Africa: the traumatised continent, a continent with hope.

Many African countries gained political independence in the 1960s and 1970s and went through difficult times in economic, political and security terms in the 1980s and early 1990s. Mental health services and research were not spared and stagnated or deteriorated during this period. The effects of poor governance, inequitable distribution of resources and environmental degradation conspired with natural and man-made disasters (wars in particular) to drive Africa into an abyss of despair.

Alcoholism and diabetes mellitus: case report.

Two male patients with diabetes mellitus and alcohol dependence syndrome are presented. Both were married and in middle age. MI stayed alone in the city while his spouse and two children lived in the rural home. He showed no obvious underlying psychiatric morbidity. FWK was living with his family in the city. He was an alcoholic receiving psychiatric care for alcoholism. They both presented separately at different hospitals with decompensated diabetes following heavy alcohol consumption. The history and clinico-laboratory picture of both patients are presented and brief management programme and outcome are also given. Review of literature on alcoholism and its potential impact on the course and management of diabetes is presented.

Levels of calcium, aluminium and chromium in serum of exclusively breastfed infants at six months of age in Savannah region of Nigeria.

This study was undertaken to determine the levels of calcium, aluminium and chromium in the serum of apparently healthy exclusively breastfed infants at the sixth month of lactation. Forty-five infants (with a male:female ratio 2:1) were studied. They were of an average age six months and one week, weighed 6.8-10.0 kg. The mean calcium levels of 83.92 ug/ml (2.1 mmol/L) obtained is within the reference range (2.1-2.5 mmol/L) in this area. The mean level of chromium was 0.11 u/ml while that of aluminium is significantly (P < 0.001) higher than the toxic level reported by some workers, yet none of the subject was manifesting any obvious signs of toxicity. We can then infer from our data that the exclusively breastfed infants are able to extract enough calcium, aluminium and chromium from the maternal breastmilk.

Concentration of eight trace minerals in milk and sera of mother-infant pairs in northern Nigeria.

Breastmilk from 15 healthy lactating women (21-31 years of age) from the hot, semi-arid sahel of Africa were analysed for copper, iron, zinc, magnesium, manganese, sodium, potassium, and phosphorus. Relative to published data from other populations worldwide, the milk of the Jos women appeared to contain adequate levels of magnesium, manganese, sodium, potassium, phosphorus and iron, but relatively low concentrations of zinc (1.07 micrograms/ml) and copper (170 micrograms/l). The sera of the exclusively breastfed infants nursed by these mothers contained levels of all these minerals that are within the international reference range of values. No statistically significant correlation was observed between the level of a particular mineral in the mothers' milk and the sera of their nursing infants.

The fatty acid composition of human milk in northern Nigeria.

The authors previously reported that the milk of Yoruba women in southwestern Nigeria was deficient in alpha-linolenic acid and contained a high percentage (42%) of medium chain-length fatty acids (MCFA, C10-C14). In the present study, the authors used capillary gas-liquid chromatography to analyze the milk of Hausa women in the northern region of Nigeria. The milk of the Hausa women contained 27% MCFA, 10.6% linoleic acid, 0.41% alpha-linolenic acid, 0.52% arachidonic acid, and 0.32% docosahexaenoic acid. The proportion of alpha-linolenic acid in the serum phospholipids of a subset of exclusively breastfed infants (n = 15; mean age, 6.2 +/- 0.3 months) was below the limit of detection (< 0.03%). While the milk of women in northern Nigeria is adequate with regard to n-3 and n-6 fatty acids, to satisfy the requirements for alpha-linolenic acid, it may be necessary to supplement the infants of these women after the first 6 months of life.

Current breastfeeding knowledge, attitude, and practices of mothers in five rural communities in the Savannah region of Nigeria.

The knowledge, attitude, and practices regarding breastfeeding of 310 mothers in five rural communities in Toto Local Government in Nassarawa State, Nigeria were investigated using a questionnaire. One hundred and sixty-two (52.3 per cent) mothers were illiterate while 148 (47.7 per cent) had either primary or secondary school education. Apart from giving babies colostrum, which was seen more amongst mothers with higher levels of education (p < 0.001), other practices investigated such as exclusive breastfeeding, demand feeding, 'rooming-in', and time of first breastfeed were not influenced by the mother's level of education. Fifty-four per cent of mothers did not give their babies colostrum. All mothers attended the antenatal clinic but only 103 (33.3 per cent) received instructions from the health worker on breastfeeding and 46.8 per cent delivered at home. Only 28.6 per cent of babies were breastfed within 24 hours of birth. The mean time after birth for the first breastfeed was 47.7 hours. Although breastfeeding is widely practiced, none of the babies was exclusively breastfed, and prelacteal feeds ranging from water, formula, or herbal tea were given by all the mothers. The practice of discarding colostrum and replacing it with a wide range of prelacteal feeds and late initiation of breastfeeding has implications for health education programmes and neonatal feeding strategies.

Treatment compliance among psychiatric outpatients in Kenya.

One hundred psychiatric outpatients discharged from mental hospital in Kenya were studied to estimate the treatment compliance after 3 months. The relatives and patients were interviewed separately to assess treatment adherence; 55 percent of them had defaulted in their treatment. Various factors were responsible for failure of compliance which included amongst many: unavailability of drugs which appears to be a common factor in Third World countries. Suggestions for better compliance included easily available injectable depot preparations or simple generic psychotropic drugs.