 18% (18/100), alcohol/drug abuse 16% (16/100), whereas in albinism depression was 51% (51/100), GAD 27% (27/100), and alcohol/drug abuse 7% (7/100). Male, married and uneducated subjects with leprosy had significantly higher psychiatric morbidity than the male, married and uneducated subjects with albinism, respectively. CONCLUSION: Psychiatric morbidity was higher in subjects with leprosy than in subjects with albinism. Male, married and uneducated subjects with leprosy significantly had higher morbidity than male, married and uneducated subjects with albinism respectively.

Factors associated with depression and suicide among patients with diabetes mellitus and essential hypertension in a Nigerian teaching hospital.

BACKGROUND: Diabetes mellitus (DM) and essential hypertension are chronic medical conditions that place a lot of burden on patients. The presence of depression and suicidal behaviour may worsen the prognosis. OBJECTIVE: To assess the prevalence of depression and suicidal behaviour in subjects with diabetes mellitus and essential hypertension and also determine the socio-demographic correlates. METHODS: Major depressive episode and suicidality modules of Mini-International Neuropsychiatric Interview were used to assess depression and suicidal behaviour respectively. RESULTS: The prevalence of depression for the subjects with DM was 27.8% and 26.7% for essential hypertension. The subjects with DM had prevalence of 6.3% for suicidal behaviour while essential hypertension had 7.8%. Depression was higher in subjects with DM if they were not married or had no education while the subjects with essential hypertension were more likely to have depression if they were not married, had no education or not employed. Suicidal behaviour was higher in subjects with DM if they had no education while in essential hypertension suicidal behaviour was higher in females, those not married and those not educated. CONCLUSION: Depression and suicidal behaviour occur with DM and essential hypertension.